An Integrated Mechanistic Model of Mindfulness-Oriented Recovery Enhancement for Opioid-Exposed Mother–Infant Dyads

A growing body of neurobiological and psychological research sheds light on the mechanisms underlying the development and maintenance of opioid use disorder and its relation to parenting behavior. Perinatal opioid use is associated with risks for women and children, including increased risk of child maltreatment. Drawing from extant data, here we provide an integrated mechanistic model of perinatal opioid use, parenting behavior, infant attachment, and child well-being to inform the development and adaptation of behavioral interventions for opioid-exposed mother–infant dyads. The model posits that recurrent perinatal opioid use may lead to increased stress sensitivity and reward dysregulation for some mothers, resulting in decreased perceived salience of infant cues, disengaged parenting behavior, disrupted infant attachment, and decreased child well-being. We conclude with a discussion of Mindfulness-Oriented Recovery Enhancement as a means of addressing mechanisms undergirding perinatal opioid use, parenting, and attachment, presenting evidence on the efficacy and therapeutic mechanisms of mindfulness. As perinatal opioid use increases in the United States, empirically informed models can be used to guide treatment development research and address this growing concern

Prenatal Predictors of Infant Self-Regulation: The Contributions of Placental DNA Methylation of NR3C1 and Neuroendocrine Activity

We examined whether placental DNA methylation of the glucocorticoid receptor gene, NR3C1 was associated with self-regulation and neuroendocrine responses to a social stressor in infancy. Placenta samples were obtained at birth and mothers and their infants (n = 128) participated in the still-face paradigm when infants were 5 months old. Infant self-regulation following the still-face episode was coded and pre-stress cortisol and cortisol reactivity was assessed in response to the still-face paradigm. A factor analysis of NR3C1 CpG sites revealed two factors: one for CpG sites 1-4 and the other for sites 5-13. DNA methylation of the factor comprising NR3C1 CpG sites 5-13 was related to greater cortisol reactivity and infant self-regulation, but cortisol reactivity was not associated with infant self-regulation. The results reveal that prenatal epigenetic processes may explain part of the development of infant self-regulation

Development and Psychometric Validation of the Pandemic-Related Traumatic Stress Scale for Children and Adults

To assess the public health impact of the COVID-19 pandemic on mental health, investigators from the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) research program developed the Pandemic-Related Traumatic Stress Scale (PTSS). Based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) acute stress disorder symptom criteria, the PTSS is designed for adolescent (13–21 years) and adult self-report and caregiver-report on 3–12-year-olds. To evaluate psychometric properties, we used PTSS data collected between April 2020 and August 2021 from non-pregnant adult caregivers (n = 11,483), pregnant/postpartum individuals (n = 1,656), adolescents (n = 1,795), and caregivers reporting on 3–12-year-olds (n = 2,896). We used Mokken scale analysis to examine unidimensionality and reliability, Pearson correlations to evaluate relationships with other relevant variables, and analyses of variance to identify regional, age, and sex differences. Mokken analysis resulted in a moderately strong, unidimensional scale that retained nine of the original 10 items. We detected small to moderate positive associations with depression, anxiety, and general stress, and negative associations with life satisfaction. Adult caregivers had the highest PTSS scores, followed by adolescents, pregnant/postpartum individuals, and children. Caregivers of younger children, females, and older youth had higher PTSS scores compared to caregivers of older children, males, and younger youth, respectively

Behavioral Coping Phenotypes and Associated Psychosocial Outcomes of Pregnant and Postpartum Women During the COVID-19 Pandemic

The impact of COVID-19-related stress on perinatal women is of heightened public health concern given the established intergenerational impact of maternal stress-exposure on infants and fetuses. There is urgent need to characterize the coping styles associated with adverse psychosocial outcomes in perinatal women during the COVID-19 pandemic to help mitigate the potential for lasting sequelae on both mothers and infants. This study uses a data-driven approach to identify the patterns of behavioral coping strategies that associate with maternal psychosocial distress during the COVID-19 pandemic in a large multicenter sample of pregnant women (N = 2876) and postpartum women (N = 1536). Data was collected from 9 states across the United States from March to October 2020. Women reported behaviors they were engaging in to manage pandemic-related stress, symptoms of depression, anxiety and global psychological distress, as well as changes in energy levels, sleep quality and stress levels. Using latent profile analysis, we identified four behavioral phenotypes of coping strategies. Critically, phenotypes with high levels of passive coping strategies (increased screen time, social media, and intake of comfort foods) were associated with elevated symptoms of depression, anxiety, and global psychological distress, as well as worsening stress and energy levels, relative to other coping phenotypes. In contrast, phenotypes with high levels of active coping strategies (social support, and self-care) were associated with greater resiliency relative to other phenotypes. The identification of these widespread coping phenotypes reveals novel behavioral patterns associated with risk and resiliency to pandemic-related stress in perinatal women. These findings may contribute to early identification of women at risk for poor long-term outcomes and indicate malleable targets for interventions aimed at mitigating lasting sequelae on women and children during the COVID-19 pandemic

Role of Infant Autonomic Functioning

xvi, 132 p. : ill. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number.The Differential Susceptibility Hypothesis and the related Biological Sensitivity to Context theory contend that individuals with "susceptible" traits reap the benefits of positive rearing environments and exhibit better outcomes compared to their less susceptible peers. Studies have largely focused on physiological reactivity as an index of this susceptibility in children and adults, and most have measured physiology by grand mean changes from baseline to a stressor. The goal of this dissertation was to examine baseline Respiratory Sinus Arrhythmia (RSA) and RSA stress reactivity by taking advantage of analytical techniques modeling growth over time, as well as individual differences in this growth-using latent Growth Modeling (LGM) and Growth Mixture Modeling (GMM), respectively. Maternal sensitivity at 5 months and the quality of the attachment environment at 17 months were used as indicators of environmental conditions that might interact with infant susceptibility. Problem behavior and social competence were assessed at 17 months as measures of child well-being. Consistent with the theory of differential susceptibility, there were no significant differences in problem behavior or social competence among infants with low baseline RSA, but infants with high baseline RSA exhibited the lowest levels of problem behavior if reared in an environment that fostered security and more competence if their mothers exhibited greater sensitivity. Contrary to hypotheses, LGM analyses revealed that withdrawal of infant RSA appeared to buffer the impact of being reared in an environment that fostered disorganization, as infants with disorganized attachment histories exhibited the lowest number of problem behaviors. Two distinct groups of children were identified by GMM analyses: a class of infants with low RSA that decreased across the still-face episode, and a class of infants with high RSA that increased across this episode. Class by maternal sensitivity interactions were significantly predictive of social competence, with the high increasing class emerging as the group most susceptible to environmental influences, consistent with the differential susceptibility hypothesis. This dissertation adds importantly to both the sharpening and extension of theories of differential susceptibility.Committee in charge: Jennifer Ablow, Chairperson, Psychology; Philip Fisher, Member, Psychology; Jeffrey Measelle, Member, Psychology; Jane Squires, Outside Member, Special Education and Clinical Science

Interpersonal Disagreement about COVID-19 and Mental Health

This project will serve as a data repository for the manuscript titled Perinatal individuals who report interpersonal disagreement about COVID-19 have higher risk for mental health problems

Early life stress and environmental influences on the neurodevelopment of children with prenatal opioid exposure

Prenatal opioid exposure has reached epidemic proportions. In the last 10 years, there has been a 242% increase in the number of babies born with the drug withdrawal syndrome known as Neonatal Opioid Withdrawal Syndrome (NOWS). Developmental outcome studies of infants with prenatal opioid exposure are limited by methodological issues including small sample sizes and lack of control for confounding variables such as exposure to poverty and maternal psychopathology. Thus, there is a critical gap in the literature that limits our ability to predict short-term effects of opioid exposure. Here we review direct neurotoxic, indirect, and stress-related pathophysiologies of prenatal opioid exposure. We describe the literature on short and long-term neurodevelopmental outcomes of children with prenatal opioid exposure, highlighting sex differences and the role of early life stress. We conclude by prioritizing avenues for future research for this group of underserved women and their children at risk for neurodevelopmental delays