Perinatal depression is a major public health problem, affecting 15 % of women during pregnancy through the postpartum period, with adverse consequences for the mother, the fetus, the infant, and the family. Despite increasing evidence of the importance of this critical risk interval, there is a paucity of research investigating the effects of depression treatment initiated during pregnancy on infant outcomes. Recent findings suggest the need for robust, integrated peripartum depression treatments that target maternal depressive symptoms, parenting skills, and the mother-infant relationship. The purpose of this mentored Patient-Oriented Career Development Award (K23) is to enable the candidate to develop a program of research that integrates psychotherapy treatment research with infant emotion development research to develop a treatment strategy for perinatal depression that maximizes outcomes in both mothers and infants. The candidate's long term goal is to become an independent clinical interventions researcher able to design, evaluate, and implement effective perinatal depression treatments. To achieve this goal, instruction and mentoring are proposed in three main areas: 1) women's health during the perinatal period, 2) infant emotional development and mental health risk, and 3) advanced statistical methods with longitudinal and observational data. The research plan for this award will be implemented with the support of the training plan and an interdisciplinary team of expert mentors and consultants. The first phase of this research plan consists of building upon an established brief form of Interpersonal Psychotherapy (Enhanced IPT-B) for perinatal depression and modifying it to specifically address the mother-infant relationship and infant emotional development during the postpartum period. A treatment manual for IPT for the Mother-Infant Dyad (IPT-Dyad) will be developed and iteratively modified based upon the protocol's feasibility and acceptability in a small open treatment trial. The second phase of the research plan consists of a small, randomized controlled trial comparing treatment as usual (n=20) to IPT-Dyad (n=20) in a sample of depressed, pregnant women from two diverse ObGyn clinic settings. Maternal depressive symptoms, psychosocial functioning, parenting self-efficacy will be assessed as well mother-infant relationship quality and infant emotional development. Data from these research activities will support the development of an R01 application for conducting a large controlled efficacy trial of IPT-Dyad and investigating mediators and moderators of treatment outcomes. The training and research activities will complement the candidate's strong background in clinical psychology and clinical research with IPT and place her in a unique position to advance our knowledge and ability to treat perinatal depression, intergenerational transmission and reduce the burden of this major public health problem for women and infants.
This project will yield new understanding of how to treat perinatal depression and minimize social and emotional risk to the infant. This project is directly responsive to the NIMH Strategic Plan objectives two (to chart the course of mental disorders over the lifespan to understand ideal times and methods for intervention), three (to develop new and better interventions that incorporate the diverse needs of people), and four (to strengthen the public health impact).
|Rogers, Cynthia E; Lenze, Shannon N; Luby, Joan L (2013) Late preterm birth, maternal depression, and risk of preschool psychiatric disorders. J Am Acad Child Adolesc Psychiatry 52:309-18|
|Luby, Joan; Lenze, Shannon; Tillman, Rebecca (2012) A novel early intervention for preschool depression: findings from a pilot randomized controlled trial. J Child Psychol Psychiatry 53:313-22|
|Lenze, Shannon N; Pautsch, Jennifer; Luby, Joan (2011) Parent-child interaction therapy emotion development: a novel treatment for depression in preschool children. Depress Anxiety 28:153-9|