Developmental Effects of Prenatal Cocaine Exposure

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DESCRIPTION (provided by applicant): This Revision Application is in response to NOT-OD-10-032: NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications (R01, R03, R15, R21, R21/R33, and R37) through the NIH Basic Behavioral and Social Science Opportunity Network (OppNet). There are few prospective studies directly assessing the impact of stress responsivity on later psychological adjustment. To fill this critical gap, this study seeks to examine early and later cortisol response to stress on its relation to psychological adjustment in a sample of low income, inner-city adolescents. This proposal involves the examination of longitudinal data from an ongoing study, "Developmental Effects of Prenatal Cocaine Exposure" (R01 DA07109), as well as the addition of new data. The original aims of the parent grant focused on the developmental effects of prenatal cocaine exposure. In this study, we will expand the original scope of the parent grant to address broader questions relating to the impact of high risk environments from which this sample is taken. For this proposal, given the time constraints and the nature of the problem, we will examine only those children in our sample who were not exposed to cocaine in utero. The proposed study will accomplish several important goals. First, we will examine how early cortisol response to stress impacts on subsequent psychological adjustment. We will examine whether individual patterns of cortisol response precede the onset of emotional and behavioral problems by analyzing data previously collected at 8 time points from ages 4 to 13 and collecting new measures of stress and psychological adjustment at age 17. Second, we will examine whether early cortisol response to stress is related to later cortisol response to stress. Few studies have examined individual patterns of cortisol response to stress within or across developmental periods early in life, and the results from these are inconsistent. Thus, we will be able to investigate both developmental change and variation in HPA activity over time, using novel analytic models of continuity and change. Our third aim is to determine whether later cortisol response to stress mediates the relation between early cortisol response and later psychological adjustment. Preliminary studies have shown that the Trier Social Stress Test for Children (TSST-C) is both age- appropriate and effective in eliciting a stress response. In a pilot study, mean cortisol levels increased after administration of the TSST-C. Preliminary data analyses at earlier ages indicate that there are important individual differences in cortisol reactivity as well as variability in measures of subsequent psychological adjustment among this subsample of adolescents from low-income, inner-city environments. Few other studies have integrated HPA response to acute stress and psychological health within a prospective longitudinal design. In addition, few studies have examined age-related changes in patterns of HPA axis reactivity within a low-income, inner-city adolescent population, taking environmental risk into account.