Caregiver and self-report of mental health symptoms in 9-year old children with prenatal cocaine exposure |
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Authors: | Annamaria Aguirre McLaughlinSonia Minnes Lynn T. Singer Meeyoung MinElizabeth J. Short Teresa Linares Scott Sudtida Satayathum |
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Affiliation: | a Department of Psychology, College of Arts and Sciences, United Statesb Mandel School of Applied Social Sciences, United Statesc School of Medicine Department of Pediatrics, United Statesd School of Medicine Department of Environmental Health Sciences, United Statese Case Western Reserve University, United Statesf University of Vermont, United States |
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Abstract: | ObjectiveTo assess the effect of prenatal cocaine exposure on mental health symptoms in 9-year old children controlling for potential confounders.Methods332 children (170 prenatally cocaine-exposed (PCE), 162 non cocaine-exposed (NCE) were assessed using self (Dominic Interactive; DI) and caregiver report (Child Behavior Checklist; CBCL).ResultsHigher levels of PCE were associated with caregiver report of clinically elevated aggressive and delinquent behavior. With each increased unit of PCE, children were 1.3 times more likely to be rated as aggressive (OR = 1.30, 95% CI: 1.02-1.67, p < 0.04). For each increased unit of PCE, girls were 2 times more likely to be rated as having delinquent behavior (OR = 2.08, 95% CI: 1.46-2.96, p < 0.0001). PCE status was also associated with increased odds of delinquent behavior (OR = 2.41; 95% CI: 1.16-4.97, p = 0.02), primarily due to the increased risk among girls with PCE. While girls with PCE status were 7 times more likely than NCE girls to have delinquent behaviors (OR = 7.42; 95% CI: 2.03-27.11, p < 0.002) boys with PCE did not demonstrate increased risk (OR = 0.98; 95% CI: 0.36-2.65, p > 0.97). Foster or adoptive parents were more likely to rate their PCE children as having more thought problems, inattention, delinquent behavior, aggression, externalizing and overall problems (p < 0.05) than biologic mothers or relative caregivers. Higher 2nd trimester tobacco exposure was associated with increased odds of caregiver reported anxiety (OR = 1.73; 95% CI 1.06-2.81, p < 0.03) and marijuana exposure increased the odds of thought problems (OR = 1.68; 95% CI 1.01-2.79, p < 0.05). Children with PCE self-reported fewer symptoms of oppositional defiant disorder (ODD) compared to NCE children (OR = 0.44, 95% CI: 0.21-0.92, p < 0.03). Greater tobacco exposure was associated with increased odds of child reported ODD (OR = 1.24; 95% CI 1.03-1.78, p < 0.03).ConclusionHigher PCE was associated with disruptive behaviors including aggression and delinquent behavior among girls by caregiver report, but not child report. These findings highlight the need for early behavioral assessment using multiple informants in multi-risk children. |
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Keywords: | Prenatal cocaine exposure Mental health Child Behavior Checklist Dominic Interactive Tobacco Neurobehavioral teratology |
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