Liebschutz Jane M, Crooks Denise, Rose-Jacobs Ruth, Cabral Howard J, Heeren Timothy C, Gerteis Jessie, Appugliese Danielle P, Heymann Orlaith D, Lange Allison V, Frank Deborah A
Clinical Addiction Research and Education Unit, Boston Medical Center.
Department of Family Medicine, Boston Medical Center.
Psychol Addict Behav. 2015 Jun;29(2):329-37. doi: 10.1037/adb0000082.
Understanding behavioral resilience among at-risk adolescents may guide public policy decisions and future programs. We examined factors predicting behavioral resilience following intrauterine substance exposure in a prospective longitudinal birth-cohort study of 136 early adolescents (ages 12.4-15.9 years) at risk for poor behavioral outcomes. We defined behavioral resilience as a composite measure of lack of early substance use initiation (before age 14), lack of risky sexual behavior, or lack of delinquency. Intrauterine substance exposures included in this analysis were cocaine, tobacco, alcohol, and marijuana. We recruited participants from Boston Medical Center as mother-infant dyads between 1990 and 1993. The majority of the sample was African American/Caribbean (88%) and 49% female. In bivariate analyses, none and lower intrauterine cocaine exposure level predicted resilience compared with higher cocaine exposure, but this effect was not found in an adjusted model. Instead, strict caregiver supervision (adjusted odds ratio [AOR] = 6.02, 95% confidence interval (CI) [1.90, 19.00], p = .002), lower violence exposure (AOR = 4.07, 95% CI [1.77, 9.38], p < .001), and absence of intrauterine tobacco exposure (AOR = 3.71, 95% CI [1.28, 10.74], p = .02) predicted behavioral resilience. In conclusion, caregiver supervision in early adolescence, lower violence exposure in childhood, and lack of intrauterine tobacco exposure predicted behavioral resilience among a cohort of early adolescents with significant social and environmental risk. Future interventions should work to enhance parental supervision as a way to mitigate the effects of adversity on high-risk groups of adolescents. (PsycINFO Database Record
了解高危青少年的行为恢复力可为公共政策决策和未来项目提供指导。在一项对136名有行为不良风险的青少年（年龄在12.4 - 15.9岁）进行的前瞻性纵向出生队列研究中，我们考察了预测子宫内物质暴露后行为恢复力的因素。我们将行为恢复力定义为早期物质使用起始（14岁之前）缺乏、危险性性行为缺乏或犯罪行为缺乏的综合指标。本分析中包括的子宫内物质暴露有可卡因、烟草、酒精和大麻。我们在1990年至1993年间从波士顿医疗中心招募母婴二元组作为研究对象。样本中的大多数是非洲裔美国人/加勒比人（88%），49%为女性。在双变量分析中，与较高的可卡因暴露相比，无可卡因暴露和较低的子宫内可卡因暴露水平可预测恢复力，但在调整模型中未发现这种效应。相反，严格的照料者监督（调整后的优势比[AOR]=6.02，95%置信区间[CI][1.90, 19.00]，p = 0.002）、较低的暴力暴露（AOR = 4.07，95% CI[1.77, 9.38]，p < 0.001）以及无子宫内烟草暴露（AOR = 3.71，95% CI[1.28, 10.74]，p = 0.02）可预测行为恢复力。总之，青春期早期的照料者监督、童年期较低的暴力暴露以及无子宫内烟草暴露可预测一组有重大社会和环境风险的青少年的行为恢复力。未来的干预措施应致力于加强父母监督，以此减轻逆境对高危青少年群体的影响。（《心理学文摘数据库记录》 ）
