PREVENTION OF POSTPARTUM TRAUMATIC STRESS IN MOTHERS WITH PRETERM INFANTS
Mccue Sarah
Stanford Universitycity: Stanford country: United States (us)
Grant 5R34MH086579-02 from National Institute Of Mental Health
Keywords: Address; Age; Anxiety; Area; base; Behavioral; biological adaptation to stress; Birth; Child; Child Development; Cognitive; comparison group; Complex; Confidential Information; Consultations; depressive symptoms; Development; Diagnosis; Diagnostic and Statistical Manual; Disease; Distress; Educational Intervention; Emotional; Event; Evidence based treatment; experience; Feedback; follow-up; Fostering; Funding; Goals; group intervention; Health; high risk infant; Infant; Institute of Medicine (U.S.); Instruction; Intervention; intervention effect; Language; Learning; Length; Life; Link; Live Birth; Long-Term Effects; Measures; Medical; meetings; Mental Depression; Mental disorders; Mission; Modeling; Modification; Mothers; National Institute of Mental Health (U.S.); parental role; Parenting behavior; Parenting Education; Parents; Perception; Persons; Post-Traumatic Stress Disorders; Postpartum Period; premature; Premature Birth; Premature Infant; prevent; Prevention; Preventive Intervention; Process; programs; psychologic; psychological distress; public health medicine (field); public health relevance; Randomized; randomized trial; Reaction; Recording of previous events; Reporting; Research; Research Design; Research Methodology; Services; Severities; skills; Strategic Planning; Stress; Stress Disorders, Traumatic, Acute; stressor; success; Symptoms; Techniques; Telephone; Testing; tool; Trauma; Visit; Woman; Work
Relevance: See instructions. State the application´s broad, long-term objectives and specific aims, making reference to the health relatedness of the project (i.e., relevance to the mission of the agency). Describe concisely the research design and methods for achieving these goals. Describe the rationale and techniques you will use to pursue these goals. In addition, in two or three sentences, describe in plain, lay language the relevance of this research to public health. If the application is funded, this description, as is, will become public information. Therefore, do not include proprietary/confidential information. DO NOT EXCEED THE SPACE PROVIDED. RELEVANCE TO PUBLIC HEALTH: Preterm births are a prevalent, costly and complex public health problem with potentially life-long sequelae for the preterm infants and their mothers. Recent recognition of PTSD as a model to explain both maternal reactions following a preterm birth and the maladaptive parenting styles that often develop in these mothers prompts the adaptation of an intervention for delivery within the NICU with a high likelihood of success in preventing trauma in these mothers and promoting more developmentally facilitating parenting styles. Thus, the proposed treatment adaptation research has a likelihood of high public health significance and meets Objective three in NIMH´s Strategic Plan-to develop better interventions for prevention, treatment and cure of mental illness
Project start date: 2010-12-07
Project end date: 2013-05-31
Budget start date: 1-DEC-2011
Budget end date: 30-NOV-2012
5R34MH086579-02 (2012): $319950
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Grants awarded to Mccue Sarah
PREVENTION OF POSTPARTUM TRAUMATIC STRESS IN MOTHERS WITH PRETERM INFANTS
Mccue Sarah, Associate Professor
Stanford Universitycity: Stanford country: United States (us)
Grant 1R34MH086579-01A2 from National Institute Of Mental Health
Abstract: Preterm births have increased almost 31% in the last 27 years, comprise 12-13% of all live births and, as described in a 2006 Institute of Medicine report, represent a major, costly, complex public health problem. The birth of a premature infant is a traumatic event for the parents, particularly the mothers, causing stress reactions such as depression and anxiety. These stress responses in mothers have been linked to poor parenting practices and subsequently to poor cognitive, emotional and behavioral development in their vulnerable infants. To address the depression, anxiety and trauma experienced by mothers of preterm infants, we developed a three-session CBT-based intervention which decreased depression symptoms in women but not trauma symptoms. Therefore, we are requesting funds through the NIMH R34 mechanism to expand the intervention to include successful CBT-based approaches developed for the treatment of trauma and to address additional critical stressors we identified in our earlier work including alterations in the parental role and negative perceptions of the infant. Specifically, we propose to 1) Adapt a manualized intervention to treat ASD and prevent the development of PTSD in women with preterm infants and to assist these mothers in redefining their infants and educating them to promote sensitivity to their infants; 2) Pilot the manualized treatment with 10 NICU mothers, solicit feedback from these mothers and modify the intervention based on the feedback; 3) Conduct a small (N=100) randomized trial of the trauma-focused plus mother redefinition/education intervention compared to an information/usual services comparison condition; and, 4) Conduct a 5-month longitudinal intervention with women in the intervention group (N=60) randomized to bi-monthly telephone or in-person follow-up by a therapist using the newly-adapted CBT-based treatment versus support from former NICU parents to determine whether an intervention closer to the length of conventional CBT treatment for trauma is superior to the proposed 6-session intervention in preventing the development of PTSD, promoting more positive perceptions of the infant and in reducing parental stress. Preterm births are a prevalent, costly and complex public health problem with potentially life-long sequelae for the preterm infants and their mothers. Recent recognition of PTSD as a model to explain both maternal reactions following a preterm birth and the maladaptive parenting styles that often develop in these mothers prompts the adaptation of an intervention for delivery within the NICU with a high likelihood of success in preventing trauma in these mothers and promoting more developmentally facilitating parenting styles. Thus, the proposed treatment adaptation research has a likelihood of high public health significance and meets Objective three in NIMH´s Strategic Plan-to develop better interventions for prevention, treatment and cure of mental illness
Keywords: 0-11 years old; Active Follow-up; Acute crisis reaction; Acute reaction to stress; Acute stress reaction; Address; Age; Anxiety; Area; base; Behavioral; biological adaptation to stress; Birth; Child; Child Development; Child Youth; children; Children (0-21); Cognitive; comparison group; Complex; Confidential Information; Consultations; Depression; depressive; depressive symptoms; Development; Diagnosis; Diagnostic and Statistical Manual; Disease; disease/disorder; Disorder; Distress; DSM; Education for Intervention; Educational Intervention; Effects, Longterm; Emotional; Emotional Depression; Event; Evidence based treatment; experience; Feedback; follow-up; Fostering; Funding; Goals; gross stress reaction; group intervention; Health; high risk infant; History; Human, Child; Infant; Infant and Child Development; Infant, Premature; Institute of Medicine; Institute of Medicine (U.S.); Instruction; Instruction Intervention; instructional intervention; Intervention; intervention effect; Intervention Strategies; interventional strategy; Language; Learning; Length; Life; Link; Live Birth; Long-Term Effects; Measures; Medical; meetings; Mental Depression; Mental disorders; Mental health disorders; mental illness; Methodology, Research; Methods and Techniques; Methods, Other; Mission; Modeling; Modification; Mothers; NAS/IOM; National Institute of Mental Health; National Institute of Mental Health (U.S.); Neuroses, Post-Traumatic; Neuroses, Posttraumatic; NIMH; parental role; Parenting; Parenting behavior; Parenting Education; Parents; Parturition; Perception; Persons; Phone; Post-Traumatic Stress Disorders; Postpartum; Postpartum Period; premature; premature baby; Premature Birth; premature childbirth; premature delivery; Premature Infant; premature infant human; preterm baby; Preterm Birth; preterm delivery; preterm infant; preterm infant human; preterm neonate; prevent; preventing; Prevention; preventional intervention strategy; Preventive Intervention; Process; programs; Programs (PT); Programs [Publication Type]; Psychiatric Disease; Psychiatric Disorder; Psychic shock; psychologic; psychological; psychological disorder; psychological distress; PTSD; Public Health; public health medicine (field); public health relevance; randomisation; randomization; Randomized; randomized trial; randomly assigned; Reaction; reaction; crisis; Recording of previous events; Reporting; Research; Research Design; Research Methodology; Research Methods; role of parent; Services; Severities; skills; Strategic Planning; Stress; Stress Disorders, Acute; Stress Disorders, Post-Traumatic; Stress Disorders, Posttraumatic; Stress Disorders, Traumatic, Acute; stress response; stress; reaction; stressor; study design; Study Type; success; Symptoms; Symptoms of depression; Techniques; Telephone; Testing; tool; Training Intervention; Trauma; traumatic neurosis; United States National Institute of Mental Health; Unspecified Mental Disorder; Visit; Woman; Work; youngster
Relevance: See instructions. State the application´s broad, long-term objectives and specific aims, making reference to the health relatedness of the project (i.e., relevance to the mission of the agency). Describe concisely the research design and methods for achieving these goals. Describe the rationale and techniques you will use to pursue these goals. In addition, in two or three sentences, describe in plain, lay language the relevance of this research to public health. If the application is funded, this description, as is, will become public information. Therefore, do not include proprietary/confidential information. DO NOT EXCEED THE SPACE PROVIDED. RELEVANCE TO PUBLIC HEALTH: Preterm births are a prevalent, costly and complex public health problem with potentially life-long sequelae for the preterm infants and their mothers. Recent recognition of PTSD as a model to explain both maternal reactions following a preterm birth and the maladaptive parenting styles that often develop in these mothers prompts the adaptation of an intervention for delivery within the NICU with a high likelihood of success in preventing trauma in these mothers and promoting more developmentally facilitating parenting styles. Thus, the proposed treatment adaptation research has a likelihood of high public health significance and meets Objective three in NIMH´s Strategic Plan-to develop better interventions for prevention, treatment and cure of mental illness
Project start date: 2010-12-07
Project end date: 2013-05-31
Budget start date: 7-DEC-2010
Budget end date: 30-NOV-2011
PFA/PA: PAR-09-173
1R34MH086579-01A2 (2011): $197500