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Min MO, Albert JM, Minnes S, Kim JY, Kim SK, Singer LT. Prenatal cocaine exposure and self-reported behavioral adjustments from ages 12 to 21: environmental pathways. Psychol Med 2024; 54:721-731. [PMID: 37614188 DOI: 10.1017/s0033291723002404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
BACKGROUND In a birth-cohort study, we followed offspring with prenatal cocaine exposure (PCE) to investigate longitudinal associations of PCE with self-reported behavioral adjustment from early adolescence to emerging adulthood (EA). Environmental pathways (family functioning, non-kinship care, maltreatment) were specified as potential mediators of PCE. METHODS Participants were 372 (190 PCE; 47% male), primarily Black, low socioeconomic status, enrolled at birth. Internalizing and externalizing behaviors were assessed using Youth Self-Report at ages 12 and 15 and Adult Self-Report at age 21. Extended random-intercept cross-lagged panel modeling was used to account for potential bidirectional relationships between internalizing and externalizing behaviors over time, examining potential mediators. RESULTS Adjusting for covariates, significant indirect effects were found for each mediator at different ages. For family functioning, these were both internalizing (β = 0.83, p = 0.04) and externalizing behaviors (β = 1.58, p = 0.02) at age 12 and externalizing behaviors at age 15 (β = 0.51, p = 0.03); for non-kinship care, externalizing behaviors at ages 12 (β = 0.63, p = 0.02) and 15 (β = 0.20, p = 0.03); and for maltreatment, both internalizing and externalizing behaviors at ages 15 (β = 0.64, p = 0.02 for internalizing; β = 0.50, p = 0.03 for externalizing) and 21 (β = 1.39, p = 0.01 for internalizing; β = 1.11, p = 0.01 for externalizing). Direct associations of PCE with internalizing and externalizing behaviors were not observed, nor cross-lagged relationships between internalizing and externalizing behaviors. CONCLUSIONS Negative associations of PCE with behavioral adjustment persist into EA via environmental pathways, specifying intervention points to disrupt adverse pathways toward healthy development.
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Affiliation(s)
- Meeyoung O Min
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
| | - Jeffrey M Albert
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sonia Minnes
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - June-Yung Kim
- Department of Social Work, College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks North Dakota, USA
| | - Sun-Kyung Kim
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Lynn T Singer
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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Richardson GA, De Genna NM, Willford JA, Goldschmidt L. Pathways from prenatal cocaine exposure to adult substance use and behavior. Neurotoxicol Teratol 2024; 102:107335. [PMID: 38373556 PMCID: PMC10990782 DOI: 10.1016/j.ntt.2024.107335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 01/24/2024] [Accepted: 02/14/2024] [Indexed: 02/21/2024]
Abstract
This is a report from the most recent adult follow-up of the longest running cohort study of prenatal cocaine exposure (PCE), in which women were enrolled prenatally and offspring were assessed in infancy, childhood, adolescence, and young adulthood. In previous studies, PCE was linked to offspring behavior problems such as early substance use and externalizing behavior problems. The current analyses examine pathways from PCE to behavioral outcomes in offspring at the 25-year assessment. Prenatal cocaine exposure was moderate in this cohort; most women decreased or discontinued use after the first trimester. During the first and third trimesters, 38% and 11% used cocaine, respectively. This represents the most common pattern of PCE in non-treatment samples. At this phase, the adult offspring were, on average, 27.3 years old (range = 25-30), had 13.4 years of education, 83% were employed, 55% were Black, and 55% were female. Offspring who were exposed to cocaine during the first trimester were significantly more likely to use marijuana in the past year, report more arrests, and have poorer scores on a decision-making task, controlling for other prenatal substance exposure, demographic, and socioeconomic factors. In mediation analyses, there were indirect pathways from PCE to current marijuana use through early initiation of marijuana use and 21-year marijuana use, and through 15-year status offenses and 21-year marijuana use. There was also an indirect pathway from PCE to lifetime arrests through early initiation of marijuana use and 21-year Conduct Disorder, although the direct pathway from PCE to arrests also remained significant. These findings are consistent with those from previous phases and are an indication that there are detrimental associations with PCE that persist across developmental stages and into adulthood.
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Affiliation(s)
- Gale A Richardson
- University of Pittsburgh School of Medicine, Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, United States of America.
| | - Natacha M De Genna
- University of Pittsburgh School of Medicine, Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, United States of America
| | - Jennifer A Willford
- Department of Psychology, Slippery Rock University, 1 Morrow Way, Slippery Rock, PA 16057, United States of America
| | - Lidush Goldschmidt
- University of Pittsburgh Medical Center, 3811 O'Hara Street, Pittsburgh, PA 15213, United States of America
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Singer LT, Powers G, Kim JY, Minnes S, Min MO. Cognitive and functional outcomes at age 21 after prenatal cocaine/polydrug exposure and foster/adoptive care. Neurotoxicol Teratol 2023; 96:107151. [PMID: 36623610 PMCID: PMC9992024 DOI: 10.1016/j.ntt.2023.107151] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Prenatal cocaine exposure (PCE) has been linked to specific cognitive deficits and behavioral outcomes through early adolescence but there is little information on adult outcomes nor on the relationship of environmental interventions, such as foster/adoptive care, to outcomes. METHODS At 21 years, data were available on 325 young adults, [163 PCE and 162 non-exposed (NCE)], primarily African-American, with low SES, who were followed from birth in a prospective longitudinal cohort study. Participants were administered the Wechsler Abbreviated Scale of Intelligence (WASI-II) and surveyed regarding high school completion, problematic substance use, and incarceration/probation history. In the PCE group, 32 remained in non-kinship foster/adoptive care (PCE/FA) from early in life (< 4 years) to 17 years. Group differences were examined through t-tests, MANOVA/ MANCOVA with post-hoc analyses, comparing outcomes and environmental correlates of young adults with PCE vs. NCE, as well as outcomes of PCE young adults in non-kinship foster/adoptive care (PCE/ FA) vs. PCE in birth/kinship care and NCE young adults. RESULTS At 21 years, young adults with PCE had lower mean Full Scale (83.7 ± 10.4 vs. 87.3 ± 12.5, p < .01) and Perceptual Reasoning IQs (87.3 ± 11.5 vs. 91.4 ± 13.9, (p < .02), lower high school completion rates (75% vs. 86%, p < .02), and were marginally more likely to have been on probation than NCE young adults, but did not differ in Verbal IQ, self-report of problematic substance use or incarceration. Young adults with PCE in F/A had similar lower IQ scores but had better verbal skills and high school graduation rates that did not differ from NCE young adults (80.6 vs 86.2%, p > .05). They had higher drug exposure at birth and more experiences of maltreatment (p's < 0.05) but their home environment quality was better and lead levels lower (p's < 0.05) than those of young adults with PCE in birth/kinship care. CONCLUSIONS Young adults with PCE had lower Perceptual Reasoning and Full-Scale IQ scores, independent of caregiving placement, compared to non-exposed young adults. Young adults with PCE placed in non-kinship foster/adoptive care had lower lead levels, more stimulating home environments, better vocabulary skills and were more likely to graduate from high school than those in birth/kinship care,but were not different in their self-report of problematic substance use, or experiences of incarceration or probation. Our data suggest that some cognitive deficits observed in young adults with PCE may be biologically based, but that some functional outcomes can be modified through environmental interventions. Our data also reflect the complexity of disentangling the effects of teratologic exposures on long term outcomes across a variety of domains and the need for studies of children in the foster care system.
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Affiliation(s)
- Lynn T Singer
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, 1090 Euclid Avenue, Cleveland, OH 44106, United States.
| | - Gregory Powers
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, 11235 Bellflower Road, Cleveland, OH, United States.
| | - June-Yung Kim
- Department of Social Work, University of North Dakota, Gillette Hall Room 302, 225 Centennial Dr. Stop 7135, Grand Forks, ND 58202-7135, United States.
| | - Sonia Minnes
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, 11235 Bellflower Road, Cleveland, OH, United States.
| | - Meeyoung O Min
- College of Social Work, University of Utah, 201 Presidents Circle, Salt Lake City, UT 84112, United States.
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Min MO, Minnes S, Kim SK, Kim JY, Singer LT. Prenatal cocaine exposure and substance use disorder in emerging adulthood at age 21. Drug Alcohol Depend 2023; 242:109736. [PMID: 36516550 PMCID: PMC9772296 DOI: 10.1016/j.drugalcdep.2022.109736] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Prenatal cocaine exposure (PCE) has been associated with child and adolescent externalizing behaviors and early substance use, yet few studies investigated its association with substance use disorder (SUD) in emerging adults. The present study examined the association of PCE with SUD in emerging adulthood, and whether childhood externalizing behaviors and adolescent substance use mediated the relationship. METHODS Participants were 367 (187 PCE; 53% female) adults at age 21, primarily urban African American who were recruited at birth. PCE and exposure to alcohol, tobacco, and marijuana were determined using biologic assays for drug metabolites and/or maternal self-report at birth. Offspring externalizing problems were assessed using the Youth Self-Report at age 12, substance use and substance use-related problems via biologic assays and/or self-report at age 15, and SUD determined using DSM-5 diagnostic criteria at age 21. RESULTS About 32.3% of the emerging adults were determined to have marijuana use disorder, 30.3% tobacco use disorder, and 15.5% alcohol use disorder. PCE was related to greater externalizing behaviors at age 12 (β = 0.12, p = .042), which in turn was related to SUD (β = 0.22, p = .008). PCE was also related to substance use, mainly marijuana, at age 15 (β = 0.22, p = .011), which was related to SUD (β = 0.51, p < .001). Total indirect effects including these two pathways were significant (β = 0.19, p = .002). CONCLUSIONS PCE may increase risk for SUD in emerging adulthood through childhood externalizing behaviors and adolescent substance use.
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Affiliation(s)
| | - Sonia Minnes
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, USA
| | - Sun-Kyung Kim
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, USA
| | - June-Yung Kim
- Department of Social Work, College of Nursing and Professional Disciplines, University of North Dakota, USA
| | - Lynn T Singer
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, USA
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Kim JY, Minnes S, Min MO, Ridenour TA. Co-occurrence of Psychopathology Problems in At-Risk Adolescents. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022; 44:1110-1125. [PMID: 37840844 PMCID: PMC10569334 DOI: 10.1007/s10862-022-09980-w] [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: 08/20/2021] [Revised: 02/24/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
No known studies have investigated co-occurrence of psychopathology problems in adolescents with biologic and/or environmental susceptibility, including prenatal drug exposure. This study identified comorbidity patterns of psychopathology problems by utilizing data from urban, primarily African American, youth, majority of whom were at heightened risk for exposure to drugs in utero. The roles of Research Domain Criteria (RDoC)-informed behavioral constructs of the Negative Valence (irritability) and Social Process Systems (social disinhibition) as antecedents of the comorbidity patterns were further examined. Lastly, the predictive validity of the identified patterns was evaluated in relation to emerging adulthood outcomes. Participants were 358 urban adolescents, primarily African Americans, drawn from a 21-year prospective birth-cohort study of the effects of prenatal drug exposure. Psychopathology problems were assessed at age 15. Irritability and social disinhibition were self-reported at age 12. Emerging adulthood outcomes were measured at age 21. Latent class modeling indicated four patterns: Normative (57%), substance-use (SU; 24%), mental-health-problems-without-substance-use (MH; 11%), and substance-use-and-other-mental-health-problems (SUMH; 7%). Higher irritability increased the odds of developing the MH pattern, whereas higher social disinhibition increased the odds of developing the SU pattern. The odds of manifesting the SUMH pattern were higher for children with higher irritability. For children with higher social disinhibition, the odds of manifesting the SUMH pattern were higher at a trend level. Adolescent comorbidity patterns were differentially associated with problematic tobacco and marijuana use and clinically relevant mental health problems in emerging adulthood, and completion of high school education. Peri-pubertal identification of individual differences in irritability and social disinhibition may mitigate the emergence of adolescent psychopathology, which could influence emerging adulthood adjustment in this at-risk population.
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Affiliation(s)
- June-Yung Kim
- University of North Dakota, College of Nursing and Professional Disciplines, Department of Social Work, Grand Forks, North Dakota
| | - Sonia Minnes
- Case Western Reserve University, Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, Ohio
| | - Meeyoung O. Min
- University of Utah, College of Social Work, Salt Lake City, Utah
| | - Ty A. Ridenour
- Research Triangle Institute International, Research Triangle Park, North Carolina
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Min MO, Kim JY, Minnes S, Kim SK, Musson Rose D, Singer LT. Substance use and individual assets in urban adolescents: Subgroups and correlates in emerging adulthood. J Adolesc 2022; 94:684-697. [PMID: 35615786 DOI: 10.1002/jad.12056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION To investigate patterns of divergence in adolescent adjustment, this study examined the co-occurring patterns of adolescents' individual assets (e.g., school engagement, values) and substance use, and whether the co-occurring patterns were associated with later functioning in emerging adulthood. METHODS Participants were 358 (54% females), predominantly African American, urban adolescents, recruited at birth for a prospective study on the effects of prenatal substance exposure in the Midwest United States. Individual assets, using the Developmental Assets Profile, substance use (alcohol, tobacco, marijuana), via biologic assays and self-report, and substance use-related problems were assessed at age 15 years. High-school completion, substance use disorder, mental health symptoms, and legal problems were assessed at age 21 years. RESULTS Latent class analysis identified five classes as follows: high assets with low substance use (C1, 10.2%); moderate assets with low substance use (C2, 28.7%); low assets with low substance use (C3, 32%); moderate assets with high substance use (C4, 9.4%); and low assets with high substance use (C5, 19.2%). Despite similar levels of assets, adolescents in C5 reported more life adversities (suboptimal caregiving environment, daily hassles, non-birth parents' care) than those in C3. C4 and C5 reported more substance use disorder at age 21 years than the three low substance use classes; adolescents in C5 were less likely to complete high school than those in C2. More females in C5 reported greater mental health symptoms than those in C1 and C3, and criminal justice involvement than those in C1. CONCLUSIONS The current findings underscore the significance of substance use in adolescence in disrupting healthy transition to adulthood, especially among females in the context of low individual assets.
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Affiliation(s)
- Meeyoung O Min
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
| | - June-Yung Kim
- Department of Social Work, College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, North Dakota, USA
| | - Sonia Minnes
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sun-Kyung Kim
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Devon Musson Rose
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
| | - Lynn T Singer
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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De Genna NM, Goldschmidt L, Richardson GA. Prenatal cocaine exposure, early cannabis use, and risky sexual behavior at age 25. Neurotoxicol Teratol 2022; 89:107060. [PMID: 34952173 PMCID: PMC8804968 DOI: 10.1016/j.ntt.2021.107060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/18/2021] [Accepted: 12/16/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Prior research on prenatal cocaine exposure (PCE) indicates that exposed children experience behavioral dysregulation resulting in risky adolescent behavior including earlier initiation of cannabis use and sexual intercourse. The goal of this study was to examine the long-term effects of PCE on adult sexual behavior. METHODS This is a prospective cohort study of the association between PCE and risky adult sexual behavior and sexually transmitted infections (STIs) in 202 young adults (mean age = 27, SD = 0.98 years). The sample was 55% female, 46% White, and 54% Black. Data from the prenatal, childhood, and adolescent phases of the study were used to delineate pathways from PCE to adult sexual behavior. RESULTS The most common risky sexual behavior was having sex while drunk or high (63%). One-third of the sample reported that they "almost always" had sex while drunk or high. We found evidence for an indirect pathway from PCE to adult sex while drunk or high via early cannabis initiation. There were no other effects of PCE on adult risky sexual behavior or on risk for STIs, after controlling for sex assigned at birth, race, age at sexual initiation, and family history of drug and alcohol problems. CONCLUSIONS Although PCE has been associated with earlier initiation of sex in prior studies, PCE was not directly associated with risky adult sex or history of STI. Exposed individuals were at greater risk of sex under the influence of alcohol or drugs via earlier initiation of cannabis use during adolescence.
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Affiliation(s)
- Natacha M. De Genna
- Corresponding Author. Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara St, Pittsburgh, PA, 15213, USA
| | | | - Gale A. Richardson
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara St, Pittsburgh, PA, 15213, USA
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Karpova N, Zhang D, Beckwith AM, Bennett DS, Lewis M. Prenatal drug exposure and executive function in early adolescence. Neurotoxicol Teratol 2021; 88:107036. [PMID: 34648914 DOI: 10.1016/j.ntt.2021.107036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 09/15/2021] [Accepted: 09/30/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE Study of the relationship between prenatal cocaine exposure (PCE) and executive function (EF) has yielded inconsistent results. The purpose of the current study is to examine whether PCE, biological sex, environmental risk, and their interaction predicted EF in early adolescence. METHODS 135 12-year-old adolescents (40.7% with PCE), who were followed prospectively from birth, attempted up to 8 Tower of Hanoi (ToH) puzzle trials of increasing complexity. The number of correctly completed puzzles served as the main outcome measure. Survival analysis was used to examine predictors of the number of successfully completed trials. RESULTS As trial difficulty increased, fewer adolescents were able to solve the TOH puzzle. Adolescents from high risk environments and with either prenatal alcohol or prenatal cannabis exposure completed fewer puzzles (p < .05). In addition, a hypothesized 3-way interaction of PCE x sex x environmental risk was found such that cocaine-exposed males with high environmental risk had the worst performance (p < .01). CONCLUSIONS The current findings are consistent with prior research indicating that males with PCE may be at particular risk of poorer functioning and highlight the potential importance of examining adolescent's sex and environmental risk as moderators of PCE effects.
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Affiliation(s)
- Natalia Karpova
- Rutgers Robert Wood Johnson Medical School, Institute for the Study of Child Development, Department of Pediatrics, 89 French Street, New Brunswick, NJ 08901, United States.
| | - Dake Zhang
- Rutgers the State University of New Jersey, Department of Educational Psychology, 10 Seminary Place, New Brunswick, NJ 08901, United States.
| | - Anna Malia Beckwith
- Children's Specialized Hospital, Rutgers Robert Wood Johnson Medical School, Department of Pediatrics, 150 New Providence Rd, Mountainside, NJ 07092, United States.
| | - David S Bennett
- Drexel University, GLAD Program, 4700 Wissahickon Avenue, Philadelphia, PA 19144, United States.
| | - Michael Lewis
- Rutgers Robert Wood Johnson Medical School, Institute for the Study of Child Development, 89 French Street, New Brunswick, NJ 08901, United States.
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Yoon M. Neighborhood structural characteristics, perceived neighborhood environment, and problem behaviors among at-risk adolescents. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:2639-2657. [PMID: 34051111 DOI: 10.1002/jcop.22621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/01/2021] [Accepted: 05/04/2021] [Indexed: 06/12/2023]
Abstract
Neighborhood environment has been linked to behavioral outcomes in adolescence. The current study examined two potential mediators (i.e., perceived social capital, perceived neighborhood disorder) in the association between neighborhood structural characteristics (i.e., neighborhood disorganization) and problem behaviors (i.e., externalizing behavior, substance use) among at-risk adolescents with prenatal substance exposure. The study sample included 350 15-year-old adolescents recruited at birth. Adolescents' addresses were linked to census tract data. Neighborhood structural characteristics were not directly associated with adolescent problem behaviors in the presence of perceived social capital and neighborhood disorder. Greater neighborhood disorganization was associated with lower levels of perceived social capital, which was related to greater perceived neighborhood disorder, and then problem behaviors. The findings suggest that community practice needs to focus on subjective perceptions of neighborhoods when developing intervention programs on problem behaviors among at-risk adolescents.
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Affiliation(s)
- Miyoung Yoon
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
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10
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Min MO, Minnes S, Momotaz H, Singer LT, Wasden A, Bearer CF. Fatty acid ethyl esters in meconium and substance use in adolescence. Neurotoxicol Teratol 2021; 83:106946. [PMID: 33340653 PMCID: PMC7855880 DOI: 10.1016/j.ntt.2020.106946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/10/2020] [Accepted: 12/13/2020] [Indexed: 12/19/2022]
Abstract
Prenatal alcohol exposure (PAE) continues to be a serious public health problem, yet no reliable clinical tools are available for assessing levels of drinking during pregnancy. Fatty acid ethyl esters (FAEEs), the nonoxidative metabolites of ethanol measured in meconium, are potential biomarkers to quantify the level of PAE. The association between the concentrations of FAEEs from meconium and adolescent substance use and related problems was examined in a prospective birth-cohort of adolescents exposed to alcohol and drugs in utero. FAEEs were quantified with gas chromatography via a flame ionization detector. Meconium was analyzed for FAEEs in 216 newborns; 183 of them (81 boys, 102 girls) were assessed at age 15 for alcohol, tobacco, and marijuana use using biologic assays and self-report. Substance use problems were assessed using the Problem Oriented Screening Instrument for Teenagers. Findings from multivariable logistic regression analyses indicated that, after controlling for other prenatal drug exposure and covariates, higher concentrations of FAEEs (ethyl myristate, ethyl palmitate, ethyl oleate, ethyl linoleate, ethyl linolenate, and ethyl arachidonate) were related to a greater likelihood of marijuana use and experiencing substance use problems, but not tobacco or alcohol use, at age 15. Elevated levels of FAEEs in meconium may be promising markers for PAE, identifying newborns at risk for early substance use and developing substance use problems.
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Affiliation(s)
- Meeyoung O Min
- College of Social Work, University of Utah, United States.
| | - Sonia Minnes
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, United States
| | - Hasina Momotaz
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, United States
| | - Lynn T Singer
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, United States
| | - Anna Wasden
- College of Social Work, University of Utah, United States
| | - Cynthia F Bearer
- Department of Pediatrics, Case Western Reserve University, United States
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Tung I, Christian-Brandt AS, Langley AK, Waterman JM. Developmental Outcomes of Infants Adopted from Foster Care: Predictive Associations from Perinatal and Preplacement Risk Factors. INFANCY 2020; 25:84-109. [PMID: 32632344 DOI: 10.1111/infa.12319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Infants adopted domestically from foster care often present with prenatal substance exposure and risky birth outcomes such as prematurity and low birth weight. Because few longitudinal studies of foster-adoptive infants exist, it is unclear how these preplacement risk factors influence development over time. The present study examined associations between perinatal risk factors and developmental outcomes among an ethnically/racially-diverse sample of 97 infants in foster-care (56% boys) placed into adoptive homes at ages 0-19 months. Relative to population-norms, foster-adoptive infants showed comparable cognitive but lower language and motor functioning at baseline and one-year follow-up. Age-adjusted language scores significantly improved one year following placement, consistent with a developmental "catch-up" effect. Low birth weight uniquely predicted lower language scores at baseline, but this association was no longer significant at follow-up. Prenatal substance exposure was associated with lower baseline cognitive scores, but only for infants placed after six months of age. In contrast, infants with low birth weight and later placement age (>12 months) showed the most accelerated motor development. Sex differences emerged at follow-up when predicting motor and language outcomes, suggesting potential sex-specific pathways of risk. Overall, results support adoption as an early intervention that may buffer vulnerability to perinatal risk on development.
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Affiliation(s)
- Irene Tung
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Audra K Langley
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jill M Waterman
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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Does prenatal cocaine exposure predict adolescent substance use? Neurotoxicol Teratol 2020; 81:106906. [PMID: 32535083 DOI: 10.1016/j.ntt.2020.106906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 05/26/2020] [Accepted: 06/09/2020] [Indexed: 11/21/2022]
Abstract
Prenatal cocaine exposure (PCE) has rarely been examined as a predictor of substance use during late adolescence, and few studies have examined both the initiation of substance use and current substance use as outcomes. The present longitudinal study examined PCE, other prenatal exposures, and psychosocial risk factors for their association with substance use in mid to late adolescence. Adolescents (n = 150) followed since birth reported on their use of alcohol, cigarette, and cannabis every 6 months from age 15.0 to 17.5 using a computer-assisted self-administration version of the Youth Risk Behavior Survey. PCE did not predict substance use in a series of growth curve analyses. Several psychosocial risk factors were associated with adolescents' substance use. Having friends who use substances predicted past month cigarette and cannabis use as well as initiation of alcohol and cannabis use, while depressive symptoms predicted initiation of alcohol, cigarette, and cannabis use. The current findings suggest that more proximal psychosocial factors may play a greater role in adolescent substance use than prenatal substance exposure.
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Abstract
Prenatal exposure to alcohol and drugs is associated with physical, cognitive, and behavioral problems across the offspring's lifespan and an increased risk of alcohol and drug use in adolescent and young adult offspring. These prenatal effects continue to be evident after control for demographic background and parental alcohol and drug use. Behavior problems in childhood and adolescence associated with prenatal exposures may serve as a mediator of the prenatal exposure effects on offspring substance use.
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Min MO, Yoon D, Minnes S, Ridenour T, Singer LT. Profiles of individual assets and mental health symptoms in at-risk early adolescents. J Adolesc 2019; 75:1-11. [PMID: 31288121 DOI: 10.1016/j.adolescence.2019.06.012] [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] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 06/19/2019] [Accepted: 06/24/2019] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Few studies investigated the combined patterns of individual assets (e.g., social competence, positive identity) and mental health symptoms (MHS) in adolescents. This study examined the patterns of early adolescents' individual assets and MHS and whether identified patterns were associated with later adolescents' outcomes. METHODS Participants were 352 (164 boys, 188 girls) adolescents who were primarily African-American and from low socioeconomic status families, participating in a prospective study of the effects of prenatal cocaine exposure from birth in the Midwest United States. Individual assets, using the Developmental Assets Profile, and MHS, using the Youth Self-Report, were assessed at age 12. Substance use, via self-report and biologic assays, early (before age 15) sexual behaviors, and behavioral adjustment were assessed at age 15. RESULTS Latent profile analysis indicated four distinctive profiles: low assets with elevated MHS (P1, n = 54, 15.3%); adequate assets with thought and social problems (P2, n = 84, 23.9%); low assets without MHS (P3, n = 101, 28.7%); and high assets without MHS (P4, n = 113, 32.1%). Children in the profile with high assets without MHS (P4) were more likely to have a higher IQ and to be in a more optimal environment (higher parental monitoring and less family conflict) than those in other profiles. Although profiles with MHS were associated with adolescent risk behaviors, this relationship was more pronounced for girls than for boys. CONCLUSIONS Girls in the low assets with elevated MHS (P1) should be a primary concern for preventive intervention. Our study demonstrates the heterogeneity of individual patterns of adaptation and maladaptation.
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Affiliation(s)
| | - Dalhee Yoon
- Binghamton University-State University of New York, Department of Social Work, USA
| | - Sonia Minnes
- Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, USA
| | - Ty Ridenour
- Research Triangle Institute International, USA
| | - Lynn T Singer
- Case Western Reserve University, School of Medicine, Department of Population and Quantitative Health Sciences, Psychiatry & Pediatrics, USA
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Ha J, Jun HJ, Shin H, Chung IJ, Park E, Min SK, Kim E. Predicting Behavior Problems in Korean Preschoolers: Interactions of the SLC6A4 Gene and Maternal Negative Affectivity. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2019; 17:200-210. [PMID: 30905120 PMCID: PMC6478087 DOI: 10.9758/cpn.2019.17.2.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/22/2018] [Accepted: 03/28/2018] [Indexed: 11/18/2022]
Abstract
Objective This study aimed to investigate whether maternal negative affectivity (MNA) moderates the effect of genetic polymorphism of SLC6A4 on behavior problems in children. Methods Study participants comprised 143 preschoolers and their mothers from South Korea. The Childhood Behavior Checklist and Emotionality, Activity, and Sociability adult scale were used to measure child behavior and maternal affectivity. DNA from saliva was genotyped to determine serotonin transporter polymorphism. Results MNA appeared to exert effects in externalizing (b=5.78, p<0.001) and internalizing problems (b=6.09, p< 0.001). Interaction between SLCA4 polymorphism and MNA showed effects on externalizing (b=−7.62, p<0.01) and internalizing problems (b=−9.77, p<0.01). Children with two short alleles showed considerable differences in both externalizing and internalizing problems according to MNA; however, children with one short allele or none showed relatively few differences in behavior problems due to maternal affectivity. Conclusion The effect of SLC6A4 polymorphism on child behavior seemed to be moderated by MNA. In addition, the impact of MNA was found to vary based on a child’s genetic risk. High MNA may trigger the risk allele while low MNA causes the risk allele to illicit less behavior problems. Children with two short variants of the SLC6A4 gene may benefit from intervention that modulates MNA.
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Affiliation(s)
- Junghee Ha
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine
| | - Hey Jung Jun
- Department of Child and Family Studies, College of Human Ecology, Yonsei University
| | - Hyewon Shin
- Department of Child Studies, Seokyeong University
| | | | - Eunmie Park
- Department of Social Welfare, Seoul Jangsin University
| | - Sung Kil Min
- Department of Neuropsychiatry, Hyoja Geriatric Hospital
| | - Eunjoo Kim
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine
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Prenatal cocaine exposure: Direct and indirect associations with 21-year-old offspring substance use and behavior problems. Drug Alcohol Depend 2019; 195:121-131. [PMID: 30622013 PMCID: PMC6430204 DOI: 10.1016/j.drugalcdep.2018.10.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 10/19/2018] [Accepted: 10/28/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Prenatal cocaine exposure (PCE) has been linked to child/adolescent behavior problems and substance use in several longitudinal cohort studies. It is unclear whether these effects extend into adulthood and influence young adult behavior problems and substance use and, if so, whether they are mediated by childhood and adolescent experiences. METHODS These data are from an ongoing longitudinal study of individuals born to women who were recruited early in pregnancy. Trimester-specific data on prenatal drug exposure were obtained. Caregivers and offspring were assessed at delivery and at 1, 3, 7, 10, 15, and 21 years postpartum. This report is from age 21, when 225 offspring (52% females; 54% African American, 46% Caucasian) reported on behavior problems, emotion regulation, and substance use. RESULTS There were significant direct associations between PCE and early initiation of marijuana, 21-year emotion regulation problems, arrest history, and Conduct Disorder. The relation between PCE and young adult internalizing behavior was mediated by adolescent mood symptoms. The association between PCE and 21-year marijuana use was mediated by early initiation of marijuana use. CONCLUSIONS PCE has both direct and indirect long-term associations with young adult development. Using statistical models that considered the complex interrelationships among PCE and adult outcomes, we demonstrated that the direct effects of PCE on young adult emotion regulation problems, arrest history, and Conduct Disorder are not completely explained by earlier adolescent behavior. Moreover, the analyses suggesting mediated pathways from PCE to young adult problems identify crucial variables to target interventions for exposed children and adolescents.
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Singer LT, Min MO, Minnes S, Short E, Lewis B, Lang A, Wu M. Prenatal and concurrent cocaine, alcohol, marijuana, and tobacco effects on adolescent cognition and attention. Drug Alcohol Depend 2018; 191:37-44. [PMID: 30077054 PMCID: PMC10187465 DOI: 10.1016/j.drugalcdep.2018.06.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Prenatal cocaine/polydrug exposure (PCE) may increase vulnerability to substance use disorders due to associated cognitive deficits. We examined whether neurocognitive deficits in executive functions and attention observed in PCE children persisted to adolescence when compared to non-cocaine/polydrug (NCE) children, and whether adolescent substance use (tobacco, alcohol, marijuana) was also associated with neurocognitive deficits. METHODS 354 (180 PCE, 174 NCE) adolescents in a longitudinal study from birth were administered the Wechsler Intelligence Scales for Children - IV (WISC-IV), and the Integrated Visual and Auditory Continuous Performance Test (IVA/CPT) at age 15.5. Assessments of prenatal exposure to cocaine, alcohol, marijuana, and tobacco and measures of use at age 15.5 were taken. Confounding factors measured included lead, the caregiving environment, and violence exposure. Relationships between drug use and prenatal exposures on outcomes were assessed through multiple regression. RESULTS Adolescents with PCE had deficits in Perceptual Reasoning IQ and visual attention. Prenatal alcohol exposure predicted verbal and working memory IQ and visual and auditory attention deficits. Adolescent tobacco, alcohol, and marijuana use predicted attention in addition to PCE, lead and the caregiving environment. CONCLUSION Prenatal cocaine and alcohol exposure and adolescent use of substances are associated with neurocognitive deficits known to increase vulnerability to SUDs.
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Affiliation(s)
- Lynn T Singer
- Departments of Pediatrics, Psychiatry, Psychology, and Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA.
| | - Meeyoung O Min
- Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA.
| | - Sonia Minnes
- Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA.
| | - Elizabeth Short
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA.
| | - Barbara Lewis
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA.
| | - Adelaide Lang
- Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA.
| | - Miaoping Wu
- Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA.
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Horn SR, Roos LE, Berkman ET, Fisher PA. Neuroendocrine and immune pathways from pre- and perinatal stress to substance abuse. Neurobiol Stress 2018; 9:140-150. [PMID: 30450380 PMCID: PMC6236513 DOI: 10.1016/j.ynstr.2018.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/06/2018] [Accepted: 09/12/2018] [Indexed: 12/26/2022] Open
Abstract
Early life adversity is a documented risk factor for substance abuse and addiction. The pre- and perinatal period (i.e., from implantation, through pregnancy, to 6 months of age) is a critical period marked by high biological plasticity and vulnerability, making perinatal stress a particularly robust form of adversity. The neuroendocrine and immune systems are key mechanisms implicated in the transmission of addiction risk. We review animal and human studies that provide preliminary evidence for links between perinatal stress, neuroendocrine and immune dysregulation, and risk for substance abuse and addiction. A translational neuroscience perspective is employed to elucidate pre- and perinatally-induced biological mechanisms linked to addiction and discuss implications for prevention and intervention efforts. Significant evidence supports associations between pre- and perinatal stress and dysregulation of the hypothalamic-pituitary-adrenal axis and immune systems as well as links between neuroendocrine/immune functioning and addiction risk. More work is needed to explicitly examine the interplay between pre- and perinatal stress and neuroendocrine/immune disruptions that together heighten substance abuse risk. Future work is needed to fully understand how pre- and perinatal stress induces biological alterations to predispose individuals to higher risk for addiction. Such knowledge will strengthen theoretically-driven and empirically-supported prevention efforts for substance abuse and addiction.
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Affiliation(s)
- Sarah R Horn
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR, 97402, USA
| | - Leslie E Roos
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR, 97402, USA
| | - Elliot T Berkman
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR, 97402, USA
| | - Philip A Fisher
- University of Oregon, Department of Psychology, 1227 University of Oregon, Eugene, OR, 97402, USA
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Min MO, Kim JY, Olgac T, Francis M, Shon EJ, Yoon D. Factor Structure of the Urban Hassles Index. RESEARCH ON SOCIAL WORK PRACTICE 2018; 28:741-750. [PMID: 34168417 PMCID: PMC8221571 DOI: 10.1177/1049731516674815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This study examined the factor structure and psychometric properties of the Urban Hassles Index (UHI). METHODS Exploratory factor analyses (EFA) were conducted via Principal Axis Factoring extraction method. Confirmatory factor analyses were conducted to evaluate the fit of the EFA-derived model using the weighted least squares estimator with mean and variance adjustments. Composite/scale scores were created for the extracted factors, with a total score derived by summing the scale scores. Criterion-related validity was examined using hierarchical regressions. RESULTS The UHI had four first-order factors (Environmental Nuisance, Safety Concerns, Drug, Coercion) accounting for 43% of the total variance. Covariance among the first-order factors was explained by a higher second-order factor. Moderate factor correlations and evidence for the criterion-related validity of the subscales and total score indicated multidimensionality of the UHI. CONCLUSIONS The shortened 16-item UHI is a brief assessment tool evaluating stressors unique to urban adolescents, providing specific intervention targets.
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Affiliation(s)
- Meeyoung O Min
- Case Western Reserve University, Jack. Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, Ohio
| | - June-Yung Kim
- Case Western Reserve University, Jack. Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, Ohio
| | - Tugba Olgac
- Case Western Reserve University, Jack. Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, Ohio
| | - Meredith Francis
- Case Western Reserve University, Jack. Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, Ohio
| | - Eu-Jung Shon
- Case Western Reserve University, Jack. Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, Ohio
| | - Dalhee Yoon
- Case Western Reserve University, Jack. Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, Ohio
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Min MO, Minnes S, Kim JY, Yoon M, Singer LT. Individual assets and problem behaviors in at-risk adolescents: A longitudinal cross-lagged analysis. J Adolesc 2018; 64:52-61. [PMID: 29408099 DOI: 10.1016/j.adolescence.2018.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 01/11/2018] [Accepted: 01/24/2018] [Indexed: 11/26/2022]
Abstract
Autoregressive cross-lagged structural equation modeling was conducted to examine longitudinal relationships between individual assets (social competence, positive values and identity) and problem behaviors in 373 adolescents (174 boys, 199 girls) who participated in a prospective study on the effects of prenatal cocaine exposure from birth. More behavioral problems at age 12 were related to fewer individual assets at age 15, while greater individual assets were related to more behavioral problems, with a non-significant yet nuanced (p = .076) gender difference. More problem behaviors were associated with decreased individual assets in girls, yet greater individual assets were associated with more problem behaviors in boys. Efforts to promote individual assets may not lower the risk of engaging in problem behaviors especially among boys. Continued studies into adulthood will uncover how individual assets and problem behaviors in childhood and adolescence may affect social and vocational adjustment in this high risk population.
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Affiliation(s)
- Meeyoung O Min
- Case Western Reserve University, Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States.
| | - Sonia Minnes
- Case Western Reserve University, Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States
| | - June-Yung Kim
- Case Western Reserve University, Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States
| | - Miyoung Yoon
- Case Western Reserve University, Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States
| | - Lynn T Singer
- Case Western Reserve University, School of Medicine, Department of Environmental Health Sciences, Psychiatry, & Pediatrics, Cleveland, OH, United States
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Parcianello RR, Mardini V, Ceresér KMM, Langleben DD, Xavier F, Zavaschi MLS, Rhode LAP, Pechansky F, Gubert C, Szobot CM. Increased cocaine and amphetamine-regulated transcript cord blood levels in the newborns exposed to crack cocaine in utero. Psychopharmacology (Berl) 2018; 235:215-222. [PMID: 29080905 DOI: 10.1007/s00213-017-4759-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 10/03/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Cocaine and amphetamine-regulated transcript (CART) is an endogenous antioxidant present since the embryonic period. CART is activated by high levels of dopamine and might be of interested in understanding the changes in the REDOX system associated with crack/cocaine intake. The goal of this study was to determine whether exposure to crack in utero is associated with increased CART levels. METHODS In this cross-sectional study with consecutive sampling, we compared the umbilical cord blood (UCB) CART levels (μg/mL) of newborns exposed to crack/cocaine in utero (EN, n = 57) to levels in non-exposed newborns (NEN, n = 99). In addition, we compared serum CART levels between EN and NEN mothers, in the immediate postpartum period. Potential confounders, such as perinatal data (e.g., weight, Apgar, etc.), psychopathology (DSM-IV), and use of drugs other than crack (ASSIST) were assessed. RESULTS According to general linear model analysis, the adjusted mean CART was significantly higher in EN (0.180, 95% CI 0.088-0.272) than in NEN (0.048, 95% CI 0.020-0.076; p < 0.002; d = 0.68). The difference in CART levels between EN and NEN mothers was not significant (p ≥ 0.05). CONCLUSION The increase in CART levels in EN UBC suggests a response to crack/cocaine-induced oxidative stress during gestational period, as a potential attempt of neuroprotection. In adult women in puerperium, however, this endogenous antioxidant recruitment does not seem to operate.
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Affiliation(s)
- Rodrigo Ritter Parcianello
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
| | - Victor Mardini
- Child and Adolescent Psychiatry Service (SPIA), Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, 4° andar, sala 400N, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
| | - Keila Maria Mendes Ceresér
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
- Laboratory of Molecular Psychiatry and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), HCPA, UFRGS, Rua Ramiro Barcelos, 2350, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
| | - Daniel D Langleben
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Fernando Xavier
- Program in Biomedical Sciences, Centro Universitário Metodista-IPA, Rua Dona Leonor, 340, Rio Branco, Porto Alegre, RS, 90420-004, Brazil
| | - Maria Lucrécia Scherer Zavaschi
- Child and Adolescent Psychiatry Service (SPIA), Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, 4° andar, sala 400N, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
| | - Luis Augusto Paim Rhode
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
- Child and Adolescent Psychiatry Service (SPIA), Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, 4° andar, sala 400N, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), Rua Dr. Ovídio Pires de Campos, 785, 1° andar, sala 6, Ala Sul, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil
- Department of Psychiatry, UFRGS, Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
| | - Flávio Pechansky
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
- Department of Psychiatry, UFRGS, Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
- Center for Drug and Alcohol Research, HCPA, UFRGS, Rua Professor Álvaro Alvim, 400, Rio Branco, Porto Alegre, RS, 90420-020, Brazil
| | - Carolina Gubert
- Laboratory of Molecular Psychiatry and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), HCPA, UFRGS, Rua Ramiro Barcelos, 2350, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
- Graduate Program in Biological Sicences, Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2600, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil
| | - Claudia Maciel Szobot
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil.
- Child and Adolescent Psychiatry Service (SPIA), Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, 4° andar, sala 400N, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil.
- Center for Drug and Alcohol Research, HCPA, UFRGS, Rua Professor Álvaro Alvim, 400, Rio Branco, Porto Alegre, RS, 90420-020, Brazil.
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Smith LM, Santos LS. Prenatal exposure: The effects of prenatal cocaine and methamphetamine exposure on the developing child. ACTA ACUST UNITED AC 2017; 108:142-6. [PMID: 27345014 DOI: 10.1002/bdrc.21131] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 06/07/2016] [Indexed: 11/09/2022]
Abstract
Prenatal substance use remains a significant issue in the United States. Initial reports regarding prenatal cocaine and methamphetamine exposure suggested profound adverse effects on child development. However, subsequent prospective, longitudinal investigations have found more subtle effects. What follows is a brief review of the health, growth, behavioral, and intellectual outcomes for children exposed to prenatal cocaine and prenatal methamphetamine. Factors that may mitigate or intensify subtle adverse effects manifested in exposed children will also be discussed. Birth Defects Research (Part C) 108:142-146, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Lynne M Smith
- Department of Pediatrics, Los Angeles Biomedical Institute at Harbor-UCLA Medical Center and David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Lucinda S Santos
- Department of Pediatrics, Los Angeles Biomedical Institute at Harbor-UCLA Medical Center and David Geffen School of Medicine at UCLA, Los Angeles, California
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Min MO, Minnes S, Kim JY, Yoon M, Singer LT. Association of prenatal cocaine exposure, childhood maltreatment, and responses to stress in adolescence. Drug Alcohol Depend 2017; 177:93-100. [PMID: 28582699 PMCID: PMC5541909 DOI: 10.1016/j.drugalcdep.2017.03.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/13/2017] [Accepted: 03/14/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Prenatal cocaine exposure (PCE) may alter responses to stress. Children with PCE tend to grow up in suboptimal caregiving environments, conducive to child maltreatment (CM). Guided by the diathesis-stress model, the present study examined differences in self-reported responses to stress and coping in adolescents with and without PCE and explored whether childhood maltreatment (CM) moderated the effects of PCE. METHODS Adolescents (N=363; 184 PCE, 179 non-cocaine exposed (NCE)), primarily African-American and of low socioeconomic status, were prospectively enrolled in a longitudinal study at birth. The Responses to Stress Questionnaire was used to assess volitional coping (primary control, secondary control, disengagement) and involuntary responses (involuntary engagement, involuntary disengagement) to stress at the 15- and 17-year follow-up visits. CM was assessed retrospectively at age 17 using the Juvenile Victimization Questionnaire. RESULTS Findings from longitudinal mixed model analyses indicated that PCE was associated with poorer coping strategies only among adolescents with a history of CM. Adolescents with PCE who experienced CM reported less dominant use of primary (e.g., problem solving, emotional regulation) and secondary control (e.g., cognitive restructuring) and more dominant use of disengagement (e.g., denial, avoidance) and involuntary disengagement (e.g., inaction) than adolescents with PCE who did not experience CM or NCE adolescents regardless of CM. CM was associated with more dominant use of involuntary engagement (e.g., intrusive thoughts). CONCLUSIONS PCE may increase sensitivity to CM, predisposing increased vulnerability to environmental risk. Continued studies into adulthood will elucidate how coping and involuntary stress responses affect social, vocational, and behavioral adjustment.
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Affiliation(s)
- Meeyoung O Min
- The Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States.
| | - Sonia Minnes
- The Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - June-Yung Kim
- The Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Miyoung Yoon
- The Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Lynn T Singer
- School of Medicine, Departments of Environmental Health Sciences, Psychiatry and Pediatrics, Case Western Reserve University, Cleveland, OH, United States
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Minnes S, Min MO, Kim JY, Francis MW, Lang A, Wu M, Singer LT. The association of prenatal cocaine exposure, externalizing behavior and adolescent substance use. Drug Alcohol Depend 2017; 176:33-43. [PMID: 28514694 PMCID: PMC5637277 DOI: 10.1016/j.drugalcdep.2017.01.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 01/04/2017] [Accepted: 01/08/2017] [Indexed: 10/19/2022]
Abstract
Prenatal cocaine exposure (PCE) may increase adolescent substance use through alterations of neurotransmitter systems affecting fetal brain development. The relationship between PCE and substance use at 15 and 17 years was examined. Subjects (365: 186 PCE; 179 non-cocaine exposed (NCE)) supplied biologic and self-report data using the Youth Risk Behavior Surveillance System (YRBSS) and Computerized Diagnostic Interview Schedule for Children (C-DISC 4) at ages 15 and 17. The relationship between PCE and substance use was assessed using General Estimating Equation (GEE) analyses controlling for confounding factors including violence exposure and preschool lead level. Teens with PCE vs. NCE teens were 2 times more likely to use tobacco (OR=2.1; 95% CI 1.21-3.63; p<.001) and marijuana (OR=1.85; CI 1.18-2.91; p<.001) and have a substance use disorder at age 17 (OR=2.51; CI 1.00-6.28; p<.05). Evaluation of PCE status by gender revealed an association between PCE and marijuana use that was more pronounced for boys than girls at 17 years. Violence exposure was also a significant predictor of alcohol (p<.001), tobacco (p<.05), and marijuana (p<.0006) use and substance abuse/dependence (p<.01). Externalizing behavior at age 12 fully mediated the effects of PCE on substance use disorder at age 17 and partially mediated effects of PCE on tobacco use, but did not mediate effects on marijuana use. The percentage of substance use reported increased between 15 and 17 years, with no differences between the PCE and NCE groups. Data suggest specialized drug use prevention measures for children with PCE may benefit this high risk group.
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Affiliation(s)
- Sonia Minnes
- The Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States.
| | - Meeyoung O Min
- The Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - June-Yung Kim
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Meredith W Francis
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Adelaide Lang
- The Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Miaoping Wu
- The Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Lynn T Singer
- School of Medicine, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, United States
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Mardini V, Rohde LA, Ceresér KMM, Gubert CDM, da Silva EG, Xavier F, Parcianello R, Röhsig LM, Pechansky F, Pianca TG, Szobot CM. IL-6 and IL-10 levels in the umbilical cord blood of newborns with a history of crack/cocaine exposure in utero: a comparative study. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2017; 38:40-9. [PMID: 27074340 DOI: 10.1590/2237-6089-2015-0081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 12/18/2015] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Prenatal cocaine exposure (PCE) is associated with neurobehavioral problems during childhood and adolescence. Early activation of the inflammatory response may contribute to such changes. Our aim was to compare inflammatory markers (IL-6 and IL-10) both in umbilical cord blood and in maternal peripheral blood at delivery between newborns with history of crack/cocaine exposure in utero and non-exposed newborns. METHODS In this cross-sectional study, 57 newborns with a history of crack/cocaine exposure in utero (EN) and 99 non-exposed newborns (NEN) were compared for IL-6 and IL-10 levels. Sociodemographic and perinatal data, maternal psychopathology, consumption of nicotine and other substances were systematically collected in cases and controls. RESULTS After adjusting for potential confounders, mean IL-6 was significantly higher in EN than in NEN (10,208.54, 95% confidence interval [95%CI] 1,328.54-19,088.55 vs. 2,323.03, 95%CI 1,484.64-3,161.21; p = 0.007; generalized linear model [GLM]). Mean IL-10 was also significantly higher in EN than in NEN (432.22, 95%CI 51.44-812.88 vs. 75.52, 95%CI 5.64-145.39, p = 0.014; GLM). Adjusted postpartum measures of IL-6 were significantly higher in mothers with a history of crack/cocaine use (25,160.05, 95%CI 10,958.15-39,361.99 vs. 8,902.14, 95%CI 5,774.97-12,029.32; p = 0.007; GLM), with no significant differences for IL-10. There was no correlation between maternal and neonatal cytokine levels (Spearman test, p ≥ 0.28 for all measures). CONCLUSIONS IL-6 and IL-10 might be early biomarkers of PCE in newborns. These findings could help to elucidate neurobiological pathways underlying neurodevelopmental changes and broaden the range of possibilities for early intervention.
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Affiliation(s)
- Victor Mardini
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | | | | | | | - Emily Galvão da Silva
- Instituto Nacional de Ciência e Tecnologia - Medicina Translacional, Porto Alegre, RS, Brazil
| | | | | | | | - Flávio Pechansky
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Minnes S, Min MO, Short EJ, Wu M, Lang A, Yoon S, Singer LT. Executive function in children with prenatal cocaine exposure (12-15years). Neurotoxicol Teratol 2016; 57:79-86. [PMID: 27485181 DOI: 10.1016/j.ntt.2016.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 07/28/2016] [Accepted: 07/29/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE Prenatal exposure to cocaine (PCE) may alter areas of the brain dense with monoamine receptors such as the prefrontal cortex and negatively affect cognitive processes implicated in executive function (EF). This study investigated the effects of PCE on EF at 12 and 15years. METHODS EF was examined in 189 PCE and 183 non-cocaine exposed (NCE) children who were primarily African American and of low socioeconomic status. Caregivers rated their child on the Behavior Rating Inventory of Executive Function (BRIEF) at ages 12 and 15. The BRIEF includes two summary scales and eight subscales: Behavioral Regulation Index (BRI) (Inhibit, Shift, and Emotion) and Metacognition Index (MI) (Monitor, Working Memory, Plan/Organize, Organization of Materials and Task Completion). Two additional measures were included at age 15 (BRIEF Self-Report and the CANTAB Stockings of Cambridge (SOC)). RESULTS Girls with PCE were perceived by caregivers to have more behavioral regulation problems at age 12 (p<0.005) and more metacognitive problems at age 12 (p<0.003) than NCE females, but there was no association for males. PCE girls improved in behavioral regulation (p<0.05) and metacognition (p<0.04) from 12 to 15years compared to NCE girls based on caregiver report. By self-report PCE was associated with problems of inhibition (p<0.006). Girls with PCE performed more poorly on number of moves to complete the SOC, requiring planning and problem solving, than NCE girls. CONCLUSION Prenatally cocaine exposed girls were perceived by caregivers as having problems of behavioral regulation, and by self-report, inhibitory control problems. Girls with PCE also performed more poorly on a task of planning and problem solving at age 15 which corresponded to caregiver report at age 12. Early assessment and remediation of these weaknesses in girls may improve school performance and behavior associated with poor EF.
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Affiliation(s)
- Sonia Minnes
- The Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States.
| | - Meeyoung O Min
- The Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States.
| | - Elizabeth J Short
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, United States.
| | - Miaoping Wu
- The Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States.
| | - Adelaide Lang
- The Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States.
| | - Susan Yoon
- The Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States; College of Social Work, The Ohio State University, 1947 College Road, Columbus, OH 43210, United States.
| | - Lynn T Singer
- School of Medicine, Department of Epidemiology and Statistics, Case Western Reserve University, Cleveland, OH, United States.
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Barthelemy OJ, Richardson MA, Cabral HJ, Frank DA. Prenatal, perinatal, and adolescent exposure to marijuana: Relationships with aggressive behavior. Neurotoxicol Teratol 2016; 58:60-77. [PMID: 27345271 DOI: 10.1016/j.ntt.2016.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 05/25/2016] [Accepted: 06/22/2016] [Indexed: 10/21/2022]
Abstract
This manuscript reviews research exploring the relationship between prenatal, perinatal, and adolescent exposure to marijuana and aggressive behavior, including physical aggression. Areas of inquiry include animal research, as well as human research, on prenatal exposure and on marijuana use during adolescence. Potential psychosocial and psychopharmacological mechanisms are identified, as well as relevant confounds. The prenatal marijuana exposure literature provides minimal support for a direct relationship with aggressive behavior in childhood. The adolescent use literature suggests a marginal (at best) association between acute intoxication and aggressive behavior, and an association between chronic use and aggressive behavior heavily influenced by demographic variables, rather than direct, psychopharmacological mechanisms. Cannabis withdrawal symptoms also may include aggression and anger, but there is little evidence to suggest that these effects are large or specific to withdrawal from marijuana compared to other substances. This review will offer recommendations for clinical care and public policy, as well as important questions for future research.
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Affiliation(s)
- Olivier J Barthelemy
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, United States
| | - Mark A Richardson
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, United States; Division of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - Howard J Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States
| | - Deborah A Frank
- Department of Pediatrics, Boston University School of Medicine, Boston, MA, United States.
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Kobulsky JM, Minnes S, Min MO, Singer MI. Violence Exposure and Early Substance Use in High-Risk Adolescents. JOURNAL OF SOCIAL WORK PRACTICE IN THE ADDICTIONS 2016; 16:46-71. [PMID: 29056877 PMCID: PMC5650204 DOI: 10.1080/1533256x.2016.1138867] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 11/18/2015] [Indexed: 06/03/2023]
Abstract
This study examines the relationship between violence exposure and early substance use as mediated by trauma symptoms. The Assessment of Liability and Exposure to Substance Use and Antisocial Behavior Scale was used to assess violence exposure at age 10 and substance use by age 12. Mediation analysis indicated direct relationships between violence exposure and tobacco/illegal drug use and indirect relationships between violence exposure and girls' substance use through trauma symptoms. Practitioners should consider violence exposure as a risk factor for early substance use in high-risk youths and potential gender differences in trauma symptom pathways to early substance use.
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Affiliation(s)
- Julia M Kobulsky
- Doctoral Candidate, Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Sonia Minnes
- Associate Professor, Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Meeyoung O Min
- Research Associate Professor, Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Mark I Singer
- Leonard W. Mayo Professor, Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Min MO, Minnes S, Lang A, Albert JM, Kim JY, Singer LT. Pathways to adolescent sexual risk behaviors: Effects of prenatal cocaine exposure. Drug Alcohol Depend 2016; 161:284-91. [PMID: 26922281 PMCID: PMC4792807 DOI: 10.1016/j.drugalcdep.2016.02.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 02/08/2016] [Accepted: 02/08/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND To assess the impact of prenatal cocaine exposure (PCE) on adolescent sexual risk behaviors. Externalizing behavior, teen substance use, and early sexual intercourse were examined as pathways mediating the effects of PCE on sexual risk behaviors. METHODS Adolescents (N=364; 185 PCE, 179 non-cocaine exposure (NCE); 205 girls, 159 boys), primarily African-American and of low socioeconomic status, were prospectively enrolled in a longitudinal study at birth. Risky sexual behaviors were assessed at ages 15 and 17. Externalizing behavior at 12 years was assessed with the Youth Self-Report. Substance use, via self-report and biologic assays, and early (before age 15) sexual intercourse were assessed at age 15. Path analyses with the weighted least squares estimator with mean and variance adjustments were performed. RESULTS The final structural equation model-based path model, χ(2)=31.97 (df=27), p=.23, CFI=.99, TLI=.99, RMSEA=.021, WRMR=.695, indicated a direct effect of PCE on sexual risk behavior (β=.16, p=.02). Although PCE was related to greater externalizing behavior (β=.14, p=.009), which in turn, predicted early sexual intercourse (β=.16, p=.03), leading to sexual risk behavior (β=.44, p<.001), bootstrapping indicated a non-significant indirect effect (β=.01, p>.10). Substance use was correlated with early sexual intercourse (r=.60, p<.001) and predicted sexual risk behavior by age 17 (β=.31, p=.01). CONCLUSIONS Prenatal cocaine exposure was related to more engagement in sexual risk behaviors, suggesting the importance of reducing substance use among pregnant women as a means of prevention of offspring substance use and sexual risk behavior.
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Affiliation(s)
- Meeyoung O Min
- Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States.
| | - Sonia Minnes
- Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States
| | - Adelaide Lang
- Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States
| | - Jeffrey M Albert
- School of Medicine, Department of Epidemiology and Biostatistics, Cleveland, OH, United States
| | - June-Yung Kim
- Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States
| | - Lynn T Singer
- Departments of Environmental Health Sciences, Psychiatry & Pediatrics, Cleveland, OH, United States
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Prenatal alcohol exposure, adaptive function, and entry into adult roles in a prospective study of young adults. Neurotoxicol Teratol 2015; 51:52-60. [PMID: 26247662 DOI: 10.1016/j.ntt.2015.07.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 07/27/2015] [Accepted: 07/31/2015] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Although many studies have demonstrated effects of prenatal alcohol exposure (PAE) on physical, cognitive, and behavioral development in children, few have focused on the long term effects on adults. In this study, data are presented on adaptive function and entry into adult roles in a community sample of young adults with PAE. The expectation was that prenatally exposed adults would show lower adaptive functioning and more difficulty with entry into adult roles than the non-exposed control group and that these effects would be related to the severity of PAE effects. METHOD The predominantly African-American, low income sample included adults with a wide range of prenatal exposure (n = 123) as well as control groups for socioeconomic (SES) (n =5 9) and disability (n = 54) status. The mothers of the alcohol-exposed and SES-control group participants were recruited before birth and offspring have been followed up periodically. The disability control group was recruited in adolescence. The adults were interviewed about adaptive function in day-to-day life and adult role entry. Collateral adults who were well-acquainted with each participant were interviewed concerning adaptive function. RESULTS Results showed that adults who were dysmorphic and/or cognitively affected by PAE had difficulty with adaptive function and entry into adult roles. Males showing cognitive effects with no physical effects were the most severely affected. Results for exposed adults not showing physical or cognitive effects were similar to or more positive than those of the control group for most outcomes. CONCLUSION PAE has long-term effects on adaptive outcomes in early adulthood. Additional research should focus on possible interventions at this transition and on factors contributing to the adjustment of the exposed, but unaffected participants.
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Min MO, Minnes S, Lang A, Yoon S, Singer LT. Effects of prenatal cocaine exposure on early sexual behavior: Gender difference in externalizing behavior as a mediator. Drug Alcohol Depend 2015; 153:59-65. [PMID: 26088698 PMCID: PMC4509836 DOI: 10.1016/j.drugalcdep.2015.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/02/2015] [Accepted: 06/03/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Prenatal cocaine exposure (PCE) is associated with increased risk for externalizing behavior problems; childhood externalizing behavior problems are linked with subsequent early sexual behavior. The present study examined the effects of PCE on early sexual initiation (sexual intercourse prior to age 15) and whether externalizing behavior in preadolescence mediated the relationship. METHODS Three hundred fifty-four (180 PCE and 174 non-cocaine exposed; 192 girls, 142 boys), primarily African-American, low socioeconomic status, 15-year-old adolescents participated in a prospective longitudinal study. Adolescents' sexual behavior was assessed at 15 years using the Youth Risk Behavior Surveillance System. Externalizing behavior was assessed at 12 years using the Youth Self-Report. RESULTS Logistic regression models indicated that adolescents with PCE (n=69, 38%) were 2.2 times more likely (95% CI=1.2-4.1, p<.01) to engage in early sexual intercourse than non-exposed peers (n=49, 28%) controlling for covariates. This relationship was fully mediated by self-reported externalizing behavior in girls but not in boys, suggesting childhood externalizing behavior as a gender moderated mediator. Blood lead level during preschool years was also related to a greater likelihood of early sexual intercourse (OR=2.6, 95% CI=1.4-4.7, p<.002). Greater parental monitoring decreased the likelihood of early sexual intercourse, while violence exposure increased the risk. CONCLUSIONS PCE is related to early sexual intercourse, and externalizing behavior problems mediate PCE effects in female adolescents. Interventions targeting externalizing behavior may reduce early sexual initiation and thereby reduce HIV risk behaviors and early, unplanned pregnancy in girls with PCE.
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Affiliation(s)
- Meeyoung O. Min
- Case Western Reserve University, Jack. Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, Ohio
| | - Sonia Minnes
- Case Western Reserve University, Jack. Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, Ohio
| | - Adelaide Lang
- Case Western Reserve University, Jack. Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, Ohio
| | - Susan Yoon
- Case Western Reserve University, Jack. Joseph, and Morton Mandel School of Applied Social Sciences, Cleveland, Ohio
| | - Lynn T. Singer
- School of Medicine, Departments of Environmental Health Sciences, Psychiatry & Pediatrics, Cleveland, Ohio
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Singer LT, Minnes S, Min MO, Lewis BA, Short EJ. Prenatal cocaine exposure and child outcomes: a conference report based on a prospective study from Cleveland. Hum Psychopharmacol 2015; 30:285-9. [PMID: 26216564 PMCID: PMC4595926 DOI: 10.1002/hup.2454] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 11/07/2014] [Accepted: 11/07/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The study aims to describe developmental outcomes from a longitudinal prospective cohort (Cleveland study) of prenatally cocaine-exposed (CE) infants. METHODS Two hundred eighteen CE and 197 nonexposed infants were enrolled at birth and followed through mid-adolescence. Birth CE status was determined by interview and biologic measures. Multiple demographic, drug, and environmental correlates were controlled. Standardized, normative, reliable measures of fetal growth, intelligence quotient (IQ), behavior, executive function, and language were given at each age and risk for substance misuse assessed in adolescence. A subset of children received volumetric magnetic resonance imaging (MRI) at 7 years and functional MRI at 14 years. The effect of CE was determined through multiple regression analyses controlling for confounders. RESULTS Cocaine exposed had significant negative effects on fetal growth, attention, executive function, language, and behavior, while overall IQ was not affected. CE had significant negative effects on perceptual reasoning IQ and visual-motor skills and predicted lower volume of corpus callosum and decreased gray matter in the occipital and parietal lobes. CE children had higher risk for substance misuse. Confounding risk factors had additive effects on developmental outcomes. CONCLUSIONS Prenatal exposure to cocaine was related to poorer perceptual organization IQ, visual-spatial information processing, attention, language, executive function, and behavior regulation through early adolescence.
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Affiliation(s)
| | - Sonia Minnes
- Case Western Reserve University, Cleveland, Ohio, USA
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Richardson GA, Goldschmidt L, Larkby C, Day NL. Effects of prenatal cocaine exposure on adolescent development. Neurotoxicol Teratol 2015; 49:41-8. [PMID: 25778776 DOI: 10.1016/j.ntt.2015.03.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 02/27/2015] [Accepted: 03/08/2015] [Indexed: 02/06/2023]
Abstract
The associations between prenatal cocaine exposure (PCE) and adolescent behavior, cognitive development, and physical growth were examined in 219 15-year-olds who have participated in a longitudinal study since their fourth gestational month. During the first trimester, 42% of the women used cocaine, with use declining across pregnancy. At the 15-year follow-up, the caregivers were, on average, 43 years old, had 13 years of education, and 50% were African American. First trimester PCE was not associated with global cognitive development or with measures of learning and memory. First trimester PCE was significantly related to adolescent-reported delinquent behavior, poorer problem solving and abstract reasoning, and reduced weight, height, and head circumference at 15 years. These results were significant after other factors that affect these domains were controlled in regression analyses. In addition, exposure to violence partially mediated the effect of PCE on delinquent behavior. These adolescent domains are important because they are predictors of poorer adult functioning.
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Affiliation(s)
- Gale A Richardson
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, United States.
| | - Lidush Goldschmidt
- University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, United States
| | - Cynthia Larkby
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, United States
| | - Nancy L Day
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, United States
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De Genna N, Goldschmidt L, Richardson GA. Prenatal cocaine exposure and age of sexual initiation: direct and indirect effects. Drug Alcohol Depend 2014; 145:194-200. [PMID: 25456330 PMCID: PMC4254808 DOI: 10.1016/j.drugalcdep.2014.10.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 10/06/2014] [Accepted: 10/16/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Prenatal cocaine exposure (PCE) has been linked to child behavior problems and risky behavior during adolescence such as early substance use. Behavior problems and early substance use are associated with earlier initiation of sexual behavior. The goal of this study was to examine the direct and indirect effects of PCE on sexual initiation in a longitudinal birth cohort, about half of whom were exposed to cocaine in utero. METHODS Women were interviewed twice prenatally, at delivery, and 1, 3, 7, 10, 15, and 21 years postpartum. Offspring (52% female, 54% African American) were assessed at delivery and at each follow-up phase with age-appropriate assessments. At age 21, 225 offspring reported on their substance use and sexual behavior. RESULTS First trimester cocaine exposure was a significant predictor of earlier age of first intercourse in a survival analysis, after controlling for race, sociodemographic characteristics, caregiver pre- and postnatal substance use, parental supervision, and child's pubertal timing. However, the association between PCE and age of first sexual intercourse was mediated by adolescent marijuana and alcohol use prior to age 15. CONCLUSIONS Most of the effect of PCE on age of sexual initiation occurred between the ages of 13-18, when rates of initiation were approximately 10% higher among exposed offspring. This effect was mediated by early adolescent substance use. These results have implications for identification of the exposed offspring at greatest risk of HIV risk behaviors and early, unplanned pregnancy.
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Affiliation(s)
- Natacha De Genna
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213
| | - Lidush Goldschmidt
- University of Pittsburgh Medical Center, Program in Epidemiology, 3811 O'Hara Street, Pittsburgh, PA 15213
| | - Gale A. Richardson
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213
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Minnes S, Singer L, Min MO, Wu M, Lang A, Yoon S. Effects of prenatal cocaine/polydrug exposure on substance use by age 15. Drug Alcohol Depend 2014; 134:201-210. [PMID: 24176200 PMCID: PMC3941005 DOI: 10.1016/j.drugalcdep.2013.09.031] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 09/18/2013] [Accepted: 09/28/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Examined effects of prenatal cocaine exposure (PCE) on tobacco, alcohol, marijuana and cocaine use by age 15. METHODS Adolescent (n=358; 183 PCE, 175 non-prenatally cocaine exposed; NCE) drug use was assessed using urine, hair, and/or blood spot samples and self-report (Youth Risk Behavior Surveillance System; YRBSS) at ages 12 and 15. Logistic regression assessed effects of PCE on drug use controlling for other drug exposures, environment and blood lead levels (BLL). RESULTS Adjusted percentages of drug use (PCE vs. NCE) were: tobacco 35% vs. 26% (p<.04), marijuana 33% vs. 23% (p<.04), alcohol 40% vs. 35% (p<.01), and any drugs 59% vs. 50% (p<.005). PCE adolescents were twice as likely to use tobacco (OR=2.02, 95% CI=1.05-3.90, p<.04), 2.2 times more likely to use alcohol (OR=2.16, 95% CI=1.21-3.87, p<.01) and 1.8 times more likely to use marijuana (OR=1.81, 95% CI=1.02-3.22, p<.04) than NCE adolescents. A race-by-cocaine-exposure interaction (p<.01) indicated PCE non-African American adolescents had greater probability of tobacco use (65%) than NCE non-African American youth (21%). PCE was associated with any drug use (OR=2.16, CI=1.26-3.69, p<.005), while higher BLL predicted alcohol use (p<.001). Violence exposure was a predictor of tobacco (p<.002), marijuana (p<.0007) and any drug (p<.04). CONCLUSIONS PCE and exposure to violence increased the likelihood of tobacco, marijuana or any drug use by age 15, while PCE and higher early BLL predicted alcohol use. Prevention efforts should target high risk groups prior to substance use initiation.
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Affiliation(s)
- Sonia Minnes
- Case Western Reserve University Jack, Joseph and Morton Mandel School of Applied Social Sciences, United States.
| | - Lynn Singer
- Case Western Reserve University School of Medicine, Departments of Pediatrics, Psychiatry and Environmental Health Sciences, United States
| | - Meeyoung O Min
- Case Western Reserve University Jack, Joseph and Morton Mandel School of Applied Social Sciences, United States
| | - Miaoping Wu
- Case Western Reserve University Jack, Joseph and Morton Mandel School of Applied Social Sciences, United States
| | - Adelaide Lang
- Case Western Reserve University Jack, Joseph and Morton Mandel School of Applied Social Sciences, United States
| | - Susan Yoon
- Case Western Reserve University Jack, Joseph and Morton Mandel School of Applied Social Sciences, United States
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Chiriboga CA, Kuhn L, Wasserman GA. Neurobehavioral and Developmental Traiectories Associated with Level of Prenatal Cocaine Exposure. ACTA ACUST UNITED AC 2014; 2. [PMID: 25664330 DOI: 10.13188/2332-3469.1000015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION In experimental models, prenatal cocaine exposure has been found to perturb GABA and dopamine development. Clinically, abnormalities in tone, posture and state regulation are noted in early infancy but the evolution of these findings over time is not well described. The current study assesses the longitudinal effects of prenatal cocaine exposure in dose-dependent fashion on developmental & behavioral and neurological trajectories over the first 2 years of life. METHODS Three hundred and eighty infants, 113 cocaine-exposed, were enrolled at birth from an urban hospital from 2000 to 2004. Exposure was determined by maternal interview, segmental hair analyses (RIAH™) in all, and meconium and urine in a subset. Developmental, behavioral and neurological assessments were carried out blind to drug exposure at 6, 12 and 24 months of age in the 306 children who returned in follow-up. Mixed-effects linear modeling (developmental growth curve) assessed change in outcome over time. RESULTS The mental developmental growth curve showed a negative slope (2.2 points) in adjusted analyses among cocaine-exposed children over the first 2 years of life. (p=.04), while the slope of the motor development growth curve did not. Adjusting for microcephaly at 6 months diminished the strength of the association between cocaine exposure and mental developmental growth curve (effect modification). Cocaine exposure was marginally associated with behavioral outcomes in adjusted analyses. Total Behavior scores and Orientation/Engagement scores improved with age. At 1 year of age, prenatal cocaine exposure was significantly associated with lower motor development scores. High rates of hypertonia (global and diparesis) identified at the 6-month visit dropped dramatically in the first 2 years of life: cocaine-exposed children showed a more rapid rate of resolution of hypertonia than unexposed children, with hypertonia improving 2.2 times faster among those with heavy cocaine exposure. CONCLUSION We found differences in mental performance over the first 2 years of life associated with prenatal cocaine exposure that was mediated by microcephaly implying that cocaine exerts a sustained teratogenic effect on brain development. Early neurological (hypertonia) and behavioral findings associated with prenatal cocaine exposure improved over time. Hypertonia did not predict long-term development impairments. Conceivably, the transient nature of neurobehavioral manifestations reflects postnatally a tendency towards homeostasis of cocaine-related embryopathic perturbations of GABA and dopaminergic systems.
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Affiliation(s)
- Claudia A Chiriboga
- Division of Pediatric Neurology, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, USA ; Sergievsky Center, Columbia University, New York, NY, USA ; Harlem Hospital Center, New York, NY, USA
| | - Louise Kuhn
- Sergievsky Center, Columbia University, New York, NY, USA
| | - Gail A Wasserman
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University, New York, NY, USA ; New York Psychiatric Institute, New York, NY, USA
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