1
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Reynolds M, Kirisci L, Zhai ZW, Tarter R. Substance use disorder is the outcome of deviant socialization: A prospective investigation spanning childhood to adulthood. Pharmacol Biochem Behav 2023; 227-228:173585. [PMID: 37308041 PMCID: PMC10357486 DOI: 10.1016/j.pbb.2023.173585] [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] [Received: 12/16/2022] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Disinhibitory behavior during childhood and adolescence has been frequently shown to amplify the risk for substance use disorder (SUD) in adulthood. This prospective study examined the hypothesis that poor communication with parents and association with deviant peers comprise an SUD-promoting environtype which catalyzes transition of disinhibitory behavior toward SUD. METHOD Male (N = 499) and female (N = 195) youths were tracked from 10 to 12 to 30 years of age. Path analysis evaluated the patterning of disinhibitory behavior and social environment during childhood on substance use during adolescence, and antisocial personality without co-occurring SUD in early adulthood and subsequently substance use disorder (SUD). RESULTS Disinhibitory behavior (SUD vulnerability) in childhood predicts antisociality without SUD (age 22) that segues to SUD (age 23-30) whereas the environtype (parents and peers) predicts substance use during adolescence which predicts antisocial personality leading to SUD. Antisociality without SUD in early adulthood mediates the association of substance use during adolescence and SUD. CONCLUSION Disinhibitory behavior and deviance-promoting social environment conjointly promote development of SUD via deviant socialization.
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Affiliation(s)
- Maureen Reynolds
- Department of Pharmaceutical Sciences, University of Pittsburgh, School of Pharmacy, 3501 Terrace Street, 10064 Salk Hall, Pittsburgh, PA 15261, United States of America.
| | - Levent Kirisci
- Department of Pharmaceutical Sciences, University of Pittsburgh, School of Pharmacy, 3501 Terrace Street, 10064 Salk Hall, Pittsburgh, PA 15261, United States of America
| | - Zu Wei Zhai
- Program in Neuroscience, Middlebury College, McCardell Bicentennial Hall, Middlebury, VT 05753, United States of America
| | - Ralph Tarter
- Department of Pharmaceutical Sciences, University of Pittsburgh, School of Pharmacy, 3501 Terrace Street, 10064 Salk Hall, Pittsburgh, PA 15261, United States of America
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2
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Henriques E, Schmidt C, Pascoe R, Liss K, Begun S. Counter-Narratives of Structural Oppressions, Stigma and Resistance, and Reproductive and Sexual Health Among Youth Experiencing Homelessness. QUALITATIVE HEALTH RESEARCH 2022; 32:1447-1463. [PMID: 35739061 PMCID: PMC9411701 DOI: 10.1177/10497323221110694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Youth experiencing homelessness (YEH) face myriad injustices regarding their reproductive and sexual health and rights. Reproductive and sexual health research with YEH often explores condom-use and sexually transmitted infections, potentially contributing to narrow conceptualizations of YEH as "unclean" or in need of disease-screening. A narrative theory perspective was applied to this study, which allowed for the emergence of alternative storylines, or counter-narratives, which attend to manifestations of power and oppression within the lives of marginalized individuals. Qualitative interviews engaged 30 young people (ages 18-21) accessing shelter services. Narrative analyses identified YEHs' documentations of dominant narratives related to structural oppressions, stigma, and numerous dimensions of reproductive and sexual health including how they create, through their resistance, counter-narratives that include their preferred futures. YEH emphasized systemic sources of stigma and outlined their criticisms of the state. Within-group stigma emerged as a noteworthy theme, with YEH showing both empathy and ambivalence towards other YEH, along with internalization of stigmatizing narratives about pregnancy and homelessness. Approaches to service provision that further amplify youths' voices in naming and challenging the many oppressions and stigmas they face should be prioritized. Moreover, policies should be implemented to dismantle the actual root causes of challenges faced by YEH, rather than perpetuating them through measures rooted in interlocking oppressions of discrimination, inequity, and judgment.
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Affiliation(s)
- Emilia Henriques
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Catherine Schmidt
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Rachael Pascoe
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Kira Liss
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Stephanie Begun
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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3
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Cavicchioli M, Ogliari A, Movalli M, Maffei C. Persistent Deficits in Self-Regulation as a Mediator between Childhood Attention-Deficit/Hyperactivity Disorder Symptoms and Substance Use Disorders. Subst Use Misuse 2022; 57:1837-1853. [PMID: 36096483 DOI: 10.1080/10826084.2022.2120358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The link between attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) has been largely demonstrated. Some scholars have hypothesized that self-regulation mechanisms might play a key role in explaining this association. Objective(s): The current study tested the hypothesis that retrospective childhood ADHD symptoms might lead to more severe SUDs and this association should be mediated by current self-ratings of behavioral disinhibition, inattention, and emotional dysregulation among 204 treatment-seeking adults (male: 67.3%; female: 32.7%) with a primary diagnosis of alcohol use disorder and other SUDs. Methods: The mediational model was estimated through self-report measures of childhood ADHD symptoms (independent variable; WURS), current self-regulation mechanisms (mediators)-behavioral disinhibition (BIS-11 motor subscale), difficulties with attention regulation (MAAS) and emotion regulation (DERS)-and severity of SUDs (dependent variable; SPQ alcohol, illicit and prescribed drugs). Results: The analysis showed that alterations in the self-regulation system fully mediated the association between the severity of childhood ADHD symptoms and SUDs in adulthood. Behavioral disinhibition and difficulties in attention regulation were the most representative alterations in self-regulation processes that explained this association. Conclusions: These findings suggest it is useful to implement several therapeutic approaches (e.g. behavioral, mindfulness-based, and pharmacological) to increase the self-regulation abilities of children and adolescents with ADHD in order to reduce the probability of SUD onset in adulthood. However, future longitudinal neuroimaging and neuropsychological studies are needed to further support the role of self-regulation mechanisms in explaining the prospective association between childhood ADHD symptoms and SUDs in adulthood.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Anna Ogliari
- Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.,Child in Mind Lab, University "Vita-Salute San Raffaele", Milan, Italy
| | - Mariagrazia Movalli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
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4
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Poulton A, Hester R. Transition to substance use disorders: impulsivity for reward and learning from reward. Soc Cogn Affect Neurosci 2021; 15:1182-1191. [PMID: 31848627 PMCID: PMC7657456 DOI: 10.1093/scan/nsz077] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/06/2019] [Accepted: 09/16/2019] [Indexed: 02/05/2023] Open
Abstract
Substance dependence constitutes a profound societal burden. Although large numbers of individuals use licit or illicit substances, few transition to dependence. The specific factors influencing this transition are not well understood. Substance-dependent individuals tend to be swayed by the immediate rewards of drug taking, but are often insensitive to delayed negative consequences of their behavior. Dependence is consequently associated with impulsivity for reward and atypical learning from feedback. Behavioral impulsivity is indexed using tasks measuring spontaneous decision-making and capacity to control impulses. While evidence indicates drug taking exacerbates behavioral impulsivity for reward, animal and human studies of drug naïve populations demonstrate it might precede any drug-related problems. Research suggests dependent individuals are also more likely to learn from rewarding (relative to punishing) feedback. This may partly explain why substance-dependent individuals fail to modify their behavior in response to negative outcomes. This enhanced learning from reward may constitute a further pre-existing risk factor for substance dependence. Although impulsivity for reward and preferential learning from rewarding feedback are both underpinned by a compromised dopaminergic system, few studies have examined the relationship between these two mechanisms. The interplay of these processes may help enrich understanding of why some individuals transition to substance dependence.
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Affiliation(s)
- Antoinette Poulton
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville 3010, VIC, Australia
| | - Robert Hester
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville 3010, VIC, Australia
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5
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Morris AS, Wakschlag L, Krogh-Jespersen S, Fox N, Planalp B, Perlman SB, Shuffrey LC, Smith B, Lorenzo NE, Amso D, Coles CD, Johnson SP. Principles for Guiding the Selection of Early Childhood Neurodevelopmental Risk and Resilience Measures: HEALthy Brain and Child Development Study as an Exemplar. ADVERSITY AND RESILIENCE SCIENCE 2020; 1:247-267. [PMID: 33196052 PMCID: PMC7649097 DOI: 10.1007/s42844-020-00025-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 10/16/2020] [Indexed: 02/06/2023]
Abstract
The vast individual differences in the developmental origins of risk and resilience pathways combined with sophisticated capabilities of big data science increasingly point to the imperative of large, neurodevelopmental consortia to capture population heterogeneity and key variations in developmental trajectories. At the same time, such large-scale population-based designs involving multiple independent sites also must weigh competing demands. For example, the need for efficient, scalable assessment strategies must be balanced with the need for nuanced, developmentally sensitive phenotyping optimized for linkage to neural mechanisms and specification of common and distinct exposure pathways. Standardized epidemiologic batteries designed for this purpose such as PhenX (consensus measures for Phenotypes and eXposures) and the National Institutes of Health (NIH) Toolbox provide excellent "off the shelf" assessment tools that are well-validated and enable cross-study comparability. However, these standardized toolkits can also constrain ability to leverage advances in neurodevelopmental measurement over time, at times disproportionately advantaging established measures. In addition, individual consortia often expend exhaustive effort "reinventing the wheel," which is inefficient and fails to fully maximize potential synergies with other like initiatives. To address these issues, this paper lays forth an early childhood neurodevelopmental assessment strategy, guided by a set of principles synthesizing developmental and pragmatic considerations generated by the Neurodevelopmental Workgroup of the HEALthy Brain and Child Development (HBCD) Planning Consortium. These principles emphasize characterization of both risk- and resilience-promoting processes. Specific measurement recommendations to HBCD are provided to illustrate application. However, principles are intended as a guiding framework to transcend any particular initiative as a broad neurodevelopmentally informed, early childhood assessment strategy for large-scale consortia science.
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Affiliation(s)
- Amanda Sheffield Morris
- Human Development and Family Science, Oklahoma State University, 700 North Greenwood Ave, Tulsa, OK 74106 USA
| | - Lauren Wakschlag
- Department of Medical and Social Sciences, & Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL USA
| | - Sheila Krogh-Jespersen
- Department of Medical and Social Sciences, & Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL USA
| | - Nathan Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD USA
| | - Beth Planalp
- Department of Psychology, University of Wisconsin, Madison, WI USA
| | - Susan B. Perlman
- Department of Psychiatry, Washington University- St. Louis, St. Louis, MO USA
| | - Lauren C. Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY USA
| | - Beth Smith
- Division of Research on Children, Youth, and Family, Children’s Hospital Los Angeles; Developmental Neuroscience and Neurogenetics Program, The Saban Research Institute; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - Nicole E. Lorenzo
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD USA
| | - Dima Amso
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI USA
| | - Claire D. Coles
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Scott P. Johnson
- Department of Psychology, University of California Los Angeles, Los Angeles, CA USA
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6
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Bush NR, Wakschlag LS, LeWinn KZ, Hertz-Picciotto I, Nozadi SS, Pieper S, Lewis J, Biezonski D, Blair C, Deardorff J, Neiderhiser JM, Leve LD, Elliott AJ, Duarte CS, Lugo-Candelas C, O’Shea TM, Avalos LA, Page GP, Posner J. Family Environment, Neurodevelopmental Risk, and the Environmental Influences on Child Health Outcomes (ECHO) Initiative: Looking Back and Moving Forward. Front Psychiatry 2020; 11:547. [PMID: 32636769 PMCID: PMC7318113 DOI: 10.3389/fpsyt.2020.00547] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 05/27/2020] [Indexed: 12/11/2022] Open
Abstract
The family environment, with all its complexity and diverse components, plays a critical role in shaping neurodevelopmental outcomes in children. Herein we review several domains of the family environment (family socioeconomic status, family composition and home environment, parenting behaviors and interaction styles, parental mental health and functioning, and parental substance use) and discuss how these domains influence neurodevelopment, with particular emphasis on mental health outcomes. We also highlight a new initiative launched by the National Institutes of Health, the Environmental influences on Child Health Outcomes (ECHO) program. We discuss the role that ECHO will play in advancing our understanding of the impact of the family environment on children's risk for psychiatric outcomes. Lastly, we conclude with important unanswered questions and controversies in this area of research, highlighting how ECHO will contribute to resolving these gaps in our understanding, clarifying relationships between the family environment and children's mental health.
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Affiliation(s)
- Nicole R. Bush
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
- Department of Pediatrics, University of California, San Francisco, CA, United States
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences and Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Il, United States
| | - Kaja Z. LeWinn
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | - Sara S. Nozadi
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Sarah Pieper
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Johnnye Lewis
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Dominik Biezonski
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Clancy Blair
- Department of Population Health, New York University, New York, NY, United States
| | - Julianna Deardorff
- Community Health Sciences, University of California, Berkeley, Berkeley, CA, United States
| | - Jenae M. Neiderhiser
- Department of Psychology, Penn State University, University Park, PA, United States
| | - Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Amy J. Elliott
- Center for Pediatric and Community Research, Avera Research Institute, Sioux Falls, SD, United States
| | - Cristiane S. Duarte
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Claudia Lugo-Candelas
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lyndsay A. Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Grier P. Page
- Department of Biostatistics and Epidemiology, RTI, Atlanta, GA, United States
| | - Jonathan Posner
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
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7
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Begun S, Weber A, Spring J, Arora SRA, Frey C, Fortin A. "This Research Is Cool": Engaging Youth Experiencing Homelessness in Research on Reproductive and Sexual Health. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:271-281. [PMID: 32631161 DOI: 10.1080/19371918.2020.1791296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Youth experiencing homelessness face myriad barriers and inequities regarding their reproductive and sexual health and rights. Moreover, homeless youth are often characterized as "disaffiliated" and depicted as difficult to engage in research. This study qualitatively explored homeless youths' attitudes, beliefs, and needs regarding reproductive and sexual health, and sought their perspectives on being involved in research on such topics, which are often thought of as "taboo" or sensitive. Youth were enthusiastic about openly discussing such issues, which they deemed as highly relevant to their daily lives. Youth identified that how they were engaged in such research, and having opportunities for longer-term contributions to such efforts, were both important and exciting to them. Future social work and public health research efforts should seek to further disrupt narratives of homeless youth as "disaffiliated" and difficult to engage, and in doing so, develop more creative, participatory, and youth-led opportunities for including this group in reproductive and sexual health research.
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Affiliation(s)
- Stephanie Begun
- Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Ontario, Canada
| | - Ariel Weber
- Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Ontario, Canada
| | - Joshua Spring
- Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Ontario, Canada
| | - Simran R A Arora
- Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Ontario, Canada
| | - Cressida Frey
- Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Ontario, Canada
| | - Alicia Fortin
- Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Ontario, Canada
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8
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Acheson A, Lake SL, Bray BC, Liang Y, Mathias CW, Ryan SR, Charles NE, Dougherty DM. Early Adolescent Trajectories of Impulsiveness and Sensation Seeking in Children of Fathers with Histories of Alcohol and Other Substance Use Disorders. Alcohol Clin Exp Res 2016; 40:2622-2630. [PMID: 27706827 DOI: 10.1111/acer.13235] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 09/06/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Problem substance use often begins in adolescence. This vulnerability likely stems, at least partially, from relatively rapid increases in sensation seeking occurring in early to mid-adolescence and more gradual improvements in impulse control occurring through later adolescence. Better understanding how these processes develop in high-risk youth may lead to enhanced substance use disorder treatment and prevention strategies. METHODS We characterized trajectories of self-reported impulsivity and sensation seeking in 305 FH+ youths who at minimum had a father with a history of alcohol or other drug use disorders and 81 youths with no family histories of substance use disorders (FH-). Assessments started at ages 10 to 12 and continued at 6-month intervals for up to 42 months. In addition, a subset of 58 FH+ youths who began alcohol or other drug use before age 15 (FH+ Users) were compared to 58 FH+ propensity-matched adolescents who did not initiate substance use before age 15 (FH+ Non-Users). RESULTS Compared to FH- youths at preadolescence, FH+ youths reported higher general impulsivity and higher impulsivity related to poor planning and attention. Over time, there were no differential effects of FH status on changes in impulsivity or sensation seeking across adolescence. FH+ Users had smaller decreases in general impulsivity and impulsivity related to restlessness and fidgeting across adolescence than FH+ Non-Users. FH+ Users also had greater increases in sensation seeking across adolescence than FH+ Non-Users. CONCLUSIONS Increased impulsivity in FH+ youths may make them less able to regulate sensation seeking drives that peak in adolescence, which may contribute to their high risk for developing substance use disorders. Additionally, FH+ adolescents who initiate early use may be at increased risk in part due to increased impulsivity coupled with greater increases in sensation seeking.
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Affiliation(s)
- Ashley Acheson
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas.,Research Imaging Institute, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Sarah L Lake
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Bethany C Bray
- The Methodology Center, The Pennsylvania State University, State College, Pennsylvania
| | - Yuanyuan Liang
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Charles W Mathias
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Stacy R Ryan
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Nora E Charles
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Donald M Dougherty
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
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9
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Parolin M, Simonelli A, Mapelli D, Sacco M, Cristofalo P. Parental Substance Abuse As an Early Traumatic Event. Preliminary Findings on Neuropsychological and Personality Functioning in Young Drug Addicts Exposed to Drugs Early. Front Psychol 2016; 7:887. [PMID: 27378983 PMCID: PMC4909766 DOI: 10.3389/fpsyg.2016.00887] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 05/30/2016] [Indexed: 12/02/2022] Open
Abstract
Parental substance use is a major risk factor for child development, heightening the risk of drug problems in adolescence and young adulthood, and exposing offspring to several types of traumatic events. First, prenatal drug exposure can be considered a form of trauma itself, with subtle but long-lasting sequelae at the neuro-behavioral level. Second, parents' addiction often entails a childrearing environment characterized by poor parenting skills, disadvantaged contexts and adverse childhood experiences (ACEs), leading to dysfunctional outcomes. Young adults born from/raised by parents with drug problems and diagnosed with a Substance Used Disorder (SUD) themselves might display a particularly severe condition in terms of cognitive deficits and impaired personality function. This preliminary study aims to investigate the role of early exposure to drugs as a traumatic event, capable of affecting the psychological status of young drug addicts. In particular, it intends to examine the neuropsychological functioning and personality profile of young adults with severe SUDs who were exposed to drugs early in their family context. The research involved three groups, each consisting of 15 young adults (aged 18–24): a group of inpatients diagnosed with SUDs and exposed to drugs early, a comparison group of non-exposed inpatients and a group of non-exposed youth without SUDs. A neuropsychological battery (Esame Neuropsicologico Breve-2), an assessment procedure for personality disorders (Shedler-Westen Assessment Procedure-200) and the Symptom CheckList-90-Revised were administered. According to present preliminary results, young drug addicts exposed to drugs during their developmental age were characterized by elevated rates of neuropsychological impairments, especially at the expense of attentive and executive functions (EF); personality disorders were also common but did not differentiate them from non-exposed youth with SUDs. Alternative multi-focused prevention and intervention programs are needed for children of drug-misusing parents, addressing EF and adopting a trauma-focused approach.
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Affiliation(s)
- Micol Parolin
- Department of Developmental Psychology and Socialization, University of Padova Padua, Italy
| | - Alessandra Simonelli
- Department of Developmental Psychology and Socialization, University of Padova Padua, Italy
| | - Daniela Mapelli
- Department of General Psychology, University of Padova Padua, Italy
| | - Marianna Sacco
- Department of Developmental Psychology and Socialization, University of Padova Padua, Italy
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10
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Begun S. The paradox of homeless youth pregnancy: a review of challenges and opportunities. SOCIAL WORK IN HEALTH CARE 2015; 54:444-460. [PMID: 25985287 DOI: 10.1080/00981389.2015.1030058] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Compared to their housed counterparts, homeless youth become pregnant at exceptionally high rates. Causes of such pregnancies are multifaceted, while a paradoxically high proportion of these pregnancies are intended. This review discusses causes and risk factors associated with homeless youth pregnancies, and notes experiences of pregnancy decision-making discord, challenges encountered during and following pregnancy, and difficulties faced by homeless youth when or if they become parents. Because homeless youth face a wide array of unique risks, future research would benefit from exploring alternative approaches to prevention to reduce pregnancies and improve sexual and reproductive health outcomes among this population.
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Affiliation(s)
- Stephanie Begun
- a Graduate School of Social Work, University of Denver , Denver , Colorado , USA
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11
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Conradt E, Degarmo D, Fisher P, Abar B, Lester BM, Lagasse LL, Shankaran S, Bada H, Bauer CR, Whitaker TM, Hammond JA. The contributions of early adverse experiences and trajectories of respiratory sinus arrhythmia on the development of neurobehavioral disinhibition among children with prenatal substance exposure. Dev Psychopathol 2014; 26:901-16. [PMID: 24909973 PMCID: PMC4447302 DOI: 10.1017/s095457941400056x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Neurobehavioral disinhibition (ND) is a complex condition reflecting a wide range of problems involving difficulties with emotion regulation and behavior control. Respiratory sinus arrhythmia (RSA) is a physiological correlate of emotion regulation that has been studied in a variety of at-risk populations; however, there are no studies of RSA in children with ND. Data were drawn from a prospective longitudinal study of prenatal substance exposure that included 1,073 participants. Baseline RSA and RSA reactivity to an attention-demanding task were assessed at 3, 4, 5, and 6 years. ND was assessed at ages 8/9, 11, and 13/14 years via behavioral dysregulation and executive dysfunction composite measures. Greater exposure to early adversity was related to less RSA reactivity at 3 years, increases in RSA reactivity from ages 3 to 6 years, and increased behavioral dysregulation from ages 8/9 to 13/14. RSA reactivity was examined as a moderator of the association between early adversity and changes in ND. A significant Early Adversity × RSA Reactivity quadratic interaction revealed that children with decelerations in RSA reactivity exhibited increases in behavioral dysregulation, regardless of their exposure to early adversity. However, greater exposure to early adversity was related to greater increases in behavioral dysregulation, but only if children exhibited accelerations in RSA reactivity from ages 3 to 6 years. The results contribute to our understanding of how interactions across multiple levels of analysis contribute to the development of ND.
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Affiliation(s)
- Elisabeth Conradt
- Women & Infants Hospital of Rhode Island
- Warren Alpert Medical School of Brown University
| | | | - Phil Fisher
- Oregon Social Learning Center
- University of Oregon
| | - Beau Abar
- Women & Infants Hospital of Rhode Island
| | - Barry M. Lester
- Women & Infants Hospital of Rhode Island
- Warren Alpert Medical School of Brown University
- University of Oregon
| | - Linda L. Lagasse
- Women & Infants Hospital of Rhode Island
- Warren Alpert Medical School of Brown University
- University of Oregon
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12
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Himes SK, LaGasse LL, Derauf C, Newman E, Smith LM, Arria AM, Grotta SAD, Dansereau LM, Abar B, Neal CR, Lester BM, Huestis MA. Risk of neurobehavioral disinhibition in prenatal methamphetamine-exposed young children with positive hair toxicology results. Ther Drug Monit 2014; 36:535-43. [PMID: 24518561 PMCID: PMC4101149 DOI: 10.1097/ftd.0000000000000049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The objective was to evaluate the effects of prenatal methamphetamine exposure (PME) and postnatal drug exposures identified by child hair analysis on neurobehavioral disinhibition at 6.5 years of age. METHODS Mother-infant pairs were enrolled in the Infant Development, Environment, and Lifestyle (IDEAL) Study in Los Angeles, Honolulu, Tulsa, and Des Moines. PME was determined by maternal self-report and/or positive meconium results. At the 6.5-year follow-up visit, hair was collected and analyzed for methamphetamine, tobacco, cocaine, and cannabinoid markers. Child behavioral and executive function test scores were aggregated to evaluate child neurobehavioral disinhibition. Hierarchical linear regression models assessed the impact of PME, postnatal substances, and combined PME with postnatal drug exposures on the child's neurobehavioral disinhibition aggregate score. Past year caregiver substance use was compared with child hair results. RESULTS A total of 264 children were evaluated. Significantly more PME children (n = 133) had hair positive for methamphetamine/amphetamine (27.1% versus 8.4%) and nicotine/cotinine (38.3% versus 25.2%) than children without PME (n = 131). Overall, no significant differences in analyte hair concentrations were noted between groups. Significant differences in behavioral and executive function were observed between children with and without PME. No independent effects of postnatal methamphetamine or tobacco exposure, identified by positive hair test, were noted and no additional neurobehavioral disinhibition was observed in PME children with postnatal drug exposures, as compared with PME children without postnatal exposure. CONCLUSIONS Child hair testing offered a noninvasive means to evaluate postnatal environmental drug exposure, although no effects from postnatal drug exposure alone were seen. PME, alone and in combination with postnatal drug exposures, was associated with behavioral and executive function deficits at 6.5 years.
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Affiliation(s)
- Sarah K. Himes
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD
| | - Linda L. LaGasse
- Brown Center for the Study of Children at Risk, Warren Alpert Medical School at Brown University and Women & Infants Hospital, Providence, RI
| | - Chris Derauf
- Division of Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Elana Newman
- Department of Psychology, The University of Tulsa, Tulsa, OK
| | - Lynne M. Smith
- Department of Pediatrics, LABioMed Institute at Harbor-UCLA Medical Center and David Geffen School of Medicine at UCLA, Torrance, CA
| | - Amelia M. Arria
- Family Science Department, Center on Young Adult Health and Development, University of Maryland School of Public Health, College Park, MD
| | - Sheri A. Della Grotta
- Brown Center for the Study of Children at Risk, Warren Alpert Medical School at Brown University and Women & Infants Hospital, Providence, RI
| | - Lynne M. Dansereau
- Brown Center for the Study of Children at Risk, Warren Alpert Medical School at Brown University and Women & Infants Hospital, Providence, RI
| | - Beau Abar
- Department of Emergency Medicine and Psychiatry, University of Rochester Medical Center, Rochester, NY
| | - Charles R. Neal
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI
| | - Barry M. Lester
- Brown Center for the Study of Children at Risk, Warren Alpert Medical School at Brown University and Women & Infants Hospital, Providence, RI
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD
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13
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Abar B, LaGasse LL, Derauf C, Newman E, Shah R, Smith LM, Arria A, Huestis M, Della Grotta S, Dansereau LM, Neal C, Lester BM. Examining the relationships between prenatal methamphetamine exposure, early adversity, and child neurobehavioral disinhibition. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2013; 27:662-73. [PMID: 23067308 PMCID: PMC3842232 DOI: 10.1037/a0030157] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Methamphetamine use is a growing problem among pregnant women in the United States. Many negative consequences of methamphetamine use have been documented for the users, but little research has examined the long-term association between prenatal methamphetamine exposure (PME) and childhood outcomes. The current study examined the extent to which PME was predictive of childhood neurobehavioral disinhibition (ND), as well as the extent to which early adversity mediated this relationship. A sample of 320 mother-infant dyads (162 PME) was followed from birth through 6.5 years of age. ND was conceptualized as a two factor model consisting of deficits in (a) behavioral and emotional control, and (b) executive function. PME was associated with behavioral and emotional control at 5 years, which was associated with executive function deficits at 6.5 years. Early adversity (birth through year 3) significantly mediated the relationship between PME and ND. Associations with previous research and implications for prevention are discussed.
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Affiliation(s)
- Beau Abar
- Center for the Study of Children at Risk, Brown University Warren Alpert Medical School
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14
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Lester BM, Lin H, DeGarmo DS, Fisher PA, LaGasse LL, Levine TP, Shankaran S, Bada HS, Bauer CR, Hammond JA, Whitaker TM, Higgins RD. Neurobehavioral disinhibition predicts initiation of substance use in children with prenatal cocaine exposure. Drug Alcohol Depend 2012; 126:80-6. [PMID: 22608010 PMCID: PMC3439586 DOI: 10.1016/j.drugalcdep.2012.04.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 03/27/2012] [Accepted: 04/19/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND In previous work we (Fisher et al., 2011) examined the emergence of neurobehavioral disinhibition (ND) in adolescents with prenatal substance exposure. We computed ND factor scores at three age points (8/9, 11 and 13/14 years) and found that both prenatal substance exposure and early adversity predicted ND. The purpose of the current study was to determine the association between these ND scores and initiation of substance use between ages 8 and 16 in this cohort as early initiation of substance use has been related to later substance use disorders. Our hypothesis was that prenatal cocaine exposure predisposes the child to ND, which, in turn, is associated with initiation of substance use by age 16. METHODS We studied 386 cocaine exposed and 517 unexposed children followed since birth in a longitudinal study. Five dichotomous variables were computed based on the subject's report of substance use: alcohol only; tobacco only; marijuana only; illicit substances and any substance. RESULTS Cox proportional hazard regression showed that the 8/9 year ND score was related to initiation of alcohol, tobacco, illicit and any substance use but not marijuana use. The trajectory of ND across the three age periods was related to substance use initiation in all five substance use categories. Prenatal cocaine exposure, although initially related to tobacco, marijuana and illicit substance initiation, was no longer significant with ND scores in the models. CONCLUSION Prenatal drug exposure appears to be a risk pathway to ND, which by 8/9 years portends substance use initiation.
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Affiliation(s)
- Barry M. Lester
- Brown Center for the Study of Children at Risk, Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI,Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI,Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI
| | - Hai Lin
- Brown Center for the Study of Children at Risk, Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI,Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI,Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI
| | | | - Philip A. Fisher
- Oregon Social Learning Center, Eugene, OR,Department of Pediatrics, University of Oregon, Eugene, OR
| | - Linda L. LaGasse
- Brown Center for the Study of Children at Risk, Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI,Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI,Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI
| | - Todd P. Levine
- Brown Center for the Study of Children at Risk, Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI,Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI,Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI
| | - Seetha Shankaran
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI
| | - Henrietta S. Bada
- Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY
| | - Charles R. Bauer
- Department of Pediatrics, University of Miami, Miller School of Medicine, Miami, FL
| | - Jane A. Hammond
- Statistics and Epidemiology Unit, Research Triangle Institute, Research Triangle Park, NC (RTI)
| | | | - Rosemary D. Higgins
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (NICHD)
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15
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Lovallo WR. Early life adversity reduces stress reactivity and enhances impulsive behavior: implications for health behaviors. Int J Psychophysiol 2012; 90:8-16. [PMID: 23085387 DOI: 10.1016/j.ijpsycho.2012.10.006] [Citation(s) in RCA: 198] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 09/29/2012] [Accepted: 10/03/2012] [Indexed: 01/06/2023]
Abstract
Altered reactivity to stress, either in the direction of exaggerated reactivity or diminished reactivity, may signal a dysregulation of systems intended to maintain homeostasis and a state of good health. Evidence has accumulated that diminished reactivity to psychosocial stress may signal poor health outcomes. One source of diminished cortisol and autonomic reactivity is the experience of adverse rearing during childhood and adolescence. The Oklahoma Family Health Patterns Project has examined a cohort of 426 healthy young adults with and without a family history of alcoholism. Regardless of family history, persons who had experienced high degrees of adversity prior to age 16 had a constellation of changes including reduced cortisol and heart rate reactivity, diminished cognitive capacity, and unstable regulation of affect, leading to behavioral impulsivity and antisocial tendencies. We present a model whereby this constellation of physiological, cognitive, and affective tendencies is consistent with altered central dopaminergic activity leading to changes in brain function that may foster impulsive and risky behaviors. These in turn may promote greater use of alcohol other drugs along with adopting poor health behaviors. This model provides a pathway from early life adversity to low stress reactivity that forms a basis for risky behaviors and poor health outcomes.
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Affiliation(s)
- William R Lovallo
- University of Oklahoma Health Sciences Center, Department of Psychiatry and Behavioral Sciences and VA Medical Center, Behavioral Sciences Laboratories (151A), 921 NE 13th Street, Oklahoma City, OK 73104, United States.
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16
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Bell CC, McBride DF. Prevention of Mental and Substance Use and Abuse Disorders and Comorbidity in African Americans. ALCOHOLISM TREATMENT QUARTERLY 2012. [DOI: 10.1080/07347324.2012.690696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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17
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Cservenka A, Nagel BJ. Risky decision-making: an FMRI study of youth at high risk for alcoholism. Alcohol Clin Exp Res 2012; 36:604-15. [PMID: 22250647 DOI: 10.1111/j.1530-0277.2011.01650.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Adolescents with a family history of alcoholism (FHP) are at risk for developing an alcohol use disorder (AUD), and some studies indicate that FHP individuals show deficits in executive functioning. The ability to make adaptive decisions is one aspect of successful executive functioning that is often measured during risk-taking tasks; however, this behavior has not been examined in FHP youth. As impaired decision-making could predispose FHP youth to make poor choices related to alcohol use, the current study examined the neural substrates of risk-taking in FHP adolescents and their family history negative (FHN) peers. METHODS Thirty-one (18 FHP, 13 FHN) youth between 13 and 15 years old were included in this study. All youth had used little to no alcohol prior to study involvement. Functional magnetic resonance imaging was used to examine the neural substrates of risk-taking during the Wheel of Fortune (WOF) decision-making task (Ernst et al., 2004) in FHP and FHN youth. RESULTS FHP youth did not differ from FHN youth in risk-taking behavior, but showed less brain response during risky decision-making in right dorsolateral prefrontal cortex and right cerebellar regions compared with FHN peers. CONCLUSIONS Despite no behavioral differences on the WOF decision-making task, FHP youth exhibited atypical neural response during risk-taking compared with FHN peers. Atypical brain activity, in regions implicated in executive functioning could lead to reduced cognitive control, which may result in risky choices regarding alcohol use. This could help explain the higher rates of AUDs seen in FHP adolescents. Further examination of risky behavior and associated brain response over the course of adolescence is necessary to characterize the vulnerabilities of FHP youth in the absence of alcohol abuse.
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Affiliation(s)
- Anita Cservenka
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, USA
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18
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The combined effects of prenatal drug exposure and early adversity on neurobehavioral disinhibition in childhood and adolescence. Dev Psychopathol 2011; 23:777-88. [PMID: 21756431 DOI: 10.1017/s0954579411000290] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The negative effects of prenatal substance exposure on neurobiological and psychological development and of early adversity are clear, but little is known about their combined effects. In this study, multilevel analyses of the effects of prenatal substance exposure and early adversity on the emergence of neurobehavioral disinhibition in adolescence were conducted. Neurobehavioral disinhibition has previously been observed to occur frequently in multiproblem youth from high-risk backgrounds. In the present study, neurobehavioral disinhibition was assessed via behavioral dysregulation and poor executive function composite measures. Data were drawn from a prospective longitudinal investigation of prenatal substance exposure that included 1,073 participants followed from birth through adolescence. The results from latent growth modeling analyses showed mean stability but significant individual differences in behavioral dysregulation and mean decline with individual differences in executive function difficulties. Prior behavioral dysregulation predicted increased executive function difficulties. Prenatal drug use predicted the emergence and growth in neurobehavioral disinhibition across adolescence (directly for behavioral dysregulation and indirectly for executive function difficulties via early adversity and behavioral dysregulation). Prenatal drug use and early adversity exhibited unique effects on growth in behavioral dysregulation; early adversity uniquely predicted executive function difficulties. These results are discussed in terms of implications for theory development, social policy, and prevention science.
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19
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Crawford DM, Trotter EC, Hartshorn KJS, Whitbeck LB. Pregnancy and mental health of young homeless women. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2011; 81:173-83. [PMID: 21486259 PMCID: PMC3383651 DOI: 10.1111/j.1939-0025.2011.01086.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pregnancy rates among young women who are homeless are significantly higher than rates among housed young women in the United States (J. M. Greene & C. L. Ringwalt, 1998). Yet, little research has addressed mental health or risk and resilience among young mothers who are homeless. Based on a sample from the Midwest Longitudinal Study of Homeless Adolescents, this study explores pregnancy and motherhood in unaccompanied homeless young women over a period of 3 years. The data are supplemented by in-depth interviews with a subset of young women. Results show that almost half (46.4%) of sexually active young women who are homeless (n=222, M age = 17.2) had been pregnant at baseline. Among those who stated they had children between Waves 2 and 13 (n=90), only half reported caring for their children consistently over time, and one fifth reported never seeing their children. Of the participants with children in their care at the last interview (Wave 13), almost one third met criteria for lifetime major depressive episode, lifetime posttraumatic stress disorder, and lifetime drug abuse, and half met criteria for lifetime antisocial personality disorder. Twelve-month diagnoses are also reported. The impacts of homelessness on maternal and child outcomes are discussed.
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Affiliation(s)
- Devan M. Crawford
- Department of Sociology, University of Nebraska-Lincoln, 206 Benton Hall, Lincoln NE 68588-0623, (402) 472-2243,
| | - Emily C. Trotter
- Department of Sociology, University of Nebraska-Lincoln, 209 Benton Hall, Lincoln NE 68588-0623, (402) 472-3632,
| | - Kelley J. Sittner Hartshorn
- Department of Sociology, University of Nebraska-Lincoln, 209 Benton Hall, Lincoln NE 68588-0623, (402) 472-3632,
| | - Les B. Whitbeck
- Department of Sociology, University of Nebraska-Lincoln, 739 Oldfather Hall, Lincoln, NE 68588-0324, (402) 472-5562,
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Massey SH, Lieberman DZ, Reiss D, Leve LD, Shaw DS, Neiderhiser JM. Association of clinical characteristics and cessation of tobacco, alcohol, and illicit drug use during pregnancy. Am J Addict 2010; 20:143-50. [PMID: 21314757 DOI: 10.1111/j.1521-0391.2010.00110.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Pregnancy is a time of relative urgency and opportunity for the treatment of substance use disorders in women, yet little is known about modifiable factors that contribute to successful abstinence. We examined self-worth, depression, anxiety, and novelty seeking in the context of substance use cessation during pregnancy in a sample of women with a high prevalence of substance abuse. Subjects were 448 birth mothers who participated in a prospective adoption study. Discontinuation rates were: tobacco 22.2%, alcohol 64.7%, marijuana 77.2%, and other drugs, 73.7-100%. Depression, anxiety, and novelty seeking were lower among women who discontinued substance use, compared to those who did not. Self-worth was higher in women who discontinued substance use. Among 110 polysubstance users, the number of substances discontinued during pregnancy was correlated with depression, anxiety, and self-worth in the hypothesized direction. Possible clinical implications are discussed.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue NW, Washington, DC 20037, USA.
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21
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Whitbeck LB, Crawford DM. Gestational risks and psychiatric disorders among indigenous adolescents. Community Ment Health J 2009; 45:62-72. [PMID: 18998209 PMCID: PMC2676774 DOI: 10.1007/s10597-008-9172-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Accepted: 10/23/2008] [Indexed: 10/21/2022]
Abstract
This study reports on the effects maternal prenatal binge drinking, cigarette smoking, drug use, and pregnancy and birth complications on meeting criteria for psychiatric disorders at ages 10-12 and 13-15 years among 546 Indigenous adolescents from a single culture in the northern Midwest and Canada. Adolescent DSM-IV psychiatric disorders were assessed with the Diagnostic Interview Schedule for Children-Revised (DISC-R). Results indicate that maternal behaviors when pregnant have significant effects on adolescent psychiatric disorders even when controlling for age and gender of adolescent, family per capita income, living in a single mother household, and adolescent reports of mother's positive parenting.
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Affiliation(s)
- Les B Whitbeck
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE 68588-0324, USA.
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Abstract
OBJECTIVE While parental supervision has been demonstrated to predict adolescent alcohol involvement, there has been little focus on the influence of adolescent characteristics, such as personality and alcohol use, on the effectiveness of parental supervisory practices. This study examined the interaction of parental supervision and adolescent alcohol use from late childhood through middle adolescence. METHOD Families were recruited through fathers with substance use disorders or fathers representing reference groups identified as having a biological child age 10 to 12 years. These children (N = 773) were assessed and follow-up visits conducted in early adolescence (ages 12-14) and middle adolescence (age 16). Parental supervision and alcohol use were determined at each visit. In the context of demographic variables and childhood psychological dysregulation, the statistical model examined global and developmental stage-specific relationships between supervision and alcohol use. RESULTS Consistent with interactional hypotheses, childhood psychological dysregulation and early adolescent alcohol use predicted less effective parental supervision. CONCLUSIONS While the study design limited the extent to which predictive associations could be interpreted as indicating causal relationships, adolescents with psychological dysregulation and higher levels of alcohol use may resist parental supervision. The challenges to parents presented by difficult adolescents need to be taken into consideration in developing preventive and treatment interventions.
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