This is a continuation of grant RO1 DA07957 "The Effects of Prenatal Cocaine Exposure at School Age," a longitudinal study of the prenatal effects of cocaine/polydrug exposure (n=382;194 cocaine-exposed and 188 non-cocaine-exposed). This study, as well as others, has found differences among prenatally cocaine- exposed children that include deficits in perceptual reasoning, attention, language development and externalizing behavior problems compared to non-exposed children. The effects of environmental lead exposure and the differential impact of caregiver placement have been identified as important determinants of early developmental outcomes in this cohort, indicating the need for continued study at this developmental stage of newly emerging risk behaviors and social stress. We propose following this large cohort from age 15 through 18 years with the overarching objective of determining whether the negative effects of prenatal cocaine exposure on brain development continue to interfere with optimal developmental outcomes, and if cocaine exposure is associated with increased incidence of risky behavior, particularly substance misuse and mental health problems. Adolescents will be assessed using self and caregiver report, interview, bioassay and standardized assessments.
Specific aims are to: assess the relationship of prenatal cocaine exposure to cognitive and behavioral outcomes (risk taking and mental health problems) in adolescence and to assess lead levels, iron deficiency, caregiving and environmental correlates of exposure;explore models that assess the relationship of early cognitive deficits and behavior problems to risk taking behaviors in an adolescent high-risk cocaine/polydrug exposed cohort;assess parenting experiences and behaviors of caregivers of cocaine- exposed and non-exposed adolescents;and assess the direct and indirect relationships of prenatal cocaine exposure to adolescent behavioral outcomes. Our model focuses on the mediating effects of earlier deficits in cognitive performance, attention and inhibitory control on risk taking behavior and the moderating effects of gender. Effects of lead exposure, iron deficiency and caregiving environment will be explored using structural equation modeling (SEM) and path modeling. The results of this study will provide the basis for designing culturally sensitive interventions prenatally or early in life that could reduce risky teen behaviors and ultimately reduce serious lifelong health problems including substance dependence, trauma and HIV infection.

Public Health Relevance

A pattern of attention, behavioral regulation and cognitive problems among prenatally cocaine-exposed infants and children has been identified by this research group as well as others. Results indicate that fetal exposure to cocaine may have specific effects on brain development that can be observed in early cognitive and behavioral outcomes and that outcomes are also influenced by level of environmental lead exposure and caregiving quality. This study hypothesizes that the pattern of deficits found in childhood may translate into greater risk taking behavior including substance misuse and mental health problems in adolescence that can have grave consequences on adult productivity and health. Further research on prenatally cocaine-exposed adolescents will identify key points for the timing and focus of intervention and provide important content for public health messages.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA007957-19
Application #
8458157
Study Section
Child Psychopathology and Developmental Disabilities Study Section (CPDD)
Program Officer
Sirocco, Karen
Project Start
1994-01-01
Project End
2014-04-30
Budget Start
2013-05-01
Budget End
2014-04-30
Support Year
19
Fiscal Year
2013
Total Cost
$812,467
Indirect Cost
$294,972
Name
Case Western Reserve University
Department
None
Type
Schools of Social Work
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
Minnes, Sonia; Singer, Lynn; Min, Meeyoung O et al. (2014) Effects of prenatal cocaine/polydrug exposure on substance use by age 15. Drug Alcohol Depend 134:201-10
Minnes, Sonia; Singer, Lynn T; Min, Meeyoung O et al. (2014) Comparison of 12-year-old children with prenatal exposure to cocaine and non-exposed controls on caregiver ratings of executive function. J Youth Adolesc 43:53-69
Min, Meeyoung O; Minnes, Sonia; Lang, Adelaide et al. (2014) Externalizing behavior and substance use related problems at 15 years in prenatally cocaine exposed adolescents. J Adolesc 37:269-79
Min, Meeyoung O; Minnes, Sonia; Yoon, Susan et al. (2014) Self-reported adolescent behavioral adjustment: effects of prenatal cocaine exposure. J Adolesc Health 55:167-74
Lewis, Barbara A; Minnes, Sonia; Short, Elizabeth J et al. (2013) Language outcomes at 12 years for children exposed prenatally to cocaine. J Speech Lang Hear Res 56:1662-76
Min, Meeyoung O; Singer, Lynn T; Minnes, Sonia et al. (2013) Mediating links between maternal childhood trauma and preadolescent behavioral adjustment. J Interpers Violence 28:831-51
Min, Meeyoung O; Minnes, Sonia; Kim, Hyunsoo et al. (2013) Pathways linking childhood maltreatment and adult physical health. Child Abuse Negl 37:361-73
Lewis, Barbara A; Minnes, Sonia; Short, Elizabeth J et al. (2011) The effects of prenatal cocaine on language development at 10 years of age. Neurotoxicol Teratol 33:17-24
Minnes, Sonia; Lang, Adelaide; Singer, Lynn (2011) Prenatal tobacco, marijuana, stimulant, and opiate exposure: outcomes and practice implications. Addict Sci Clin Pract 6:57-70
McLaughlin, Annamaria Aguirre; Minnes, Sonia; Singer, Lynn T et al. (2011) Caregiver and self-report of mental health symptoms in 9-year old children with prenatal cocaine exposure. Neurotoxicol Teratol 33:582-91

Showing the most recent 10 out of 32 publications