University of Pittsburgh School of Medicine, Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
University of Pittsburgh School of Medicine, Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
Drug Alcohol Depend. 2019 Feb 1;195:121-131. doi: 10.1016/j.drugalcdep.2018.10.033. Epub 2018 Nov 24.
Prenatal cocaine exposure (PCE) has been linked to child/adolescent behavior problems and substance use in several longitudinal cohort studies. It is unclear whether these effects extend into adulthood and influence young adult behavior problems and substance use and, if so, whether they are mediated by childhood and adolescent experiences.
These data are from an ongoing longitudinal study of individuals born to women who were recruited early in pregnancy. Trimester-specific data on prenatal drug exposure were obtained. Caregivers and offspring were assessed at delivery and at 1, 3, 7, 10, 15, and 21 years postpartum. This report is from age 21, when 225 offspring (52% females; 54% African American, 46% Caucasian) reported on behavior problems, emotion regulation, and substance use.
There were significant direct associations between PCE and early initiation of marijuana, 21-year emotion regulation problems, arrest history, and Conduct Disorder. The relation between PCE and young adult internalizing behavior was mediated by adolescent mood symptoms. The association between PCE and 21-year marijuana use was mediated by early initiation of marijuana use.
PCE has both direct and indirect long-term associations with young adult development. Using statistical models that considered the complex interrelationships among PCE and adult outcomes, we demonstrated that the direct effects of PCE on young adult emotion regulation problems, arrest history, and Conduct Disorder are not completely explained by earlier adolescent behavior. Moreover, the analyses suggesting mediated pathways from PCE to young adult problems identify crucial variables to target interventions for exposed children and adolescents.
几项纵向队列研究表明，产前可卡因暴露（PCE）与儿童/青少年行为问题和物质使用有关。目前尚不清楚这些影响是否会持续到成年期，以及是否会影响年轻成年人的行为问题和物质使用，如果有影响，是否会通过儿童和青少年时期的经历来介导。
这些数据来自一项正在进行的纵向研究，研究对象为在妊娠早期招募的女性所生的个体。获得了孕期特定时期的药物暴露数据。在分娩时和产后 1、3、7、10、15 和 21 岁时对照顾者和后代进行了评估。本报告来自 21 岁时，此时 225 名后代（52%为女性；54%为非裔美国人，46%为白种人）报告了行为问题、情绪调节和物质使用情况。
PCE 与大麻的早期使用、21 岁时的情绪调节问题、被捕记录和品行障碍之间存在显著的直接关联。PCE 与青少年时期情绪症状之间存在中介关系，与年轻成年人内化行为之间存在关联。PCE 与 21 岁时大麻使用之间的关联，是通过早期使用大麻来中介的。
PCE 与年轻成年人的发展既有直接影响，也有间接影响。通过使用考虑 PCE 与成人结果之间复杂相互关系的统计模型，我们证明了 PCE 对年轻成年人情绪调节问题、被捕记录和品行障碍的直接影响，不能完全用早期青少年行为来解释。此外，提示从 PCE 到年轻成年人问题的中介途径的分析，确定了针对暴露于可卡因的儿童和青少年进行干预的关键变量。
