Prenatal Cocaine Exposure: Adolescent Follow-up

描述(申请人提供)：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，只有随着青春期神经成熟和社会需求的增加才能确定，这一点尚未解决。这项名为产前可卡因暴露：青少年随访的提案是对DA065320的竞争性更新，DA065320是一项掩盖的前瞻性纵向研究，跟踪了大约140名照顾者/儿童从1990-93年出生到小学的队列。我们研究了IUCE可能的多维影响，使用了多个信息者，确认婴儿胎粪物质暴露和照顾者尿液的重复测量，重复的行为和神经心理评估，以及不常见的测量，如婴儿期的依恋分类，童年中期的精神诊断，重复照顾者和儿童暴露于暴力的评估(EV)。当前提案的目标是扩展这一丰富的纵向数据集，以记录从早期到青春期早期(12-14.4岁)、中期(14.5-16.4岁)和青春期晚期(16.5-18岁)的发展轨迹，理论和先前的数据表明，这些领域可能特别容易受到IUCE的影响。这些包括认知、表达语言、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，通过青少年、照顾者和教师的标准评估和报告来衡量。青少年早期开始使用酒精、烟草和其他药物，以及相关危险行为和后来的药物使用障碍的演变，是详细评估的重点，使用机密的计算机化语音访谈和重复的尿液分析烟草、鸦片、可卡因、大麻和苯丙胺代谢物。青少年S照顾者目前的物质使用，心理痛苦和其他重要的家庭特征也将被记录在这个队列中，这些特征从婴儿期起就被记录下来。复杂的纵向统计模型将允许评估发育和并发的EV以及其他生物和社会因素，这些因素作为IUCE的协变量、混淆、中介或调节因素，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患有宫内发育迟缓的青少年。

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.