Investigating the role of substance use exposure and maternal psychological risk on child neural and behavioral assessments of executive functioning

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Project Summary Alcohol and illicit drug use during the past month increased from 2019 to 2020 among pregnant women. Of women abstaining from substance use during pregnancy, up to 51% relapse by 3 months postpartum. Importantly, maternal substance use continues throughout childhood and adolescence, with 1 in 8 children under the age of 17 in the United States living with at least one parent with a substance use disorder. While previous work has evidenced prenatal substance exposure effects on child neurocognitive outcomes, prior assessments have overlooked the impact of being raised in households where substance use continues after delivery and throughout childhood. Further, this prior work has focused on prenatal substance use exposure in isolation without considering other psychological risk factors highly comorbid with substance use. Therefore, it is critical to identify the impact of substance use during pregnancy and beyond on child neurocognitive functioning, and determine whether substance use, or the myriad of psychological risk factors associated with substance use, shape child neurocognitive development. Here, I will analyze data from the Adolescent Brain Cognitive Development (ABCD) Study to assess the impact of prenatal and household substance exposure independently and in concert with maternal psychological risk on child executive functioning during early adolescence through measures of neural and behavioral correlates of executive functioning. Together, this work will provide further evidence of prenatal substance exposure effects on child neurocognitive development, highlighting the importance of continued household exposure to substance use and broader maternal psychological risk to child outcomes. Further, this approach will recognize the importance of psychological symptoms beyond substance use and provide an empirical foundation for future lifespan assessments of maternal psychopathology and its impact on other domains of children’s neurocognitive functioning. Finally, clinical implications include informing intervention and treatment programs for families affected by substance use by necessitating parenting-specific support across the lifespan and recognition of co-morbid psychological symptoms.