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Principal Investigator: Elisabeth Bernhardt
Organization: UNIV OF NORTH CAROLINA CHAPEL HILL
Fiscal Year: 2024
Award: $12,655
Funding agency: National Institute of Nursing Research
PROJECT SUMMARY
Both high incidence (i.e., 15%) and low remission rate (i.e., 30-50%) of postpartum distress symptoms indicate
a need for more research on the underlying mechanisms associated with elevated maternal distress and
caregiving deficits. Severe symptoms of maternal distress will continue to inflict significant morbidity and elicit
poor child health outcomes unless we initiate a system-wide change in how nurses and other healthcare
professionals understand and recognize indicators of maternal distress. Prior research has determined that
mothers with elevated distress symptoms (e.g., irritability and anhedonia) display suppressed neurological
reward responsivity. However, few studies have examined the role of reward responsivity to loss and
caregiving behaviors. Even fewer studies have asked women to describe their experience with goal pursuit
during the postpartum period and perceived functional ability as a mother. To address this research gap, the
proposed study will apply the Regulatory Focus Theory to link both aberrant reward responses and disruptive
caregiving behaviors to specific distress symptom sets assessed with the Inventory of Depression and Anxiety
Symptoms (IDAS) self-report measure. Aim 1 will use a retrospective, secondary analysis to correlate fMRI
imaging data with IDAS scores to determine distinct symptom sets that are associated with suppressed reward
responsivity. Aim 2 will use prospective, mixed-methods analyses to correlate maternal caregiving behaviors
with IDAS scores and qualitative interviews from a subset of 12 mothers. Exploratory Aim 3 will interpretively
synthesize findings from Aims 1 and 2 to propose an initial risk phenotype for maternal distress. This initial step
toward developing a risk phenotype will guide future research to improve early detection of women most
vulnerable to developing debilitating symptoms of distress during the postpartum period. The proposed study
and associated research training provide a comprehensive foundation for an innovative program of nursing
research focused on the bidirectional nature of the caregiver-child relationship as it relates to Regulatory Focus
Theory, specifically whether enhancing maternal self-regulation can prevent child development disorders.
Terms: <0-11 years old><Activities of Daily Living><Activities of everyday life><Address><Anhedonia><Behavior><Behavioral><Brain><Brain Nervous System><Care Givers><Caregivers><Child><Child Development Disorders><Child Health><Child Rearing><Child Youth><Childbirth><Children (0-21)><Clinical assessments><Code><Coding System><Cognitive><Corpus Luteum Hormone><Data><Delta4-pregnene-3,20-dione><Developmental Disabilities><Disease remission><Distress><Dysfunction><Early Diagnosis><Emotional><Emotional Depression><Encephalon><Endocrine Gland Secretion><Equipment and supply inventories><Estrogens><Foundations><Functional MRI><Functional Magnetic Resonance Imaging><Functional disorder><Future><Goals><Health Care Professional><Health Professional><Healthcare professional><Hormonal><Hormones><Image><Impairment><Incidence><Infant><Infant Development><Informal Social Control><Interview><Inventory><Left><Link><Managed Care><Measures><Methods><Modeling><Moods><Morbidity><Morbidity - disease rate><Mother-Child Relations><Mother-Child Relationship><Mothers><Nature><Nerve Cells><Nerve Unit><Neural Cell><Neural Pathways><Neurocyte><Neurologic><Neurological><Neurons><Nurses><Nursing Research><Outcome><Parenting><Parenting behavior><Participant><Pathway interactions><Patient Self-Report><Pattern><Phase><Phenotype><Physiopathology><Play><Postpartum Period><Prefrontal Cortex><Pregn-4-ene-3,20-dione><Pregnant Women><Pregnenedione><Preventative strategy><Prevention><Prevention strategy><Preventive strategy><Process><Progesterone><Remission><Research><Research Training><Rewards><Risk><Role><Self Management><Self Regulation><Self-Report><Severities><Sleep><Symptoms><System><Therapeutic Estrogen><Therapeutic Hormone><Therapeutic Progesterone><Time><Variant><Variation><Ventral Striatum><Withdrawal><Woman><Work><anxiety symptoms><anxious symptom><associated symptom><care giving><caregiving><child birth><childrearing><co-morbid symptom><co-occuring symptom><comorbid symptom><concurrent symptom><cooccuring symptom><daily functioning><daily living function><daily living functionality><debilitating symptom><depression symptom><depressive><depressive symptoms><develop therapy><digital><early detection><effective therapy><effective treatment><expectant mother><expecting mother><experience><fMRI><financial incentive><financial reward><functional ability><functional capacity><imaging><improved><innovate><innovation><innovative><intervention development><kids><manage symptom><maternal care giving><maternal caregiving><monetary incentive><mother child interaction><motherhood><neural><neural correlate><neural stimulation><neuronal><new approaches><novel approaches><novel strategies><novel strategy><nurse><pathophysiology><pathway><post-partum><post-partum care><postpartum care><pregnant mothers><prevent><preventing><programs><prospective><response><secondary analysis><social role><stressor><symptom association><symptom comorbidity><symptom management><symptom science><theories><therapy development><treatment development><youngster>