Women’s adversity exposure, HPA axis regulation, and internalizing symptoms: a longitudinal study of a depression intervention
Summary
Women living in low resource contexts, such as low- and middle-income countries (LMICs), face a multitude of compounding adversities (e.g., poverty, intimate partner violence [IPV]) that place them at risk for mental health difficulties and altered functioning of the hypothalamic pituitary adrenal (HPA axis). Intervention efforts targeting women in LMIC contexts may benefit from examining psychobiological function across domains (i.e., self-reported mental health symptoms and physiological HPA axis activity) to capture the full extent of intervention effects. However, there is a paucity of longitudinal research examining adversity exposure, intervention, and psychobiological function among women in low-resource contexts. In the current study, we will leverage data from the Bachpan project, an ongoing longitudinal cohort study with an embedded cluster randomized control trial of a maternal depression intervention. The Bachpan project includes approximately 900 women recruited during their third trimester of pregnancy and followed for 6 years (the 6th year of data is currently being collected). The rich dataset includes measures of adversity exposure, anxiety and depression symptoms, and hair-derived HPA axis hormones at multiple time points. The proposed grant would fund analysis of HPA axis hormones at the 6-year time point. Specific aims include: (1) Identify associations between longitudinal trajectories of adversity exposure and womens psychobiological function across domains, as measured by HPA axis hormones and depression and anxiety symptoms; (2) Evaluate the longitudinal effect of a maternal depression intervention (delivered from pregnancy through 5 years) on womens psychobiological function at 6 years; and (3) Evaluate the impact of various COVID-19-related shocks (e.g. loss of income, illness) on psychobiological function.