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，这只能通过青春期神经成熟和社会需求的增加来明确测量，目前尚无定论。这一建议，产前可卡因暴露：青少年随访，是DA065320的竞争更新，DA065320是一项蒙面前瞻性纵向研究，该研究跟踪了大约140名照顾者/儿童对从1990-93年出生到小学的队列。我们研究了IUCE可能产生的多维效应，方法包括多名被调查者、通过婴儿胎粪确认物质暴露、重复测量照顾者尿液、重复行为和神经心理学评估，以及不太常见的测量方法，如婴儿期依恋分类、儿童中期精神诊断、重复照顾者和儿童暴力暴露评估（EV）。当前建议的目标是扩展这一丰富的纵向数据集，以记录从早期时期到早期（12-14.4岁）中期（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、注意力唤醒/调节以及精神和行为障碍和症状，这些都是通过青少年、照顾者和教师的标准评估和报告来衡量的。青少年早期开始使用酒精、烟草和其他药物以及相关危险行为的演变和后来的物质使用障碍是详细评估的重点，使用保密的计算机语音访谈和反复的尿液检测烟草、鸦片、可卡因、大麻和安非他明代谢物。青少年照顾者目前的药物使用、心理困扰和其他重要的家庭特征也将被测量，这些特征在该队列中从婴儿时期就被记录下来。复杂的统计纵向模型将允许评估发展性和并发性EV以及其他生物和社会因素，这些因素作为IUCE的协变量、混杂、中介或调节因子，有助于适应或不适应青少年的结果。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.