We determined the role of risk and protective factors on the trajectories of behavior problems associated with high prenatal cocaine exposure (PCE)/polydrug exposure.
The Maternal Lifestyle Study enrolled 1388 children with or without PCE, assessed through age 15 years. Because most women using cocaine during pregnancy also used other substances, we analyzed for the effects of 4 categories of prenatal drug exposure: high PCE/other drugs (OD), some PCE/OD, OD/no PCE, and no PCE/no OD. Risks and protective factors at individual, family, and community levels that may be associated with behavior outcomes were entered stepwise into latent growth curve models, then replaced by cumulative risk and protective indexes, and finally by a combination of levels of risk and protective indexes. Main outcome measures were the trajectories of externalizing, internalizing, total behavior, and attention problems scores from the Child Behavior Checklist (parent).
A total of 1022 (73.6%) children had known outcomes. High PCE/OD significantly predicted externalizing, total, and attention problems when considering the balance between risk and protective indexes. Some PCE/OD predicted externalizing and attention problems. OD/no PCE also predicted behavior outcomes except for internalizing behavior. High level of protective factors was associated with declining trajectories of problem behavior scores over time, independent of drug exposure and risk index scores.
High PCE/OD is a significant risk for behavior problems in adolescence; protective factors may attenuate its detrimental effects. Clinical practice and public health policies should consider enhancing protective factors while minimizing risks to improve outcomes of drug-exposed children.
"Many of these correlates of age of sexual initiation have also been documented in youth with prenatal cocaine exposure (PCE). For example, PCE is associated with increased child behavior problems (Ackerman et al., 2010; Bada et al., 2012; Bennett et al., 2013; Delaney-Black et al., 2004; McLaughlin et al., 2011; Minnes et al., 2010; Richardson et al., 2011; Whitaker et al., 2011). Children with PCE are often raised in less than optimal environments that are also linked to poor behavioral outcomes (Bradley and Corwyn, 2002; McLeod et al., 2007). "
"Environmental factors associated with prenatal drug use, such as poor quality of the home environment, caregiver ongoing substance use and psychological distress, violence exposure (Bada et al., 2007, 2011; Frank et al., 2011), non-kinship adoptive/foster care placement (Linares et al., 2006), negative attachment to caregiver (Warner et al., 2011) and low levels of parental monitoring (Bohnert, Anthony, & Breslau, 2012; Laird, Criss, Pettit, Dodge, & Bates, 2008) may heighten the drug exposed child's vulnerability to maladaptive behavioral development and obscure the long-term effects of PCE. In contrast, positive environmental factors may be protective or compensate for earlier biologic risk factors (Bada et al., 2012; Singer, 2004, 2008). "
[Show abstract][Hide abstract] ABSTRACT: The effect of prenatal cocaine exposure (PCE) on externalizing behavior and substance use related problems at 15 years of age was examined. Participants consisted of 358 adolescents (183 PCE, 175 non-cocaine exposed (NCE)), primarily African–American and of low socioeconomic status, prospectively enrolled in a longitudinal study from birth. Regression analyses indicated that the amount of PCE was associated with higher externalizing behavioral problems (β = .15, p = .02). Adolescents with PCE were also 2.8 times (95% CI = 1.38–5.56) more likely to have substance use related problems than their NCE counterparts. No differences between PCE adolescents in non-kinship adoptive/foster care (n = 44) and PCE adolescents in maternal/relative care (n = 139) were found in externalizing behavior or in the likelihood of substance use related problems. Findings demonstrate teratologic effects of PCE persisting into adolescence. PCE is a reliable marker for the potential development of problem behaviors in adolescence, including substance use related problems.
Journal of Adolescence 04/2014; 37(3):269–279. DOI:10.1016/j.adolescence.2014.01.004 · 2.05 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In the Jerusalem Institute for Child Development children with various developmental disorders at ages of 0-5 years are examined. Thirty-six children aged 2-4 years were examined by us and were found to have inattention, hyperactivity and speech delay with an IQ or DQ above 70 and were reexamined at 7-14 years of age. They were compared to a group of 27 control children. All children had a complete neurodevelopmental examination using the Touwen & Prechtel examination for Minor Neurological Dysfunction. They also had a Pollack tapper test for the identification of learning disabilities and the Conners parent's and teacher's hyperactivity rating scales. Of the 36 children from the research group 20 studied in special education classes because of behavioral disorders, inattention, and severe learning disabilities. They all had ADD-ADHD. There were 16 children in regular schools, of whom 9 had ADD-ADHD. In the control group only one child had ADD-ADHD. A very high number of the research group children failed in 2 or all 3 tests used in this study in comparison to controls. It seems that "soft" neurological signs with hyperactivity, inattention and speech delay may be early clinical signs of ADD-ADHD as 80% of the children with these clinical features developed ADD-ADHD during early school age.
The Israel journal of psychiatry and related sciences 01/1993; 30(3):155-63. · 0.79 Impact Factor
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