Developmental Effects of Prenatal Cocaine Exposure

描述（由申请人提供）：这是拨款R01 DA07109“产前可卡因暴露的发育影响”的延续，是一项正在进行的关于产前可卡因暴露对儿童发育影响的纵向研究。为了这个延续，我们建议观察14-17岁的受试者。广泛的目的是确定产前可卡因暴露是否会继续影响发育结果，特别是危险行为。具体目标是：使用我们的模型（该模型控制了新生儿医疗风险、环境风险和其他产前物质暴露对结果的影响），确定在早期阶段看到的可卡因效应是否持续存在，特别是对危险行为的影响；探讨可卡因暴露对性腺激素和青春期发育的影响；确定男性对可卡因的易感性是否在其青春期的危险行为中继续存在；为了测试我们关于青少年危险行为的模型，我们使用了纵向数据分析技术，如路径模型、线性增长模型和结构方程模型。我们的模型特别关注早期抑制控制、注意力和情绪调节缺陷对危险行为的中介作用，以及性别和青春期发育的调节作用。青少年及其母亲将每年接受一次检查，以评估这些功能领域。措施将包括行为观察、生物分析、访谈、问卷调查、标准化测试和学校报告。公共卫生相关性：了解这些青少年在青春期中后期的情况将为他们的成年生活提供一个窗口。掌握青少年功能的数据将为在青少年时期进行干预提供基础，这可能会改变这些儿童的整个生命历程。鉴于抑制控制和情绪调节方面的困难，产前接触可卡因的青少年可能特别容易出现青少年问题，包括性冒险和药物使用，这些问题可能导致严重的健康后果，如创伤和艾滋病毒感染。

DESCRIPTION (provided by applicant): This is a continuation of grant R01 DA07109, "Developmental Effects of Prenatal Cocaine Exposure," an ongoing longitudinal study on the effects of prenatal cocaine exposure on children's development. For this continuation, we propose to observe the subjects from 14-17 years. The broad aim is to determine whether prenatal cocaine exposure continues to impact developmental outcome, in particular risky behavior. Specific aims are: to determine, using our model which controls for effects of neonatal medical risk, environmental risk, and other prenatal substance exposures on outcomes, whether the cocaine effects seen at earlier ages persist, particularly for risky behavior; to investigate whether cocaine exposure affects gonadal hormones and pubertal development; to determine whether increased male vulnerability to cocaine continues to be seen in their risky behavior in adolescence; and to test our model on risky behavior in adolescence, using longitudinal data analytic techniques, such as path modeling, linear growth modeling, and structural equation modeling. Our model focuses particularly on the mediating effects of earlier inhibitory control, attention, and emotional regulation deficits on risky behavior and the moderating role of gender and pubertal development. Adolescents and their mothers will be seen once a year to assess these domains of functioning. Measures will include behavioral observations, bioassays, interviews, questionnaires, standardized tests, and school reports. PUBLIC HEALTH RELEVANCE: Knowing what these teens are like during mid to late adolescence will provide a window into their adult lives. Having data on adolescent functioning will provide a basis for generating interventions during the teen years that could potentially change the entire life course of these children. Given difficulties of inhibitory control and emotional regulation, prenatally cocaine-exposed teens may be especially at risk for adolescent problems that include sexual risk-taking and substance use which potentiate serious health outcomes such as trauma and HIV infection.