Exposure to maternal depressive symptoms is one of the most well established risk factors for the development of later child psychopathology. Accumulating evidence from naturalistic observational studies documents that fetal exposure to maternal depressive symptoms is associated with risk for later child mental health problems. Maternal depression is one of the most common prenatal complications with approximately 40% of women experiencing elevated levels of depressive symptoms. The majority of past research has been correlational, so potential causal conclusions have been limited. This project will break new ground by testing the hypothesis that manipulating maternal depressive symptoms will benefit infant outcomes. In this project, maternal depressive symptoms will be reduced using brief interpersonal therapy (IPT), a well-established and efficacious treatment, and testing whether this reduction leads to an improvement in the development of infant mechanisms associated with risk for later psychopathology. Consistent with NIMH's priority of Research Domain Criteria (RDoC)-based processes, we will assess infants with multiple measures that assess the constructs of potential threat (?anxiety?) from the Negative Valence System and cognitive (effortful) control from the Cognitive System. We propose to assess 300 pregnant women who report elevated levels of depressive symptoms and their infants. Prior to the intervention, maternal measures will be collected. Then half of the women will be randomized to receive IPT and the other half will receive enhanced usual care. After completion of the intervention, maternal measures will be collected longitudinally through 14 months postpartum. Infants will be evaluated at birth and at 7- and 14-months corrected age. Infants will be assessed across four units of analysis (brain structure and function, physiology, behavior, and maternal-report).

Public Health Relevance

Mood and anxiety disorders are a significant public health concern, as over 25% of Americans will experience a disorder in their lifetimes, and anxiety and depression are associated with substantial impairments in social, occupational, and educational functioning. Maternal history of depression is a well-established and profound risk factor for later child development of anxiety and depression, and new evidence suggests that prenatal maternal depressive symptoms have a larger consequence for child outcomes as compared to postpartum depressive symptoms. This project would have clear relevance and impact to affect this significant mental health problem by determining whether reducing prenatal maternal depressive symptoms affects the development of infant mechanisms that contribute to risk for psychopathology later in life; this knowledge would provide clear translational impact on when, where, and how to intervene, as well as identify infant risk mechanisms that could become the targets for later intervention development among at-risk offspring.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH109662-01A1
Application #
9236903
Study Section
Biobehavioral Mechanisms of Emotion, Stress and Health Study Section (MESH)
Program Officer
Garvey, Marjorie A
Project Start
2017-04-07
Project End
2022-03-31
Budget Start
2017-04-07
Budget End
2018-03-31
Support Year
1
Fiscal Year
2017
Total Cost
$765,204
Indirect Cost
$223,883
Name
University of Denver
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
007431760
City
Denver
State
CO
Country
United States
Zip Code
80210