产前药物暴露与青少年早期同伴侵害：检验儿童期焦虑/抑郁和攻击性作为可能的中介。
Prenatal drug exposure and peer victimization in early adolescence: testing childhood anxiety/depression and aggression as possible mediators.
机构信息
Division of Growth & Nutrition, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
出版信息
J Dev Behav Pediatr. 2012 Jun;33(5):416-22. doi: 10.1097/DBP.0b013e31825609f0.
OBJECTIVE
Children who are prenatally exposed to drugs may be at risk for emotion dysregulation, including childhood anxiety/depression and aggression, potentially increasing their risk for peer victimization. The objectives of this study were to investigate how prenatal drug exposure relates to adolescent peer victimization and the mediating effects of childhood anxiety/depression and aggression.
METHODS
Seventy-six prenatally drug exposed (PDE) and 38 nonexposed (NE) adolescent-caregiver dyads followed since birth and middle childhood, respectively, participated in an evaluation during adolescence. In middle childhood, caregivers reported on their child's anxiety/depression and aggression, and children reported on violence exposure. In adolescence, caregivers and adolescents responded to a parallel single-item measure of peer victimization. Analyses were conducted using multivariate linear and logistic regression models, adjusting for covariates, including violence exposure.
RESULTS
One-third (33.3%, n = 35) of the sample endorsed peer victimization: 40.8% PDE and 17.6% NE, p = .01. In middle childhood, PDE youth had more aggressive behaviors (11.92 vs 7.45, p < .01) and anxiety/depression symptoms (3.43 vs 1.76, p < .01) than NE youth. Anxious/depressed behavior during childhood mediated the association between prenatal drug exposure and adolescent peer victimization. Aggression was not a significant mediator.
CONCLUSIONS
The consequences of prenatal drug exposure extend into adolescence. Prenatal drug exposure may interfere with emotion regulation, resulting in anxious/depressed behavior during childhood and significantly increasing the risk for peer victimization during adolescence, even in the presence of violence exposure. Strategies to reduce anxious/depressed behavior among children with a history of prenatal drug exposure may reduce adolescent peer victimization.
目的
产前接触毒品的儿童可能存在情绪调节障碍，包括儿童期焦虑/抑郁和攻击性，这可能增加他们被同伴侵害的风险。本研究的目的是探讨产前药物暴露与青少年同伴侵害的关系，以及儿童期焦虑/抑郁和攻击性的中介作用。
方法
76 名产前药物暴露（PDE）和 38 名未暴露（NE）的青少年-照顾者对子从出生和儿童中期开始分别进行了随访，在青少年时期进行了评估。在儿童中期，照顾者报告了他们孩子的焦虑/抑郁和攻击性，儿童报告了暴力暴露情况。在青少年时期，照顾者和青少年对同伴侵害的平行单项测量进行了回应。使用多元线性和逻辑回归模型进行分析，调整了包括暴力暴露在内的协变量。
结果
三分之一（33.3%，n=35）的样本报告了同伴侵害：40.8%的 PDE 和 17.6%的 NE，p=0.01。在儿童中期，PDE 青少年的攻击性行为更多（11.92 比 7.45，p<0.01）和焦虑/抑郁症状（3.43 比 1.76，p<0.01）比 NE 青少年多。儿童期焦虑/抑郁行为中介了产前药物暴露与青少年同伴侵害的关系。攻击性不是一个显著的中介因素。
结论
产前药物暴露的后果延伸到青少年时期。产前药物暴露可能会干扰情绪调节，导致儿童期焦虑/抑郁行为，并显著增加青少年时期同伴侵害的风险，即使存在暴力暴露。减少有产前药物暴露史的儿童焦虑/抑郁行为的策略可能会减少青少年同伴侵害。
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