The proposed study applies developmental theory and research on parenting cognitions to the study of a major public health problem, maternal substance use during pregnancy and its implications for infant developmental outcome. Ultimately, the project aims to provide guidance for the development of appropriate interventions for optimizing the developing early mother-infant relationship of substance using mothers and their newborns, thereby laying the foundation for positive child developmental outcome. Specifically, the proposed research will examine four constructs of parenting cognition in substance using and substance free women, both prenatally and over the first 6-8 months post-partum: parenting beliefs, attitudes towards child-rearing, perceptions of infant difficulties, and self-perceptions of parenting competence. The proposed investigation will be guided by the following goals: (a) to refine the existing conceptual understanding of parenting cognitions by examining the interrelationships among the various constructs in both substance using and substance free samples; (b) to elucidate the influence of maternal substance use on parenting cognitions by comparing substance using and substance free pregnant women and mothers; (c) to examine if and how parenting cognitions change over time, from pregnancy through 6-8 months post-partum in both substance using and substance free mothers, and the extent to which level of infant difficultness appears to influence these changes; (d) to examine the extent that parenting cognitions explain both quality of mother-infant interaction and child developmental outcome at 6-8 months above and beyond the influence of maternal substance use; and (e) based on these data, to provide suggestions for designing more appropriate interventions with substance using mothers that best match the unique cognitive demands of this high risk population. The project will operate collaboratively with the Wake County Department of Health (located in Raleigh, North Carolina) which currently runs an outpatient substance abuse treatment program for pregnant women and new mothers up to 18 months post-partum. With the assistance of staff at the health department, 40 substance using pregnant women enrolled in the treatment program and 40 substance free pregnant women utilizing the clinic for routine prenatal care will be recruited for the proposed study. In order to expedite the research, only women in their third trimester of pregnancy will be recruited. In addition, to control for the effects of race, age, and socioeconomic status, only African American women over the age of 18 who are eligible for Medicaid will be recruited. The study will be conducted in three interviewing phase. First, prior to delivery, participants will be administered a measure of parenting cognitions. along with several other measures designed to gather information about potential interacting or confounding variables (e.g., maternal IQ, depression, social support, experience of childhood abuse). These women will then be interviewed again at 1-month and 6-8 months post-partum, at which times they will also be videotaped during a play session with their babies for later coding of quality of mother-infant interaction and observer rating of infant difficulties. Finally, at 6-8 months, infant developmental outcome will be assessed using the Bayley Scales of Infant Development. All interviews will take place at Wake County Department of Health in a private setting. In an effort to reduce the likelihood of attrition, participants will receive gift certificates to a local department store at each phase of the study, in the amount of $10, $15, and $15 respectively.
