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Krzeczkowski JE, Hall M, Saint-Amour D, Oulhote Y, McGuckin T, Goodman CV, Green R, Muckle G, Lanphear B, Till C. Prenatal fluoride exposure, offspring visual acuity and autonomic nervous system function in 6-month-old infants. ENVIRONMENT INTERNATIONAL 2024; 183:108336. [PMID: 38064923 PMCID: PMC10981044 DOI: 10.1016/j.envint.2023.108336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/10/2023] [Accepted: 11/17/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Prenatal fluoride exposure can have adverse effects on children's development; however, associations with visual and cardiac autonomic nervous system functioning are unknown. We examined associations between prenatal fluoride exposure and visual acuity and heart rate variability (HRV) in 6-month-old infants. METHODS We used data from Canadian mother-infant pairs participating in the Maternal-Infant Research on Environmental Chemicals (MIREC) cohort. We estimated prenatal fluoride exposure using: i) fluoride concentration in drinking water (mg/L), ii) maternal urinary fluoride adjusted for specific gravity (MUFSG; mg/L) and averaged across pregnancy, and iii) maternal fluoride intake (µg/kg/day) from consumption of water, tea, and coffee, adjusted for maternal body weight (kg). We used multivariable linear regression to examine associations between each measure of fluoride exposure and Teller Acuity Card visual acuity scores (n = 435) and assessed HRV (n = 400) using two measures: root mean square of successive differences (RMSSD) and the standard deviation of N-N intervals (SDNN) measured at 6-months of age. RESULTS Median (IQR) values for water fluoride, MUFSG, and daily fluoride intake were 0.20 (IQR: 0.13-0.56) mg/L; 0.44 (0.28-0.70) mg/L and 4.82 (2.58-10.83) µg/kg/day, respectively. After adjustment for confounding variables, water fluoride concentration was associated with poorer infant visual acuity (B = -1.51; 95 % CI: -2.14,-0.88) and HRV as indicated by lower RMSSD (B = -1.60; 95 % CI: -2.74,-0.46) but not SDNN. Maternal fluoride intake was also associated with poorer visual acuity (B = -0.82; 95 % CI: -1.35,-0.29) and lower RMSSD (B = -1.22; 95 % CI: -2.15,-0.30). No significant associations were observed between MUFSG and visual acuity or HRV. CONCLUSION Fluoride in drinking water was associated with reduced visual acuity and alterations in cardiac autonomic function in infancy, adding to the growing body of evidence suggesting fluoride's developmental neurotoxicity.
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Affiliation(s)
- John E Krzeczkowski
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada.
| | - Meaghan Hall
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Dave Saint-Amour
- Faculté de médecine - Département d'ophtalmologie, Université de Montréal, Montréal, Québec, Canada
| | - Youssef Oulhote
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sina, New York, NY, USA
| | - Taylor McGuckin
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Carly V Goodman
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Rivka Green
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Gina Muckle
- Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; École de Psychologie, Université Laval, Québec, Québec, Canada
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Christine Till
- Department of Psychology, York University, Toronto, Ontario, Canada
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Hocagil TA, Ryan LM, Cook RJ, Jacobson SW, Richardson GA, Day NL, Coles CD, Olson HC, Jacobson JL. A hierarchical meta-analysis for settings involving multiple outcomes across multiple cohorts. Stat (Int Stat Inst) 2022; 11:e462. [PMID: 37841211 PMCID: PMC10569156 DOI: 10.1002/sta4.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/24/2022] [Indexed: 11/10/2022]
Abstract
Evidence from animal models and epidemiological studies has linked prenatal alcohol exposure (PAE) to a broad range of long-term cognitive and behavioural deficits. However, there is a paucity of evidence regarding the nature and levels of PAE associated with increased risk of clinically significant cognitive deficits. To derive robust and efficient estimates of the effects of PAE on cognitive function, we have developed a hierarchical meta-analysis approach to synthesize information regarding the effects of PAE on cognition, integrating data on multiple outcomes from six U.S. Iongitudinal cohort studies. A key assumption of standard methods of meta-analysis, effect sizes are independent, is violated when multiple intercorrelated outcomes are synthesized across studies. Our approach involves estimating the dose-response coefficients for each outcome and then pooling these correlated dose-response coefficients to obtain an estimated "global" effect of exposure on cognition. In the first stage, we use individual participant data to derive estimates of the effects of PAE by fitting regression models that adjust for potential confounding variables using propensity scores. The correlation matrix characterizing the dependence between the outcome-specific dose-response coefficients estimated within each cohort is then run, while accommodating incomplete information on some outcome. We also compare inferences based on the proposed approach to inferences based on a full multivariate analysis.
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Affiliation(s)
- Tugba Akkaya Hocagil
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Louise M Ryan
- School of Mathematical and Physical Sciences, University of Technology Sydney, Sydney, NSW, 2007, Australia
| | - Richard J. Cook
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Sandra W. Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, 48201, USA
| | - Gale A. Richardson
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, 15213, USA
| | - Nancy L. Day
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, 15213, USA
| | - Claire D. Coles
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, 30322, USA
| | - Heather Carmichael Olson
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, 98195, USA
| | - Joseph L. Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, 48201, USA
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Godleski S, Schuetze P, Eiden RD, Nickerson AB, Ostrov JM. Developmental Pathways from Prenatal Substance Exposure to Reactive Aggression. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2022; 83:101474. [PMID: 38827951 PMCID: PMC11142622 DOI: 10.1016/j.appdev.2022.101474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Few studies have examined etiological pathways from prenatal substance exposure to adolescent reactive aggression. We tested a conceptual model that included hypothesized pathways from prenatal substance exposure to adolescent aggression via autonomic reactivity and violence exposure from infancy to early school age and maternal harshness across early childhood. The sample included 216 families (106 boys) who primarily self-identified as Black or Mixed Race. Results supported the hypothesized path from violence exposure across early childhood and early school age to school age autonomic reactivity and early adolescent reactive aggression. There was also a significant interaction effect of sympathetic and parasympathetic reactivity on adolescent reactive aggression, with sympathetic arousal and parasympathetic suppression at early school age associated with higher reactive relational and physical aggression in adolescence. Results emphasize the importance of early experiences and autonomic nervous system changes in contributing to the cascade of risk for reactive aggression in early adolescence.
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Affiliation(s)
- Stephanie Godleski
- Department of Psychology, College of Liberal Arts, Rochester Institute of Technology
| | - Pamela Schuetze
- Department of Psychology, State University of New York Buffalo State
| | - Rina D. Eiden
- Department of Psychology and The Social Science Research Institute, The Pennsylvania State University, University Park
| | - Amanda B. Nickerson
- Alberti Center for Bullying Abuse Prevention, University at Buffalo, The State University of New York
| | - Jamie M. Ostrov
- Department of Psychology, University at Buffalo, The State University of New York
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Finger B, McNeill V, Schuetze P, Eiden RD. Sex moderated and RSA mediated effects of prenatal cocaine exposure on behavior problems at age 7. Neurotoxicol Teratol 2022; 89:107052. [PMID: 34826569 PMCID: PMC9053578 DOI: 10.1016/j.ntt.2021.107052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 11/03/2021] [Accepted: 11/18/2021] [Indexed: 01/03/2023]
Abstract
This study was designed to assess whether prenatal cocaine exposure (PCE) is associated with sex differences in behavior problems in middle childhood and whether there are sex differences in the way in which parasympathetic functioning mediates the relations between PCE and behavior problems within a diverse low-income sample. Participants included 164 high risk mother-child dyads including 89 PC exposed children and 75 control children participating in an ongoing longitudinal study. Respiratory sinus arrhythmia (RSA) was measured to assess parasympathetic functioning at 13 months of age and maternal reports of child behavior problems were collected at 7 years of age. Results revealed no significant association between PCE and behavior problems for the full sample. A 2 × 2 Anova revealed a significant interaction between PCE and child sex on internalizing, externalizing, and total behavior problems (F (3, 160) = 13.45, p < .001) with cocaine exposed females averaging the highest behavior problem scores. Results also revealed a statistically significant indirect effect linking cocaine exposure to lower externalizing problems via lower baseline RSA among males. Findings indicate that cocaine exposed females may be more vulnerable to developing behavior problems than cocaine exposed males and that high baseline RSA may present a sex specific risk factor for externalizing problems among exposed males.
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Schuetze P, Eiden RD, Shisler S. Autonomic functioning among cocaine-exposed kindergarten-aged children: Examination of child sex and caregiving environmental risk as potential moderators. Neurotoxicol Teratol 2020; 80:106889. [PMID: 32360377 PMCID: PMC7340562 DOI: 10.1016/j.ntt.2020.106889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to examine the hypothesis that child sex moderates the association between prenatal cocaine exposure (PCE) and autonomic functioning as well as to examine the role that caregiving environmental risk played in sex differences in autonomic functioning among exposed children. Measures of the parasympathetic nervous system (indexed by respiratory sinus arrhythmia [RSA]) and the sympathetic nervous system (indexed by skin conductance level [SCL]) were obtained from 146 (75 cocaine-exposed, 38 male; and 71 nonexposed, 36 male) children during baseline and a task designed to elicit negative affect (NA). We also examined the role of caregiving environmental risk as a moderator of the association between PCE and autonomic functioning separately for boys and girls. PCE boys had a significantly higher baseline RSA and lower baseline SCL than PCE girls or nonexposed children. Environmental risk also moderated the association between PCE and baseline RSA for boys, but not girls, such that boys with PCE and high environmental risk had the highest baseline RSA. These findings indicate that exposed boys had significantly lower levels of sympathetic activation while at rest. However, for autonomic reactivity, the exposed girls had a larger change in both RSA and SCL relative to nonexposed girls while exposed boys had significantly smaller increases in SCL during environmental challenge. Finally, girls with both PCE and high environmental risk had the highest levels of parasympathetic reactivity during challenge. These results underscore the importance of examining sex differences and considering comorbid environmental risk factors when examining developmental outcomes in cocaine-exposed children and highlight the complexity involved with understanding individual differences in cocaine-exposed populations.
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Affiliation(s)
- Pamela Schuetze
- Department of Psychology, State University of New York College at Buffalo, 1300 Elmwood Avenue, Buffalo, NY 14222-1095, United States of America.
| | - Rina D Eiden
- Department of Psychology, Consortium for Combatting Substance Abuse, Pennsylvania State University, United States of America
| | - Shannon Shisler
- Department of Pediatrics, SUNY at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States of America
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Li Z, Lei K, Coles CD, Lynch ME, Hu X. Longitudinal changes of amygdala functional connectivity in adolescents prenatally exposed to cocaine. Drug Alcohol Depend 2019; 200:50-58. [PMID: 31085378 PMCID: PMC6607904 DOI: 10.1016/j.drugalcdep.2019.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Prenatal cocaine exposure (PCE) is associated with arousal dysregulation, but interactions between exposure and age are rarely investigated directly with longitudinal study designs. Our previous study had examined task-elicited emotional arousal and noted persistently high amygdala activations in the development of adolescents with PCE. However, while externally imposed emotional arousal could be considered a "state" effect depending on specific task stimuli, it is still unclear whether similar developmental alterations extend to intrinsic functional connectivity (FC), reflecting more of a "trait" effect. METHODS We used a longitudinal design and analyzed resting-state functional magnetic resonance imaging data acquired twice from 25 adolescents with PCE and 16 non-exposed controls. Both groups were each scanned first at the mean age of 14.3 and then again at 16.6 years. Seeding in bilateral amygdalae and comparing the 2nd scan with the 1st, we examined the interaction effect between PCE and age on FCs in the emotional network. RESULTS Compared with the younger age, we observed a generally decreased FC in the emotional network of the control group at the older age, but these FCs were generally increased at the older age in this same network of the PCE group. Additionally, this interaction effect of exposure by age in the right fusiform was positively correlated with the emotional interference imposed by external task stimuli. CONCLUSIONS These results provided additional data directly characterizing developmental changes in the emotional network of adolescents with PCE, complementing and extending the notion of a PCE-associated long-term teratogenic effect on arousal regulation.
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Affiliation(s)
- Zhihao Li
- School of Psychology and Sociology, Shenzhen University, Shenzhen, 518060, Guangdong, PR China; Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, 518060, Guangdong, PR China; Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.
| | - Kaikai Lei
- School of Psychology and Sociology, Shenzhen University, Shenzhen, 518060, Guangdong, PR China; Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, 518060, Guangdong, PR China
| | - Claire D Coles
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Mary Ellen Lynch
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Xiaoping Hu
- Department of Bioengineering, University of California at Riverside, Riverside, CA, USA.
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Willford JA, Singhabahu D, Herat A, Richardson GA. An examination of the association between prenatal cocaine exposure and brain activation measures of arousal and attention in young adults: An fMRI study using the Attention Network Task. Neurotoxicol Teratol 2018; 69:1-10. [PMID: 29953942 DOI: 10.1016/j.ntt.2018.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 05/23/2018] [Accepted: 06/22/2018] [Indexed: 11/19/2022]
Abstract
Prenatal drug exposure, including cocaine, alcohol, marijuana, and tobacco, is associated with deficits in behavioral regulation and attention. Using fMRI, the objective of this study was to characterize the association between prenatal cocaine exposure (PCE) and the underlying neural substrates associated with behavioral outcomes of attention. Forty-seven young adults were recruited for this study from the ongoing Maternal Health Practices and Child Development (MHPCD) Project, a longitudinal study of the effects of PCE on growth, behavior, and cognitive function. Three groups were compared: 1) prenatal exposure to cocaine, alcohol, marijuana, and tobacco (CAMT, n = 15), 2) prenatal exposure to alcohol, marijuana, and tobacco (AMT, n = 17), and 3) no prenatal exposure to drugs (Controls, n = 15). Subjects were frequency matched on gender, race, handedness, and 15-year IQ. This study used the theoretical model proposed by Posner and Peterson (1990), which posits three dissociable components of attention: alerting, orienting, and executive attention. Subjects completed a functional MRI (fMRI) scan while performing the Attention Network Task, a validated neuroimaging measure of the 3-network model of attention. Behavioral and fMRI data revealed no associations between PCE and task accuracy, speed of processing, or activation in key brain regions associated with each of the attention networks. The results of this study show that any subtle differences in brain function associated with PCE are not detectable using the ANT task and fMRI. These results should be interpreted in the context of other studies that have found associations between PCE and arousal with emotionally arousing stimuli, compared to this study that found no associations using emotionally neutral stimuli.
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Affiliation(s)
- Jennifer A Willford
- Department of Psychology, Slippery Rock University, 1 Morrow Way, Slippery Rock, PA 16057, United States of America.
| | - Dil Singhabahu
- Department of Mathematics, Slippery Rock University, 1 Morrow Way, Slippery Rock, PA 16057, United States of America.
| | - Athula Herat
- Department of Physics, Slippery Rock University, 1 Morrow Way, Slippery Rock, PA 16057, United States of America.
| | - Gale A Richardson
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213, United States of America.
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Dworkin ER, Zambrano-Vazquez L, Cunningham SR, Pittenger SL, Schumacher JA, Stasiewicz PR, Coffey SF. Treating PTSD in Pregnant and Postpartum Rural Women with Substance Use Disorders. ACTA ACUST UNITED AC 2017; 41:136-151. [PMID: 28983389 DOI: 10.1037/rmh0000057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The co-occurrence of posttraumatic stress disorder and substance use disorder (PTSD-SUD) can pose significant problems for rural pregnant and postpartum women (PPW) and the well-being of their children. Although effective treatments exist, PPW experience limitations in their ability to access and engage in treatment that may be compounded by various aspects of rural settings, so providers must be attentive to these barriers in order to address this pressing public health need. In addition, as part of increasing rural access to care, it is important to consider the costs and benefits to PPW of selecting exposure-based techniques (e.g., prolonged exposure) to disseminate. The current article discusses the treatment of PTSD-SUD in rural PPW in the context of the authors' experiences providing an exposure-based cognitive behavioral treatment for PTSD in this population. Barriers to treatment access and engagement are discussed and recommendations are provided.
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Affiliation(s)
- Emily R Dworkin
- University of Mississippi Medical Center, Jackson MS.,G.V. (Sonny) Montgomery Veteran Affairs Medical Center, Jackson MS
| | - Laura Zambrano-Vazquez
- University of Mississippi Medical Center, Jackson MS.,G.V. (Sonny) Montgomery Veteran Affairs Medical Center, Jackson MS
| | - Sarah R Cunningham
- University of Mississippi Medical Center, Jackson MS.,G.V. (Sonny) Montgomery Veteran Affairs Medical Center, Jackson MS
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Li Z, Coles CD, Lynch ME, Luo Y, Hu X. Longitudinal changes of amygdala and default mode activation in adolescents prenatally exposed to cocaine. Neurotoxicol Teratol 2015; 53:24-32. [PMID: 26577285 DOI: 10.1016/j.ntt.2015.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 10/29/2015] [Accepted: 11/09/2015] [Indexed: 12/30/2022]
Abstract
Prenatal cocaine exposure (PCE) is associated with long-term and negative effect on arousal regulation. Recent neuroimaging studies have examined brain mechanisms related to arousal dysregulation with cross-sectional experimental designs; but longitudinal changes in the brain, reflecting group differences in neurodevelopment, have never been directly examined. To directly assess the interaction of PCE and neurodevelopment, the present study used a longitudinal design to analyze functional magnetic resonance imaging (fMRI) data collected from 33 adolescents (21 with PCE and 12 non-exposed controls) while they performed the same working memory task with emotional distracters at two points in time. The mean age of participants was 14.3 years at time_1 and 16.7 years at time_2. With confounding factors statistically controlled, the fMRI data revealed significant exposure-by-time interaction in the activations of the amygdala and default mode network (DMN). For the control adolescents, brain activations associated with emotional arousal (amygdala) and cognitive effort (DMN) were both reduced at time_2 as compared to that at time_1. However, these activation reductions were not observed in the PCE group, indicating persistently high levels of emotional arousal and cognitive effort. In addition, correlations between longitudinal changes in the brain and in behavior have shown that adolescents with persistently high emotional arousal were more likely in need of high cognitive effort; and their cognitive performance was more likely to be affected by distractive challenges. The present results complement and extend previous findings from cross-sectional studies with further evidence supporting the view of PCE associated long-term teratogenic effects on arousal regulation.
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Affiliation(s)
- Zhihao Li
- Institute of Affective and Social Neuroscience, Shenzhen University, Shenzhen 518060, Guangdong, PR China; Biomedical Imaging Technology Center, Department of Biomedical Engineering, Emory University & Georgia Institute of Technology, Atlanta 30322, GA, USA.
| | - Claire D Coles
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta 30322, GA, USA
| | - Mary Ellen Lynch
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta 30322, GA, USA
| | - Yuejia Luo
- Institute of Affective and Social Neuroscience, Shenzhen University, Shenzhen 518060, Guangdong, PR China
| | - Xiaoping Hu
- Biomedical Imaging Technology Center, Department of Biomedical Engineering, Emory University & Georgia Institute of Technology, Atlanta 30322, GA, USA.
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Abstract
This was a prospective longitudinal multisite study of the effects of prenatal cocaine and/or opiate exposure on temperament in 4-month-olds of the Maternal Lifestyle Study (N = 958: 366 cocaine exposed, 37 opiate exposed, 33 exposed to both drugs, 522 matched comparison). The study evaluated positivity and negativity during The Behavior Assessment of Infant Temperament (Garcia Coll et al., 1988). Parents rated temperament (Infant Behavior Questionnaire; Rothbart, 1981). Cocaine-exposed infants showed less positivity overall, mainly during activity and threshold items, more negativity during sociability items, and less negativity during irritability and threshold items. Latent profile analysis indicated individual temperament patterns were best described by three groups: low/moderate overall reactivity, high social negative reactivity, and high nonsocial negative reactivity. Infants with heavy cocaine exposure were more likely in high social negative reactivity profile, were less negative during threshold items, and required longer soothing intervention. Cocaine- and opiate-exposed infants scored lower on Infant Behavior Questionnaire smiling and laughter and duration of orienting scales. Opiate-exposed infants were rated as less respondent to soothing. By including a multitask measure of temperament we were able to show context-specific behavioral dysregulation in prenatally cocaine-exposed infants. The findings indicate flatter temperament may be specific to nonsocial contexts, whereas social interactions may be more distressing for cocaine-exposed infants.
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Siqveland TS, Haabrekke K, Wentzel-Larsen T, Moe V. Patterns of mother–infant interaction from 3 to 12 months among dyads with substance abuse and psychiatric problems. Infant Behav Dev 2014; 37:772-86. [DOI: 10.1016/j.infbeh.2014.09.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 07/04/2014] [Accepted: 09/29/2014] [Indexed: 11/24/2022]
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12
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Conradt E, Degarmo D, Fisher P, Abar B, Lester BM, Lagasse LL, Shankaran S, Bada H, Bauer CR, Whitaker TM, Hammond JA. The contributions of early adverse experiences and trajectories of respiratory sinus arrhythmia on the development of neurobehavioral disinhibition among children with prenatal substance exposure. Dev Psychopathol 2014; 26:901-16. [PMID: 24909973 PMCID: PMC4447302 DOI: 10.1017/s095457941400056x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Neurobehavioral disinhibition (ND) is a complex condition reflecting a wide range of problems involving difficulties with emotion regulation and behavior control. Respiratory sinus arrhythmia (RSA) is a physiological correlate of emotion regulation that has been studied in a variety of at-risk populations; however, there are no studies of RSA in children with ND. Data were drawn from a prospective longitudinal study of prenatal substance exposure that included 1,073 participants. Baseline RSA and RSA reactivity to an attention-demanding task were assessed at 3, 4, 5, and 6 years. ND was assessed at ages 8/9, 11, and 13/14 years via behavioral dysregulation and executive dysfunction composite measures. Greater exposure to early adversity was related to less RSA reactivity at 3 years, increases in RSA reactivity from ages 3 to 6 years, and increased behavioral dysregulation from ages 8/9 to 13/14. RSA reactivity was examined as a moderator of the association between early adversity and changes in ND. A significant Early Adversity × RSA Reactivity quadratic interaction revealed that children with decelerations in RSA reactivity exhibited increases in behavioral dysregulation, regardless of their exposure to early adversity. However, greater exposure to early adversity was related to greater increases in behavioral dysregulation, but only if children exhibited accelerations in RSA reactivity from ages 3 to 6 years. The results contribute to our understanding of how interactions across multiple levels of analysis contribute to the development of ND.
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Affiliation(s)
- Elisabeth Conradt
- Women & Infants Hospital of Rhode Island
- Warren Alpert Medical School of Brown University
| | | | - Phil Fisher
- Oregon Social Learning Center
- University of Oregon
| | - Beau Abar
- Women & Infants Hospital of Rhode Island
| | - Barry M. Lester
- Women & Infants Hospital of Rhode Island
- Warren Alpert Medical School of Brown University
- University of Oregon
| | - Linda L. Lagasse
- Women & Infants Hospital of Rhode Island
- Warren Alpert Medical School of Brown University
- University of Oregon
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Wiebe SA, Fang H, Johnson C, James KE, Espy KA. Determining the impact of prenatal tobacco exposure on self-regulation at 6 months. Dev Psychol 2014; 50:1746-56. [PMID: 24512173 PMCID: PMC4050340 DOI: 10.1037/a0035904] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Our goal in the present study was to examine the effects of maternal smoking during pregnancy on infant self-regulation, exploring birth weight as a mediator and sex as a moderator of risk. A prospective sample of 218 infants was assessed at 6 months of age. Infants completed a battery of tasks assessing working memory/inhibition, attention, and emotional reactivity and regulation. Propensity scores were used to statistically control for confounding risk factors associated with maternal smoking during pregnancy. After prenatal and postnatal confounds were controlled, prenatal tobacco exposure was related to reactivity to frustration and control of attention during stimulus encoding. Birth weight did not mediate the effect of prenatal exposure but was independently related to reactivity and working memory/inhibition. The effect of tobacco exposure was not moderated by sex.
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Affiliation(s)
| | - Hua Fang
- Department of Quantitative Health Sciences, University of Massachusetts Medical School
| | - Craig Johnson
- Developmental Cognitive Neuroscience Laboratory, University of Nebraska-Lincoln
| | - Karen E James
- Developmental Cognitive Neuroscience Laboratory, University of Nebraska-Lincoln
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Schuetze P, Eiden RD, Molnar DS, Colder CD. Empathic responsivity at 3 years of age in a sample of cocaine-exposed children. Neurotoxicol Teratol 2014; 42:1-8. [PMID: 24444666 PMCID: PMC3968185 DOI: 10.1016/j.ntt.2014.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 01/02/2014] [Accepted: 01/08/2014] [Indexed: 11/17/2022]
Abstract
This study examined the association between prenatal exposure to cocaine and behavioral and physiological responsivity. Participants were 216 mother-infant dyads (116 cocaine exposed-CE, 100 nonexposed-NCE) recruited at birth. Measures of heart rate (HR) and respiratory sinus arrhythmia (RSA) were obtained during baseline and during a task designed to elicit empathy (exposure to infant crying). When the effects of prenatal cocaine use were examined in the context of polydrug use, results of model testing indicated that lower gestational age, prenatal exposure to cocaine and postnatal exposure to alcohol were each associated with a reduced suppression of RSA during the empathy task. These findings provide additional support for an association between prenatal cocaine exposure and dysregulation during early childhood during affect-eliciting environmental challenges.
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Affiliation(s)
- Pamela Schuetze
- Department of Psychology, State University of New York College at Buffalo, 1300 Elmwood Avenue, Buffalo, NY 14222-1095, United States; Research Institute on Addictions, SUNY University at Buffalo, 1021 Main Street, Buffalo, NY 14203, United States; Department of Pediatrics, SUNY University at Buffalo School of Medicine, Buffalo, NY, United States.
| | - Rina D Eiden
- Research Institute on Addictions, SUNY University at Buffalo, 1021 Main Street, Buffalo, NY 14203, United States; Department of Pediatrics, SUNY University at Buffalo School of Medicine, Buffalo, NY, United States.
| | - Danielle S Molnar
- Research Institute on Addictions, SUNY University at Buffalo, 1021 Main Street, Buffalo, NY 14203, United States.
| | - Craig D Colder
- Department of Psychology, SUNY University at Buffalo, Buffalo, NY, United States.
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15
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Finger B, Schuetze P, Eiden RD. Behavior problems among cocaine exposed children: role of physiological regulation and parenting. Neurotoxicol Teratol 2014; 42:51-9. [PMID: 24480789 PMCID: PMC4163043 DOI: 10.1016/j.ntt.2014.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Revised: 12/03/2013] [Accepted: 01/02/2014] [Indexed: 11/27/2022]
Abstract
This study examined interrelations between prenatal cocaine exposure, child autonomic regulation, parenting behavior and child sex on parent-reported behavior problems at 36 months of age. We hypothesized that respiratory sinus arrhythmia (RSA) at 13 months of age would mediate the relation between cocaine exposure and behavior problems. We also hypothesized that child sex, maternal negative affect, and maternal sensitivity observed at 13 months of age would moderate the relation between RSA and behavior problems. Results revealed that cocaine exposure predicted low baseline RSA and low RSA withdrawal during a negative affect task. Low baseline RSA, in turn, predicted fewer behavior problems offering support for an indirect association between cocaine exposure and behavior problems. The association between baseline RSA and behavior problems was further moderated by maternal negative affect such that high baseline RSA was more strongly related to behavior problems under conditions of high compared to low maternal negative affect. Results also revealed a near significant trend for baseline RSA to be more strongly related to behavior problems among boys than girls. These findings highlight several possible pathways toward behavior problems among cocaine exposed children.
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Affiliation(s)
- Brent Finger
- Montana State University Billings, 1500 University Drive, Billings, MT 59101, United States.
| | - Pamela Schuetze
- Psychology Department, Buffalo State College, 1300 Elmwood Avenue, Buffalo, NY 14222, United States
| | - Rina D Eiden
- Montana State University Billings, 1500 University Drive, Billings, MT 59101, United States; Research Institute on Addictions, State University of New York at Buffalo, 1021 Main Street, Buffalo, NY 14203, United States
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16
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Prenatal substance exposure: neurobiologic organization at 1 month. J Pediatr 2013; 163:989-94.e1. [PMID: 23743094 PMCID: PMC3773295 DOI: 10.1016/j.jpeds.2013.04.033] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 03/20/2013] [Accepted: 04/16/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine the autonomic nervous system and neurobehavioral response to a sustained visual attention challenge in 1-month-old infants with prenatal substance exposure. STUDY DESIGN We measured heart rate, respiratory sinus arrhythmia, and neurobehavior during sustained visual orientation tasks included in the Neonatal Intensive Care Unit Network Neurobehavioral Scale in 1129 1-month-old infants with prenatal substance exposure. Four groups were compared: infants with prenatal cocaine and opiate exposure, infants with cocaine exposure, infants with opiate exposure, and infants with exposure to other substances (ie, alcohol, marijuana, and tobacco). RESULTS The infants with prenatal exposure to both cocaine and opiates had the highest heart rates and lowest levels of respiratory sinus arrhythmia during a sustained visual attention challenge compared with the other 3 groups. Infants with prenatal cocaine and opiate exposure had poorer quality of movement and more hypertonicity during the Neonatal Intensive Care Unit Network Neurobehavioral Scale examination. They also had more nonoptimal reflexes and stress/abstinence signs compared with infants with prenatal exposure to cocaine only and those with prenatal exposure to alcohol, tobacco, and marijuana. CONCLUSION Problems with arousal regulation were identified in infants with prenatal substance exposure. Autonomic dysregulation has been implicated as a mechanism by which these difficulties occur. Our results suggest that infants with prenatal exposure to both cocaine and opiates have the greatest autonomic response to the challenge of a sustained visual attention task, possibly putting these infants at risk for problems associated with physiologic and behavioral regulation, a necessary prerequisite for early learning.
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17
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Conradt E, Abar B, Sheinkopf S, Lester B, Lagasse L, Seifer R, Shankaran S, Bada-Ellzey H, Bauer C, Whitaker T, Hinckley M, Hammond J, Higgins R. The role of prenatal substance exposure and early adversity on parasympathetic functioning from 3 to 6 years of age. Dev Psychobiol 2013; 56:821-35. [PMID: 24002807 DOI: 10.1002/dev.21155] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 06/25/2013] [Indexed: 12/15/2022]
Abstract
We employed latent growth curve analysis to examine trajectories of respiratory sinus arrhythmia (RSA) from 3 to 6 years among children with varying levels of prenatal substance exposure and early adversity. Data were drawn from a prospective longitudinal study of prenatal substance exposure that included 1,121 participants. Baseline RSA and RSA reactivity to an attention-demanding task were assessed at 3, 4, 5, and 6 years. Overall, there were significant individual differences in the trajectories of RSA reactivity, but not baseline RSA, across development. Greater levels of prenatal substance exposure, and less exposure to early adversity, were associated with increased RSA reactivity at 3 years, but by 6 years, both were associated with greater RSA reactivity. Prenatal substance exposure had an indirect influence through early adversity on growth in RSA reactivity. Results are in support of and contribute to the framework of allostatic load.
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Affiliation(s)
- Elisabeth Conradt
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Brown Center for the study of Children at Risk; Department of Psychiatry, Warren Alpert Medical School of Brown University.
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18
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Propper CB, Holochwost SJ. The influence of proximal risk on the early development of the autonomic nervous system. DEVELOPMENTAL REVIEW 2013. [DOI: 10.1016/j.dr.2013.05.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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19
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Oppenheimer JE, Measelle JR, Laurent HK, Ablow JC. Mothers' vagal regulation during the Still-Face Paradigm: normative reactivity and impact of depression symptoms. Infant Behav Dev 2013; 36:255-67. [PMID: 23454427 PMCID: PMC3615144 DOI: 10.1016/j.infbeh.2013.01.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 12/02/2012] [Accepted: 01/12/2013] [Indexed: 10/27/2022]
Abstract
This study examined mothers' physiological reactivity in response to infant distress during the Still-Face Paradigm. We aimed to explore normative regulatory profiles and associated physiological and behavioral processes in order to further our understanding of what constitutes regulation in this dyadic context. We examined physiological patterns--vagal tone, indexed by respiratory sinus arrhythmia (RSA)--while mothers maintained a neutral expression over the course of the still face episode, as well as differential reactivity patterns in mothers with depression symptoms compared to non-depressed mothers. Behavioral and physiological data were collected from mothers of 5-month-old infants during the emotion suppression phase of the Still-Face Paradigm. We used Hierarchical Linear Modeling to examine changes in mothers' RSA during infant distress and explored maternal depression as a predictor of physiological profiles. Mothers were generally able to maintain a neutral expression and simultaneously demonstrated a mean-level increase in RSA during the still face episode compared to baseline, indicating an active regulatory response overall. A more detailed time-course examination of RSA trajectories revealed that an initial RSA increase was typically followed by a decrease in response to peak infant distress, suggesting a physiological mobilization response. However, this was not true of mothers with elevated depressive symptoms, who showed no change in RSA during infant distress. These distinct patterns of infant distress-related physiological activation may help to explain differences in maternal sensitivity and adaptive parenting.
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20
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Schuetze P, Eiden RD, Colder CR, Gray TR, Huestis MA. Physiological Regulation at 9 Months of Age in Infants Prenatally Exposed to Cigarettes. INFANCY 2013; 18:233-255. [PMID: 23646002 PMCID: PMC3640595 DOI: 10.1111/j.1532-7078.2012.00118.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The primary purpose of this study was to examine the association between prenatal cigarette exposure and physiological regulation at 9 months of age. Specifically, we explored the possibility that any association between prenatal cigarette exposure and infant physiological regulation was moderated by postnatal environmental tobacco smoke (ETS) exposure or infant gender. We evaluated whether male infants with prenatal cigarette exposure or infants who were also exposed to ETS after birth had the highest levels of physiological dysregulation. Respiratory sinus arrhythmia (RSA) was obtained from 206 (142 exposed and 64 nonexposed) infants during a baseline period and during procedures designed to elicit both positive and negative affect. There was a significant suppression of RSA during the negative affect task for nonexposed infants but not for exposed infants. Postnatal ETS exposure did not moderate this association; however, gender did moderate this association such that boys with prenatal cigarette exposure had a significant increase in RSA rather than the suppression seen among both nonexposed boys and girls. These results provide additional support for the idea that boys are particularly vulnerable to the effects of prenatal cigarette exposure.
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Affiliation(s)
- Pamela Schuetze
- Department of Psychology, Buffalo State College
- Research Institute on Addictions, University at Buffalo
| | - Rina D. Eiden
- Research Institute on Addictions, University at Buffalo
| | | | - Teresa R. Gray
- Chemistry and Drug Metabolism Intramural Research Program, National Institute on Drug Abuse
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism Intramural Research Program, National Institute on Drug Abuse
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Schuetze P, Molnar DS, Eiden RD. Profiles of Reactivity in Cocaine-Exposed Children. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2012. [PMID: 23204615 DOI: 10.1016/j.appdev.2012.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study explored the possibility that specific, theoretically consistent profiles of reactivity could be identified in a sample of cocaine-exposed infants and whether these profiles were associated with a range of infant and/or maternal characteristics. Cluster analysis was used to identify distinct groups of infants based on physiological, behavioral and maternal reported measures of reactivity. Five replicable clusters were identified which corresponded to 1) Dysregulated/High Maternal Report Reactors, 2) Low Behavioral Reactors, 3) High Reactors, 4) Optimal Reactors and 5) Dysregulated/Low Maternal Report Reactors. These clusters were associated with differences in prenatal cocaine exposure status, birthweight, maternal depressive symptoms, and maternal negative affect during mother-infant interactions. These results support the presence of distinct reactivity profiles among high risk infants recruited on the basis of prenatal cocaine exposure and demographically similar control group infants not exposed to cocaine.
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Affiliation(s)
- Pamela Schuetze
- Department of Psychology, State University of New York College at Buffalo, 1300 Elmwood Avenue, Buffalo, NY 14222-1095 ; Research Institute on Addictions, SUNY University at Buffalo, 1021 Main Street, Buffalo, NY 14203 ; Department of Pediatrics, SUNY University at Buffalo School of Medicine, Buffalo, NY
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22
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Motz M, Espinet SD, Jeong JJ, Zimmerman P, Chamberlin J, Pepler DJ. Use of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0-3R) with Canadian Infants and Young Children Prenatally Exposed to Substances. Infant Ment Health J 2012. [DOI: 10.1002/imhj.21351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Mary Motz
- Mothercraft, Toronto and York University
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23
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The impact of optimality on maternal sensitivity in mothers with substance abuse and psychiatric problems and their infants at 3 months. Infant Behav Dev 2012; 35:60-70. [DOI: 10.1016/j.infbeh.2011.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 03/09/2011] [Accepted: 09/28/2011] [Indexed: 11/21/2022]
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24
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Accornero VH, Anthony JC, Morrow CE, Xue L, Mansoor E, Johnson AL, McCoy CB, Bandstra ES. Estimated effect of prenatal cocaine exposure on examiner-rated behavior at age 7 years. Neurotoxicol Teratol 2011; 33:370-8. [PMID: 21640292 DOI: 10.1016/j.ntt.2011.02.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Revised: 02/21/2011] [Accepted: 02/24/2011] [Indexed: 01/24/2023]
Abstract
UNLABELLED Prenatal cocaine exposure has been linked to increased child behavior difficulties in some studies but not others. OBJECTIVE The primary aim was to estimate the relationship between in utero cocaine exposure and child behavioral functioning at age 7 years with ratings made by blinded examiners during a structured testing session. A second aim was to examine whether caregiver drug use and psychological problems might mediate suspected relationships between prenatal cocaine exposure and aspects of examiner-rated behavior. METHODS 407 children (212 cocaine-exposed, 195 non-exposed) participating in the longitudinal Miami Prenatal Cocaine Study (MPCS) were rated with regard to their behavior during a neuropsychological assessment conducted at age 7 years. Raters were trained research psychometricians blinded to drug exposure status. Individual behavioral items were summarized and the cocaine-behavior relationship was estimated within the context of latent variable modeling, using Mplus software. RESULTS Two latent variables, Behavioral Regulation and Sociability, were derived via exploratory latent structure analysis with promax rotation. Prenatal cocaine exposure, statistically controlling for child sex, test age, and prenatal exposure to alcohol, tobacco, and marijuana, was associated with Behavioral Regulation (estimated slope ß=-0.25; 95% CI=-0.48, -0.02; p=0.04) but not Sociability (estimated slope ß=-0.03; 95% CI=-0.26, 0.20; p=0.79). Neither postnatal drug use by caregivers nor the severity of their psychological problems at age 5 follow-up predicted levels of child Behavioral Regulation or Sociability at age 7 years (p>0.10). CONCLUSIONS Examiner ratings of child behavior at age 7 revealed less optimal behavioral regulation for prenatally cocaine-exposed compared to non-exposed children, in contrast with what had been previously found from parent-report data. This evidence highlights the potential value of trained observers in assessing behavioral outcomes of children exposed in utero to drugs and other toxicants.
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Affiliation(s)
- Veronica H Accornero
- University of Miami Miller School of Medicine, Department of Pediatrics, Miami, FL 33101, United States.
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25
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Minnes S, Lang A, Singer L. Prenatal tobacco, marijuana, stimulant, and opiate exposure: outcomes and practice implications. Addict Sci Clin Pract 2011; 6:57-70. [PMID: 22003423 PMCID: PMC3188826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Abuse of drugs by pregnant women both in the United States and worldwide has raised many questions regarding the effects of prenatal drug exposure on the developing fetus and subsequent child outcomes. Studies using the neurobehavioral teratology model have been undertaken to determine specific prenatal drug effects on cognitive and behavioral development. Here we summarize the findings of studies that have investigated the developmental effects of prenatal exposure to tobacco, marijuana, stimulants, and opiates. These studies consider the timing and amount of prenatal exposure; other drug exposures; maternal characteristics; and other health, nutritional, and environmental factors. We review treatment options for pregnant, substance-dependent women and therapeutic interventions for exposed children.
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Affiliation(s)
- Sonia Minnes
- Mandel School of Applied Social Sciences Case Western Reserve University, Cleveland, Ohio,CORRESPONDENCE: Sonia Minnes, Case Western Reserve University, 11235 Bellflower Road, Room 304, Cleveland, OH 44106; e-mail:
| | - Adelaide Lang
- Mandel School of Applied Social Sciences Case Western Reserve University, Cleveland, Ohio
| | - Lynn Singer
- School of Medicine Case Western Reserve University, Cleveland, Ohio
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26
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Chaplin TM, Freiburger MB, Mayes LC, Sinha R. Prenatal cocaine exposure, gender, and adolescent stress response: a prospective longitudinal study. Neurotoxicol Teratol 2010; 32:595-604. [PMID: 20826209 PMCID: PMC2983086 DOI: 10.1016/j.ntt.2010.08.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 08/23/2010] [Accepted: 08/26/2010] [Indexed: 11/18/2022]
Abstract
Prenatal cocaine exposure is associated with alterations in arousal regulation in response to stress in young children. However, relations between cocaine exposure and stress response in adolescence have not been examined. We examined salivary cortisol, self-reported emotion, heart rate, and blood pressure (BP) responses to the Trier Social Stress Test (TSST) in 49 prenatally cocaine and other drug exposed (PCE) and 33 non-cocaine-exposed (NCE) adolescents. PCE adolescents had higher cortisol levels before and after stress exposure than NCE adolescents. PCE girls showed an elevated anxiety response to stress (compared to NCE girls) and PCE boys showed a dampened diastolic BP response (compared to NCE boys). Girls showed higher anger response and lower pre-stress systolic BP than boys. Group differences were found controlling for potential confounding variables and were not moderated by caregiver-child relationship quality (although relationship quality predicted HPA axis and anxiety response). The findings suggest that prenatal drug exposure is associated with altered stress response in adolescence and that gender moderates this association.
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Affiliation(s)
- Tara M Chaplin
- Department of Psychiatry, Yale University School of Medicine, USA.
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27
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Kulaga V, Shor S, Koren G. Correlation between drugs of abuse and alcohol by hair analysis: parents at risk for having children with fetal alcohol spectrum disorder. Alcohol 2010; 44:615-21. [PMID: 20580184 DOI: 10.1016/j.alcohol.2010.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2008] [Revised: 11/13/2009] [Accepted: 04/15/2010] [Indexed: 10/19/2022]
Abstract
The fatty acid ethyl esters (FAEEs) hair test, a biomarker of excessive alcohol exposure, has demonstrated its potential for use in fetal alcohol spectrum disorder (FASD) diagnosis. FASD may be compounded by polydrug exposure. Our objective was to determine the likelihood of positive FAEE test among parents testing positive for other drugs of abuse. Samples submitted for FAEE hair analysis by Children's Aid Societies between October 2005 and May 2007, also concurrently tested for cocaine, cannabinoids, opiates, methamphetamine, amphetamine, benzodiazepines, methadone, and/or oxycodone, were included in our analysis. Subjects consisted of parents suspected of using excessive amounts of alcohol. Parents testing positive for drugs of abuse had a significantly increased risk for testing positive for high FAEE. Mothers testing positive for heavy chronic alcohol use were found to have a threefold increased risk of testing positive for cocaine (odds ratio=3.26, 1.1-9.7). Our results suggest that parents abusing stimulants are at risk of high alcohol exposure, which put their unborn children at risk for FASD.
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28
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Schuetze P, Eiden RD, Danielewicz S. The association between prenatal cocaine exposure and physiological regulation at 13 months of age. J Child Psychol Psychiatry 2009; 50:1401-9. [PMID: 19744182 PMCID: PMC3082947 DOI: 10.1111/j.1469-7610.2009.02165.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study examined the association between prenatal cocaine exposure (PCE) and autonomic regulation at 13 months of age. METHODS Measures of respiratory sinus arrhythmia (RSA) were obtained from 156 (79 exposed, and 77 nonexposed) infants during baseline and during tasks designed to elicit positive (PA) and negative affect (NA). RESULTS There was a significant suppression of RSA during the negative affect task for nonexposed infants but not for exposed infants. Maternal symptoms of depression or anxiety (MDA) did not mediate this association. However, gender and MDA did moderate this association such that exposed boys and exposed infants whose mothers had higher levels of MDA had an increase in RSA during a task designed to elicit NA rather than the typical pattern of RSA suppression. CONCLUSIONS These results suggest that there are several possible pathways from PCE to physiological dysregulation during late infancy.
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Affiliation(s)
- Pamela Schuetze
- Department of Psychology, Buffalo State College, 1300 Elmwood Avenue, Buffalo, NY 14222-1095, USA.
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29
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Prenatal cocaine exposure alters emotional arousal regulation and its effects on working memory. Neurotoxicol Teratol 2009; 31:342-8. [PMID: 19699795 DOI: 10.1016/j.ntt.2009.08.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2008] [Revised: 07/17/2009] [Accepted: 08/11/2009] [Indexed: 11/20/2022]
Abstract
While prenatal cocaine exposure (PCE) has been associated with arousal dysregulation and attentional impairments in both human and animal studies, the neurobiological bases of these teratogenic effects have not been well characterized. In the current study, we report functional neuroimaging observations of these effects in exposed youth. Using functional magnetic resonance imaging (fMRI), we embedded task-irrelevant emotional distracters in a working memory task to examine the interaction of emotional arousal and memory in 33 PCE and 23 non-exposed adolescents. Though with similar behavioral performance, the two groups exhibited different activation patterns associated with emotion-memory interactions. On the one hand, higher memory load attenuated emotion-related amygdala activation in controls but not in the exposed adolescents; on the other hand, prefrontal activation associated with memory load decreased in the presence of emotional distraction in the controls but increased in the exposed group. These group interaction differences suggest neurobiological substrates for arousal-associated neuronal alterations related to prenatal cocaine exposure. Consistent with previous findings in behavioral and physiological studies, the present neuroimaging data provided more in-depth evidence supporting the view that PCE has significant long-term teratogenic effect on arousal regulation system.
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30
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Eyler FD, Warner TD, Behnke M, Hou W, Wobie K, Garvan CW. Executive functioning at ages 5 and 7 years in children with prenatal cocaine exposure. Dev Neurosci 2009; 31:121-36. [PMID: 19372693 PMCID: PMC3155819 DOI: 10.1159/000207500] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Accepted: 10/10/2008] [Indexed: 11/19/2022] Open
Abstract
This prospective longitudinal study evaluated the effect of prenatal cocaine exposure (PCE) on executive functioning in 5- and 7-year-old children. In total, 154 pregnant cocaine users, identified by urine toxicology and structured interviews, were matched to 154 nonusers. Children were assessed by certified masked evaluators, and caregivers were interviewed by experienced staff during home visits. In approximately 90% of the surviving sample tested at ages 5 and 7 years, structural equation modeling demonstrated that an increased head circumference at birth (adjusted for gestation) significantly predicted better performance on executive functioning, and that PCE was indirectly related to executive functioning through its significant negative effect on head circumference at birth. At age 5 years, quality of environment also predicted executive functioning, and the R(2) for the total model was 0.24. At 7 years, caregiver functioning predicted quality of environment, which in turn was positively related to executive functioning, and girls had better executive functioning. The total model at age 7 years accounted for 30% of the variance in executive functioning.
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Affiliation(s)
- Fonda Davis Eyler
- Department of Pediatrics, University of Florida, PO Box 100296, Gainesville, FL 32610-0296, USA.
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31
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Meyer KD, Zhang L. Short- and long-term adverse effects of cocaine abuse during pregnancy on the heart development. Ther Adv Cardiovasc Dis 2009; 3:7-16. [PMID: 19144667 DOI: 10.1177/1753944708099877] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The effect of cocaine on the developing fetus is a topic of considerable interest and debate. One of the potential effects of fetal cocaine exposure is damage to the developing heart. This review provides an overview of the current understanding of the short- and long-term effects of fetal cocaine exposure on the heart in both humans and animal models. Human studies are still preliminary but have suggested that fetal cocaine exposure impacts on the developing heart. Studies in animal models provide strong evidence for a programming effect resulting in detrimental long-term changes to the heart induced by fetal cocaine exposure. In the rat model, fetal cocaine results in apoptosis in the term heart, left ventricular remodeling and myocyte hypertrophy, as well as increased sensitivity to ischemia/reperfusion injury in the adult male offspring. The rat model has also shown evidence of epigenetic modifications in response to intrauterine cocaine. Increased DNA methylation of promoter regions leads to a long-term decrease in the expression of the cardioprotective gene, PKCepsilon. The current data shows fetal cocaine exposure has significant immediate and long-term cardiac consequences in animal models and while human studies are still incomplete they suggest this phenomenon may also be significant in humans exposed to cocaine during development.
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Affiliation(s)
- Kurt D Meyer
- Center for Perinatal Biology, Department of Physiology/Pharmacology and Biochemistry, Loma Linda University, School of Medicine, Loma Linda, California 92350, USA.
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Abstract
This study examined the effects of prenatal cocaine exposure on infant hypothalamic-pituitary-adrenal axis activity and reactivity at 7 months of infant age. Participants were 168 caregiver-infant dyads (87 cocaine exposed, 81 not cocaine exposed; 47% boys). Maternal behavior, caregiving instability, and infant growth and behavior were assessed, and children's saliva was sampled before, during, and after standardized procedures designed to elicit emotional arousal. Results revealed cocaine-exposed infants had a high amplitude trajectory of cortisol reactivity compared to non-cocaine-exposed infants. Infant gender and caregiving instability moderated this association. The findings support a dual hazard vulnerability model and have implications for evolutionary-developmental theories of individual differences in biological sensitivity to context.
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Affiliation(s)
- Rina D Eiden
- University at Buffalo, State University of New York, USA.
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Eiden RD, McAuliffe S, Kachadourian L, Coles C, Colder C, Schuetze P. Effects of prenatal cocaine exposure on infant reactivity and regulation. Neurotoxicol Teratol 2009; 31:60-8. [PMID: 18822371 PMCID: PMC2631277 DOI: 10.1016/j.ntt.2008.08.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Revised: 07/21/2008] [Accepted: 08/22/2008] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to examine the role of prenatal cocaine exposure and associated risk factors on infant reactivity and regulation at 7 months of infant age. Participants consisted of 167 mother-infant dyads participating in an ongoing longitudinal study of prenatal cocaine exposure, who completed the arm restraint procedure at the 7-month assessment (87 cocaine exposed, 80 non-cocaine exposed). We hypothesized that cocaine exposed infants would display higher arousal or reactivity and lower regulation during a procedure designed to arouse anger/frustration. Results indicated that cocaine exposed infants were more reactive to increases in the level of stress from trial 1 to trial 2 but exhibited no change in the number of regulatory strategies as stress increased, unlike the control group infants. Infant birth weight moderated the association between cocaine exposure and infant regulation. Among cocaine exposed infants, those with lower birth weight displayed higher reactivity compared to those with higher birth weight. Contrary to expectations, there were no indirect effects between cocaine exposure and infant reactivity/regulation via environmental risk, parenting, or birth weight. Results are supportive of a teratological model of prenatal cocaine exposure for infant reactivity/regulation in infancy.
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Affiliation(s)
- Rina D Eiden
- University at Buffalo, State University at New York, Buffalo, NY 14203, USA.
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Kable JA, Coles CD, Lynch ME, Platzman K. Physiological responses to social and cognitive challenges in 8-year olds with a history of prenatal cocaine exposure. Dev Psychobiol 2008; 50:251-65. [DOI: 10.1002/dev.20285] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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