Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, 88 East Newton Street, Boston, MA 02118, United States.
Neurotoxicol Teratol. 2011 May-Jun;33(3):379-92. doi: 10.1016/j.ntt.2011.02.013. Epub 2011 Mar 1.
Individual differences in adolescents' executive functioning are often attributed either to intrauterine substance exposure or to adolescents' own substance use, but both predictors typically have not been evaluated simultaneously in the same study. This prospective study evaluated whether intrauterine drug exposures, the adolescents' own substance use, and/or their potential interactions are related to poorer executive functioning after controlling for important contextual variables. Analyses were based on data collected on a sample of 137 predominantly African-American/African Caribbean adolescents from low-income urban backgrounds who were followed since their term birth. Intrauterine substance exposures (cocaine, marijuana, alcohol, and cigarettes) and adolescents' substance use were documented using a combination of biological assays and maternal and adolescent self-report. At 12-14 years of age, examiners masked to intrauterine exposures and current substance use assessed the adolescents using the Delis-Kaplan Executive Function System (D-KEFS), an age-referenced instrument evaluating multiple dimensions of executive functioning (EF). Results of covariate-controlled analyses in this study suggest that when intrauterine substance exposures and young adolescents' substance use variables were in the same analysis models, subtle differences in specific EF outcomes were identifiable in this non-referred sample. While further study with larger samples is indicated, these findings suggest that 1) research on adolescent substance use and intrauterine exposure research should evaluate both predictors simultaneously, 2) subtle neurocognitive effects associated with specific intrauterine drug exposures can be identified during early adolescence, and 3) intrauterine substance exposure effects may differ from those associated with adolescents' own drug use.
青少年执行功能的个体差异通常归因于宫内物质暴露或青少年自身的物质使用，但这两个预测因素通常在同一研究中没有同时评估。本前瞻性研究评估了宫内药物暴露、青少年自身的物质使用以及/或它们的潜在相互作用是否与控制重要背景变量后执行功能较差相关。分析基于对 137 名主要来自非洲裔美国/非洲加勒比背景的低收入城市青少年的样本进行的数据，这些青少年自出生以来就一直受到跟踪。宫内物质暴露（可卡因、大麻、酒精和香烟）和青少年的物质使用情况通过结合生物检测和母亲和青少年的自我报告来记录。在 12-14 岁时，对宫内暴露和当前物质使用情况不知情的检查者使用 Delis-Kaplan 执行功能系统（D-KEFS）对青少年进行评估，该系统是一种年龄参照工具，评估执行功能的多个维度（EF）。本研究中进行了协变量控制分析的结果表明，当宫内物质暴露和青少年早期物质使用变量在相同的分析模型中时，在这个非推荐样本中可以识别出特定 EF 结果的细微差异。虽然需要进一步的研究，但这些发现表明：1）青少年物质使用和宫内暴露研究的研究应该同时评估这两个预测因素；2）在早期青少年时期可以识别出与特定宫内药物暴露相关的微妙神经认知影响；3）宫内物质暴露的影响可能与青少年自身药物使用的影响不同。
