Neurophysiological Social Reward Processing, Birth Trauma, and Depression Symptoms in the Peripartum Period

Vanderbilt University, Nashville TN

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Abstract

PROJECT SUMMARY/ABSTRACT Peripartum depression (i.e., depression during pregnancy and following childbirth; PPD) is prevalent and debilitating for women. PPD is associated with significant negative outcomes, including functional impairment and suicidality risk in mothers as well as cognitive, developmental, emotional, and social impacts on infants. Another common factor impacting women during the peripartum period is birth trauma. Nearly half of women giving birth endorse birth trauma, including labor complications, emergency interventions that violate expectations, or needs for intensive medical treatment. Depression during pregnancy is a known risk factor for birth trauma. Further, birth trauma is associated with a range of adverse outcomes for mothers and offspring similar to the effects of PPD. Many women endorsing birth trauma do not develop PPD, raising questions about vulnerabilities for depression that may contribute to PPD in interaction with birth trauma. Vulnerability- stress models of depression posit depression is the result of interactions between underlying vulnerabilities and stress. Growing evidence supports the use of neuroscientific methods to identify depression vulnerabilities across development, such as reduced neural reward responsiveness. Further, stress moderates effect of reward processing on subsequent depression. Reward processing may interact with birth trauma on PPD symptoms. As part of a larger project, this project measures neural social reward responsiveness using a novel and ecologically valid paradigm, birth trauma objectively coded based on contextual factors, and depressive symptoms assessed in 120 mothers. Depression symptoms and diagnoses are collected across pregnancy and postpartum. During an assessment at 8 weeks postpartum, participants complete a novel social inventive delay task while electroencephalogram is recorded in response to reward (i.e., green arrow leading to a photo of participant’s infant) and neutral feedback (i.e., red arrow leading to a photo of rocks). Event-related potential (e.g., the reward positivity, a time-domain measure of reward responsiveness) and time-frequency data (i.e., delta activity, a frequency-domain marker of sensitivity to rewards) are used to measure neurophysiological response to social reward. Further, participants complete the Birth Experience Interview to capture dimensions of birth trauma (i.e., overall severity, violations of expectations, and loss of control). The project examines the effects of low social reward responsiveness (Aim 1) and birth trauma (Aim 2) on PPD symptoms, accounting for depressive symptoms during pregnancy. Further, the project tests birth trauma as a moderator of associations between social reward responsiveness and postpartum depressive symptoms, accounting for depressive symptoms during pregnancy (Aim 3). This project brings together experts in respective fields and allow for advanced training on the role of stress and trauma in PPD, advanced EEG methods, and advanced quantitative methods. The project and training provide opportunities to develop necessary skills for an independent career as a researcher identifying processes and environmental factors driving PPD risk.