Brown Center for the Study of Children at Risk, Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI 02905, USA.
Drug Alcohol Depend. 2012 Nov 1;126(1-2):80-6. doi: 10.1016/j.drugalcdep.2012.04.014. Epub 2012 May 18.
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.
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.
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.
Prenatal drug exposure appears to be a risk pathway to ND, which by 8/9 years portends substance use initiation.
在之前的研究中，我们（Fisher 等人，2011 年）研究了产前物质暴露的青少年中神经行为抑制（ND）的出现。我们在三个年龄点（8/9 岁、11 岁和 13/14 岁）计算了 ND 因子得分，发现产前物质暴露和早期逆境均预测了 ND。本研究的目的是确定这些 ND 分数与该队列中 8 至 16 岁之间物质使用开始之间的关联，因为物质使用的早期开始与以后的物质使用障碍有关。我们的假设是，可卡因暴露使儿童易患 ND，而 ND 又与 16 岁时物质使用的开始有关。
我们研究了自出生以来在一项纵向研究中跟踪的 386 名可卡因暴露和 517 名未暴露的儿童。根据受试者的物质使用报告，计算了五个二分变量：仅酒精；仅烟草；仅大麻；非法物质和任何物质。
Cox 比例风险回归显示，8/9 岁的 ND 得分与酒精、烟草、非法和任何物质使用的开始有关，但与大麻使用无关。在三个年龄阶段，ND 的轨迹与所有五个物质使用类别的物质使用开始有关。尽管产前可卡因暴露最初与烟草、大麻和非法物质的开始有关，但在模型中，ND 评分不再显著。
产前药物暴露似乎是 ND 的风险途径，到 8/9 岁时预示着物质使用的开始。
