The theoretical construct of resilience, better-than-expected outcome following potential risk, provides an innovative framework for the longitudinal study of intrauterine cocaine exposure (IUCE) &intrauterine substance exposure (IUSE). Resilience evolves from person/environment interactions, which may buffer the impact of biologic &social risks. We propose a masked multidisciplinary longitudinal follow-up of 140-150 urban primarily African American/African Caribbean participants aged 18-24 (50% with IUCE), continuously followed since birth to document risks, protective &promotive factors in multiple domains. Unique features of the already collected &proposed data set include: Ainsworth attachment classification at 12 months, repeated prospective measurement since infancy of the caregiver's &child's exposure to violence, repeated measures of material hardship, &parents'incarceration, with the addition in this cycle of measures of discrimination, positive ethnic identity, &quality of young adult intimate relationships 61% of the sample initiated substance use by age 16 by self-report or urine assay. During the proposed period of study (4/1/2010 - 3/31/2015) the participants enter the developmental epoch when the emergence of SUDs, possible recovery from such disorders, &ability to undertake early adult roles become measurable, &executive &memory functions mature. We focus on selected biological contextual factors, which may be crucial in determining resilience &risk in these domains. We consider as potential biologic factors among others: gender, birth weight, IUCE, age at assessment, &a novel composite measurement of overall level of intrauterine substance exposures (IUSE) including levels of cocaine, tobacco, alcohol, &marijuana in a single scale, as well as the individual substances as distinct variables. The participant's timing of initiation &concurrent level of adolescent / young adult use of psychoactive substances are both indicators of biologic risk to the still developing central nervous system &a major outcome. We will analyze the influence of potentially buffering contextual factors from infancy to young adulthood contributing to: 1) Freedom from SUDs;2) Greater adaptive role function including fewer HIV risk behaviors, later childbearing, fewer psychiatric symptoms, less criminal behavior, &positive adaptation in education, employment &personal relationships;&3) Expected maturation of executive &memory functions. We propose generalized mixed linear models to utilize fully the longitudinal nature of the data, including growth curve models to delineate trajectories, stratified &interaction models to examine moderators, &structural equation path models to evaluate mediation. IUSE impacts many Americans of all ethnic groups ranging from infants to adults. This sample represents a demographic, which, compared to other groups, suffers more adverse life consequences from substance use &which, with or without IUSE, faces disproportionate levels of community stressors. Identification of factors fostering resilience in this context of health disparities is of particular scientific &public health relevance.

Public Health Relevance

Many Americans, ranging from infants to adults, have experienced intrauterine exposures to psychoactive substances which may put them at increased risk of adverse life trajectories in many dimensions. Therefore, following intrauterine exposures, delineation of infant, childhood, adolescent, and concurrent factors which can promote or inhibit resilience during young adulthood in multiple domains (including freedom from substance use disorders) has important implications for public health interventions.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA006532-23
Application #
8249442
Study Section
Child Psychopathology and Developmental Disabilities Study Section (CPDD)
Program Officer
Boyce, Cheryl A
Project Start
1999-08-01
Project End
2015-03-31
Budget Start
2012-04-01
Budget End
2013-03-31
Support Year
23
Fiscal Year
2012
Total Cost
$691,664
Indirect Cost
$229,068
Name
Boston Medical Center
Department
Type
DUNS #
005492160
City
Boston
State
MA
Country
United States
Zip Code
02118
Beeghly, Marjorie; Rose-Jacobs, Ruth; Martin, Brett M et al. (2014) Level of intrauterine cocaine exposure and neuropsychological test scores in preadolescence: subtle effects on auditory attention and narrative memory. Neurotoxicol Teratol 45:1-17
Frank, Deborah A; Kuranz, Seth; Appugliese, Danielle et al. (2014) Problematic substance use in urban adolescents: role of intrauterine exposures to cocaine and marijuana and post-natal environment. Drug Alcohol Depend 142:181-90
Frank, Deborah A; Rose-Jacobs, Ruth; Crooks, Denise et al. (2011) Adolescent initiation of licit and illicit substance use: Impact of intrauterine exposures and post-natal exposure to violence. Neurotoxicol Teratol 33:100-9
Gerteis, Jessie; Chartrand, Molinda; Martin, Brett et al. (2011) Are there effects of intrauterine cocaine exposure on delinquency during early adolescence? A preliminary report. J Dev Behav Pediatr 32:393-401
Rose-Jacobs, Ruth; Soenksen, Shayna; Appugliese, Danielle P et al. (2011) Early adolescent executive functioning, intrauterine exposures and own drug use. Neurotoxicol Teratol 33:379-92
Maril, A; Davis, P E; Koo, J J et al. (2010) Developmental fMRI study of episodic verbal memory encoding in children. Neurology 75:2110-6
Rose-Jacobs, Ruth; Waber, Deborah; Beeghly, Marjorie et al. (2009) Intrauterine cocaine exposure and executive functioning in middle childhood. Neurotoxicol Teratol 31:159-68
MacDonald, Helen Z; Beeghly, Marjorie; Grant-Knight, Wanda et al. (2008) Longitudinal association between infant disorganized attachment and childhood posttraumatic stress symptoms. Dev Psychopathol 20:493-508
Rivkin, Michael J; Davis, Peter E; Lemaster, Jennifer L et al. (2008) Volumetric MRI study of brain in children with intrauterine exposure to cocaine, alcohol, tobacco, and marijuana. Pediatrics 121:741-50
Lumeng, Julie C; Cabral, Howard J; Gannon, Katherine et al. (2007) Pre-natal exposures to cocaine and alcohol and physical growth patterns to age 8 years. Neurotoxicol Teratol 29:446-57

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