Prenatal Cocaine Exposure: Adolescent Follow-up

描述（由申请人提供）：子宫内可卡因暴露（IUCE）是否对神经认知和社会行为功能产生影响，这只能通过青少年神经成熟和社会需求的增加来确定，目前尚未解决。这项建议，产前接触：青少年随访，是一个竞争性的更新DA 065320，一个掩蔽的前瞻性纵向研究，已跟踪队列的约140名照顾者/儿童二对从1990年至1993年出生到小学。我们研究了IUCE可能的多方面影响，使用多个信息提供者，婴儿胎粪和照顾者尿液的重复测量，重复的行为和神经心理学评估，以及不太常见的措施，如婴儿期的依恋分类，儿童中期的精神病诊断，重复的照顾者和儿童暴露于暴力（EV）的评估。目前建议的目标是扩展这一丰富的纵向数据集，以记录从早期（12-14.4岁）到早期（14.5-16.4岁）和晚期（16.5-18岁）青春期的发展轨迹，这些领域的理论和先前的数据表明可能特别容易受到IUCE的影响。这些包括认知，表达性语言，执行认知功能的组成部分，注意力唤起/调节，精神和行为障碍和症状，通过青少年，照顾者和教师的标准评估和报告进行测量。青少年早期开始使用酒精、烟草和其他药物，以及相关风险行为的演变和后来的物质使用障碍是使用保密的计算机语音访谈和重复的烟草、阿片类药物、可卡因、大麻和安非他明代谢物尿液分析进行详细评估的重点。青少年的照顾者目前的物质使用，心理困扰和其他重要的家庭特征，已记录在这个队列中，因为婴儿期也将被测量。复杂的统计纵向模型将允许评价发展和并发EV和其他生物和社会因素，作为协变量，混淆，调解人，或主持人的IUCE有助于适应或适应不良的青少年的结果。这些数据可以为临床干预和公共政策选择提供信息，以照顾从婴儿期到青春期的IUCE青少年。

DESCRIPTION (provided by applicant): Whether in utero cocaine exposure (IUCE) exerts effects on neurocognitive and social behavioral functions that can only be definitively measured with the increasing neuromaturation and social demands of adolescence is unresolved. This proposal, Prenatal Cocaine Exposure: Adolescent Follow-Up, is a competing renewal to DA065320, a masked prospective longitudinal study which has followed a cohort of approximately 140 caregiver/child dyads from birth in 1990-93 through elementary school. We have studied the possible multidimensional effect of IUCE using multiple informants, confirmation of substance exposure by infant meconium and repeated measures of caregivers' urine, repeated behavioral and neuropsychological assessments, and less common measures such as attachment classification in infancy, psychiatric diagnoses in middle childhood, repeated caregiver and child assessments of exposure to violence (EV). The goals of the current proposal are to extend this rich longitudinal data set to document trajectories of development from earlier epochs to early (12-14.4 years) middle (14.5-16.4 years) and late (16.5-18 years) adolescence in domains which theory and prior data suggest may be particularly vulnerable to IUCE. These include cognition, expressive language, components of executive cognitive function, attention arousal/regulation, and psychiatric and behavioral disorders and symptoms, measured by standard assessments and reports of adolescents, caregivers, and teachers. Adolescents' early initiation of alcohol, tobacco, and other drug use and evolution of associated risk behaviors and later substance use disorders are the focus of detailed assessment using confidential computerized voiced interviews and repeated urine assays for tobacco, opiate, cocaine, marijuana, and amphetamine metabolites. The adolescent s caregivers' current substance use, psychological distress and other important family characteristics which have been documented in this cohort since infancy will also be measured. Complex statistical longitudinal models will permit evaluation of developmental and concurrent EV and other biologic and social factors which, as covariates, confounds, mediators, or moderators of IUCE contribute to adaptive or maladaptive adolescent outcomes. Such data can inform clinical interventions and public policy choices for care of youngsters with IUCE from infancy to adolescence.