COCAINE EXPOSED INFANTS AND THEIR MOTHERS

描述：(申请人摘要) 在贫穷的城市，孕妇的可卡因使用率稳定在高水平， 在过去的十年里，少数族裔人口，以及由此产生的对 胎儿可卡因暴露对发育的长期负面影响 孩子。母亲使用可卡因还与许多其他风险有关 可能对儿童结局产生负面影响的情况，如增加 虐待/忽视儿童的风险，更大的母亲心理痛苦， 改变了照顾行为和暴力暴露。除了……之外 记录了学龄前和学龄前儿童的一系列结果， 这项拟议的研究旨在评估环境和母亲的心理 可卡因暴露儿童预后的相关因素。 拟议的研究将是纵向的、前瞻性的研究的继续 医疗、环境和发展方面的调查(NIDA 07957) 在生命的头两年，可卡因暴露的相关性。377 婴儿(195名接触可卡因；182名未接触)及其母亲/照顾者 将在4岁和6岁时看到，并给予标准化的评估 成长、认知、情绪行为、语言和神经心理学 结果。可卡因暴露由生物(尿/胎粪)和 自我报告措施，所有儿童来自同一种族/社会 阶级人口，并与非常低的出生体重匹配。在出生时， 人口统计、医学和产前药物滥用暴露情况从 病历回顾、临床访谈和胎粪分析。标准化 评估母亲心理状况、应对方式、社交能力的问卷 支持、智力和暴露在暴力环境中 之前评估的内容将会更新。环境风险，包括 虐待/忽视、成长失败、离家安置，以及 家庭环境，将被记录在整个过程中。录像带 儿童游戏和母婴互动的观察将 指挥。 数据将进行描述性评估，并通过一系列 MANOVAS/MANCOVAS(具有重复测量)和等级倍数 描述接触可卡因儿童的功能的回归分析 学龄前和早期学龄，以及可卡因和 其他药物暴露于儿童结局、母亲心理功能、 和环境风险。来自先前纵向研究的数据集将是 与4年和6年数据合并，以评估随时间推移的变化和预测性 婴儿风险模型，使用HLM或结构方程模型。这个 拟议的研究将提供有关长期儿童的信息 胎儿可卡因暴露的发育后遗症与母亲心理 状态与关爱行为对有效设计的指导作用 孕产妇药物治疗和儿童干预方案。

DESCRIPTION: (Applicant's Abstract) Cocaine use by pregnant women has stabilized at high rates in poor, urban, minority populations over the past decade, with resultant concern over the long-term negative effects of fetal cocaine exposure on the developing child. Maternal use of cocaine is also associated with numerous other risk conditions which can negatively affect child outcomes, such as increased risk for child abuse/neglect, greater maternal psychological distress, altered care-giving behavior, and violence exposure. In addition to documenting a range of child outcomes at preschool and early school ages, the proposed study aims to assess environmental and maternal psychological correlates of outcome in cocaine-exposed children. The proposed study will be a continuation of a longitudinal, prospective investigation (NIDA 07957) of the medical, environmental, and developmental correlates of cocaine exposure during the first two years of life. 377 infants (195 cocaine exposed; 182 non-exposed) and their mothers/care givers will be seen at 4 and 6 years of age, and given standardized assessments of growth, cognitive, emotional-behavioral, language, and neuropsychological outcomes. Cocaine exposure was determined by biologic (urine/meconium) and self-report measures, with all children drawn from the same race/social class population, and matched for very low birth weight status. At birth, demographic, medical, and prenatal substance abuse exposure were noted from chart review, clinical interview, and meconium analysis. Standardized questionnaires assessing maternal psychological status, coping style, social supports, intellectual ability, and exposure to violence which were previously assessed will be updated. Environmental risk, including abuse/neglect, growth failure, out of home placement, and characteristics of the home environment, will be documented throughout. Videotaped observations of child play and maternal child interactions will be conducted. Data will be evaluated descriptively, and through a series of MANOVAS/MANCOVAS (with repeated measures), and hierarchical multiple regression to describe the functioning of cocaine-exposed children at preschool and early school ages, and the relative impact of cocaine and other drug exposures to child outcomes, maternal psychological functioning, and environmental risk. Data sets from the prior longitudinal study will be merged with 4 and 6 year data to assess change over time and predictive models of infant risk, using HLM or structural equation models. The proposed research will provide information about long-term child developmental sequelae of fetal cocaine-exposure and maternal psychological status and care giving behaviors which can guide the design of effective maternal drug treatment and child intervention programs.