This project is designed to improve the lives of women with psychosis and their children, an ?ignored? population, despite the stress and adversity experienced by these women during the perinatal period, and the documented biological and psychosocial risks on their children for a wide range of behavioral and cognitive problems. What is promising are the ways to potentially identify the early signs for these impairments by studying mothers and offspring as early as pregnancy. This K-award application aims to prepare Dr. Cindy Liu to become an independent clinical researcher and to develop expertise in many of the issues that face women with psychosis and their families; specifically, expertise in the consequences of maternal stress experiences and the ability to ultimately develop interventions that ameliorate stress and its derailing consequences for children. To accomplish this, the proposed research strategy bridges two highly relevant areas within the field: familiar high-risk (HR) research in psychosis and biologically based early stress models from developmental science through complementary two studies. Through Study 1, a secondary data analysis of a large longitudinal birth cohort dataset, early biological and environmental risks and early behavioral impairments from birth to age 7 years will be identified in offspring of parents with psychosis (n=208) and in matched controls (n=132). In Study 2, Dr. Liu will identify behavioral and physiological markers of adverse outcomes in a new sample of children and their mothers with psychosis (n=25), and matched comparison groups, mothers with non-psychotic mood disorders (n=25), and control mothers without psychiatric disorders (n=25) through primary data collection, by assessing behavioral and physiological responses in mothers and children from pregnancy until 4 months postpartum. These two studies provide the opportunity to investigate prenatal stress across different time frames and to utilize developmentally appropriate biological and behavioral measures of stress with this population. Doing so may answer questions about the mechanisms leading to developmental impairments in these high-risk children and will prepare Dr. Liu to develop a R01 proposal that informs how perinatal stress experiences affect socio-emotional development in high-risk children at 4 years of age. In summary, the training plan to be implemented will support Dr. Liu's transition to independence. The two studies will provide a range of unique macro to micro skill development that targets the role of stress on behavioral and physiological reactivity in high-risk children at specific developmental time points. Moreover, the project focus of assessing longitudinal trajectories for risk through a biological and behavioral model of early stress advances the NIMH priority for developmental translational research. It is poised to make a meaningful contribution toward understanding the development of psychiatric conditions and to inform targeted prevention and treatment interventions for families affected by psychosis.

Public Health Relevance

Psychotic disorders, such as schizophrenia, begin typically in late adolescence and early adulthood, however, their roots can be traced to genetics and to early environmental risk factors that affect pregnancy and early development. For safe, early, and preventative interventions to be ultimately developed, knowledge about this earliest phase of life must be refined for those at risk for psychosis. Through two studies, this proposal will identify how stress experienced by mothers and offspring from pregnancy might be associated with problems across early development, in one study through 4 months of age, and in the other, through 7 years. Identifying impairments within childhood can facilitate the development of interventions to reduce these risks among ?high- risk? offspring, a long-run goal of the principal investigator.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Mentored Patient-Oriented Research Career Development Award (K23)
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Psychosocial Development, Risk and Prevention Study Section (PDRP)
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Sarampote, Christopher S
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Brigham and Women's Hospital
United States
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Liu, Cindy H; Phan, Jenny; Yasui, Miwa et al. (2018) Prenatal Life Events, Maternal Employment, and Postpartum Depression across a Diverse Population in New York City. Community Ment Health J 54:410-419
Liu, Cindy H; Liu, Heidi (2016) Concerns and Structural Barriers Associated with WIC Participation among WIC-Eligible Women. Public Health Nurs 33:395-402
Giallo, Rebecca; Cooklin, Amanda; Brown, Stephanie et al. (2015) Trajectories of fathers' psychological distress across the early parenting period: Implications for parenting. J Fam Psychol 29:766-76