Elucidating Mechanisms of Pregnancy's Protective Effect on Drug Abuse Using Integrated Data Analysis

项目总结/摘要 怀孕对妇女吸烟和其他毒品使用的显着保护作用是一种普遍的， 一种未被充分研究的现象，其中成瘾过程在缺乏药物的情况下暂时减弱。 治疗确定潜在的机制将提供新的见解成瘾过程如何可以 更有效地瓦解。 为了加快实现这一目标的进展，克服先前研究的方法学限制，我们 重新利用具有独特功能的多个现有数据集来实现我们的目标。具体而言，我们将： 1.利用人内设计来估计怀孕的独特“效应”，以及 怀孕，在一个单一的怀孕吸烟行为。 2.通过以下方式分离和估计一般和父母相关的发展影响对吸烟的影响： 检查在两次怀孕中评估的妇女子集的怀孕之间的差异。 3.检查产前反思功能的作用，从现有的黄金标准定性访谈编码， 怀孕对吸烟的保护作用。 目标1和2将提供有史以来第一次准确估计怀孕何时以及如何与吸烟相互作用 行为，为未来的工作奠定基础，以指定新的干预目标。因为反射功能是 已知是可塑性的物质使用孕妇，了解其在妊娠相关的作用， 吸烟的改变将为新的戒烟干预措施提供基础。 这一创新的建议融合了Massey博士（MPI）日常临床工作中产生的假设， 成瘾精神科医生与尖端的定量和方法学的专业知识， 严格检验流行病学家艾伦博士（MPI）提出的这些假设。拟纳入的队列包括 短期（妊娠内）和长期（多胎妊娠）纵向数据，最新技术水平 药物暴露的措施，以及定性和定量的孕产妇数据提供了一个经验丰富的 一个成熟的发展科学家团队：Neiderhiser（Co-I），Eiden（Co-I）和Wakschlag（Co-I）博士。 由于数据最初是在NIDA的支持下开发的，用于检查药物暴露的儿童， 特别适合于单独和联合检查药物。需要从这项研究中获得知识， 个性化的产前干预措施，并指导未来的调查， 结果。阐明怀孕对药物使用的保护作用的潜在机制也提供了一个信息， 更广泛地理解社会过程如何成功地与成瘾过程竞争。

PROJECT SUMMARY/ABSTRACT The notable protective effect of pregnancy on women’s tobacco and other drug use is a common yet understudied phenomenon in which addictive processes are temporarily attenuated in the absence of treatment. Identifying underlying mechanisms would provide novel insights into how addictive processes could be more effectively disrupted. To accelerate progress towards this goal and overcome methodologic limitations of prior studies, we repurpose multiple existing datasets with unique features to accomplish our aims. Specifically, we will: 1. Utilize a within-person design to estimate the unique “effect” of pregnancy, and salient events of pregnancy, on smoking behavior within a single pregnancy. 2. Isolate and estimate the impact of general and parenting-related developmental influences on smoking by examining between-pregnancy differences in a subset of women who were assessed on two pregnancies. 3. Examine the role of prenatal reflective functioning, coded from existing gold-standard qualitative interviews, in pregnancy’s protective effect on smoking. Aims 1 & 2 will provide the first ever estimates of precisely when and how pregnancy interacts with smoking behavior, setting the stage for future work to specify novel intervention targets. As reflective functioning is known to be malleable in substance using pregnant women, understanding its role in pregnancy-associated change in smoking will provides the foundation for novel smoking cessation interventions. This innovative proposal blends hypotheses generated from Dr. Massey’s (MPI) day-to-day clinical work as an addiction psychiatrist with the cutting-edge quantitative and methodological expertise necessary to rigorously test these hypotheses provided by epidemiologist Dr. Allen (MPI). Cohorts to be integrated contain short-term (within pregnancy) and long-term (across multiple pregnancies) longitudinal data, state-of-the-art drug exposure measures, and both qualitative and quantitative maternal data contributed by an experienced team of established developmental scientists: Drs. Neiderhiser (Co-I), Eiden (Co-I), and Wakschlag (Co-I). As data were originally developed with NIDA’s support to examine drug-exposed children, they are uniquely suited to examine drugs alone, and in combination. Knowledge from this study is needed to improve and personalize prenatal interventions and to guide future investigations of exposure-related offspring outcomes. Elucidating mechanisms underlying pregnancy’s protective effect on drug use also informs a broader understanding of how social processes successfully compete with addictive processes.