Sensorimotor development in cocaine-exposed infants

This study investigated the effects of prenatal cocaine exposure on infant sensorimotor development. One hundred and sixty-seven12-month-olds (74 cocaine-exposed and 93 unexposed) were assessed using the Bayley Scales of Infant Development (BSID). Ninety-seven had previously been evaluated on the Movement Assessment of Infants and the Test of Sensory Functions in Infants at age 4 months. On the BSID, the cocaine-exposed infants performed less well on the Mental portion and were more frequently rated as behaviorally suspect. Cocaine-exposed infants also performed less well at four months on the motor and sensory measures. Early motor performance predicted 12 month BSID mental, motor and behavioral outcomes. Cocaine exposure had an effect independent from confounders on general cognitive and specific motor and behavioral outcomes.     

Prenatal exposure to methadone and buprenorphine: A review of the potential effects on cognitive development

The amount of opioid users receiving opioid maintenance therapy has increased significantly over the last few years. As a result, an increasing number of children are prenatally exposed to long-lasting opioids such as methadone and buprenorphine. This article reviews the literature on the cognitive development of children born to mothers in opioid maintenance therapy. Topics discussed are the effects of prenatal exposure on prematurity, somatic growth, brain volume, myelination, and the endocrine and neurotransmitter system. Social-environmental factors, including parental functioning, as well as genetic factors are also described. Areas requiring further research are identified.     

Effects of maternal inattentiveness on infant social referencing

The aim of the study was to clarify the meaning of infant looking behaviour when the infant is confronted with an ambiguous situation in order to disentangle the two processes social referencing and attachment. Ninety‐six 12‐month‐olds, presented with an ambiguous or an unambiguous toy, were assigned to one of four conditions; mother inattentive, mother conveyed positive information, and mother conveyed negative information about the ambiguous toy. In the fourth condition (control condition), an unambiguous toy was presented (mother inattentive). The ambiguous situation elicited more referencing looks than the unambiguous situation. During the presentation of the ambiguous toy, infants with inattentive mothers referenced the experimenter more than infants whose mothers provided guidance. In the following free‐play situation, infants in the inattentive group referenced mother to a higher degree than did the other infants. They played less with the toy than infants who had received positive information and infants in the control group, and were less eager to explore the surroundings than infants in the other three groups. When mother turned attentive the infants ceased referencing her and showed an interest in exploring. Copyright © 2003 John Wiley & Sons, Ltd.     

Effects of maternal employment patterns on adolescents' substance use and other risk-taking behaviors

Employment for mothers with school-age children has generated great concern regarding its possible harmful effects on adolescents and their families. We examined the influence of maternal employment on the risk-taking behavior of adolescents in two-parent families. Three hundred and eighty-nine high school students completed a 48-item survey in which they indicated their mother's and father's employment patterns, and their own risk-taking behaviors (e.g., substance use, driving while under the influence). Results showed no significant effects of maternal employment on adolescent risk-taking behaviors.     

Prenatal SSRI exposure: Effects on later child development

The aim of this review is to integrate research on the pharmacological mechanisms of selective serotonin reuptake inhibitors (SSRIs) and the following effects on fetal brain development and child cognitive function seen in children with prenatal exposure to SSRIs. As antidepressants are transferred from the mother to the fetus through the placenta, the fetus is vulnerable to alterations in neurotransmission and possibly altered neural functioning. Because of this risk, pregnant women suffering from depression are often advised to discontinue their use of antidepressants during pregnancy. Though, maternal untreated depression may also have negative consequences for the fetus and child after birth. In the present review, we find a distinction between studies of early versus late development. Studies on early cognitive development indicate no negative effects, while studies on later development report some cognitive difficulties and behavioral problems, indicating latent effects of exposure. However, the reviewed studies are not all converging, and it is not clear whether and to what extent prenatal SSRI exposure affects cognitive development.     

Predictors and moderators of improved social-emotional functioning in mothers with substance use disorders and their young children enrolled in a relationship-based case management program

Mothers with substance use disorders (SUDs) typically have trauma histories and psychosocial difficulties that lead to poor social-emotional functioning and disrupted mother–child relationships. This 12-month study explored associations of family adverse circumstances and services (case management, therapeutic, and community-based) received by 57-mothers with SUDs and their infants (less than 24-months-old) with changes in social-emotional functioning. All mothers were enrolled in a relationship-based case management program (Parent–Child Assistance Program [PCAP]) that emphasized connecting mothers to appropriate community services. A subset of mothers was additionally provided a trauma-focused psychotherapeutic intervention (infant–parent psychotherapy [IPP]). Dyads in both treatment groups improved in overall social-emotional functioning as assessed by the Functional Emotional Assessment Scale (FEAS). A combined-sample regression analysis revealed that improved FEAS scores were significantly predicted by the number of community services received but not by PCAP case management hours (IPP was not included in this analysis). More adverse circumstances were associated with less improvement in social-emotional functioning in the children; but among the mothers trauma level did not predict FEAS scores. We also found a moderating effect of trauma: Dyads with relatively more adversity showed a significantly greater association of community services received with improvement in FEAS scores than did those with relatively less adversity.     

Effects of cocaine and alcohol, alone and in combination, on human learning and performance.

The acute effects of cocaine hydrochloride (4 to 96 mg/70 kg) and alcohol (0 to 1.0 g/kg), administered alone and in combination, were assessed in two experiments with human volunteers responding under a multiple schedule of repeated acquisition and performance of response chains. Subjects were intermittent users of cocaine and regular drinkers who were not cocaine or alcohol dependent. Alcohol was mixed with orange juice and ingested in six drinks within 30 min; cocaine was administered intranasally 45 min after completion of drinking. In each component of the multiple schedule, subjects completed response sequences using three keys of a numeric keypad. In the acquisition component, a new sequence was learned each session. In the performance component, the response sequence always remained the same. Results were consistent in both experiments, despite variations in the order in which the drugs were tested alone and in combination. Alcohol administered alone increased overall percentage of errors and decreased rates of responding in the acquisition component, whereas responding in the performance component generally was unaffected. Cocaine administered alone decreased rates of responding but did not affect accuracy of responding in the acquisition component, and enhanced accuracy of responding without affecting rates of responding in the performance component. The combined doses of cocaine and alcohol attenuated the effects observed with alcohol and cocaine alone. These results suggest that, under the conditions investigated in this study, (a) alcohol produces greater behavioral disruption than cocaine or cocaine-alcohol combinations, (b) cocaine and alcohol each attenuate effects of the other, and (c) such attenuation is most pronounced for cocaine attenuating the disruptive effects of alcohol.     

A randomized trial of employment-based reinforcement of cocaine abstinence in injection drug users

High-magnitude and long-duration abstinence reinforcement can promote drug abstinence but can be difficult to finance. Employment may be a vehicle for arranging high-magnitude and long-duration abstinence reinforcement. This study determined if employment-based abstinence reinforcement could increase cocaine abstinence in adults who inject drugs and use cocaine during methadone treatment. Participants could work 4 hr every weekday in a workplace where they could earn about $10.00 per hour in vouchers; they were required to provide routine urine samples. Participants who attended the workplace and provided cocaine-positive urine samples during the initial 4 weeks were invited to work 26 weeks and were randomly assigned to an abstinence-and-work (n = 28) or work-only (n = 28) group. Abstinence-and-work participants had to provide urine samples showing cocaine abstinence to work and maintain maximum pay. Work-only participants could work independent of their urinalysis results. Abstinence-and-work participants provided more (p = .004; OR = 5.80, 95% CI = 2.03-16.56) cocaine-negative urine samples (29%) than did work-only participants (10%). Employment-based abstinence reinforcement can increase cocaine abstinence.     

Effects of daily morphine administration and deprivation on choice and demand for remifentanil and cocaine in rhesus monkeys

Choice procedures have indicated that the relative reinforcing effectiveness of opioid drugs increases during opioid withdrawal. The demand curve, an absolute measure of reinforcer value, has not been applied to this question. The present study assessed whether mild morphine withdrawal would increase demand for or choice of remifentanil or cocaine. Four rhesus monkeys chose between remifentanil and cocaine during daily sessions. Demand curves for both drugs were subsequently obtained. The effects of daily injections of 3.2 mg/kg morphine on both choice and demand for these drugs was assayed 3 and 20.5 hr after each morphine injection, and then during a postmorphine period. Three hours following morphine injections, choice of remifentanil over cocaine decreased and demand for remifentanil--but not cocaine--became more elastic. During morphine withdrawal (20.5 hr postinjection), choice of remifentanil increased and remifentanil demand became more inelastic in 3 of 4 monkeys. Cocaine demand also became more inelastic during this period. Four to five weeks following the morphine regimen, demand for both drugs was more inelastic relative to the initial determination. The results suggest that both the relative and absolute reinforcing effectiveness of remifentanil decreased following morphine administration and increased during morphine withdrawal. The absolute reinforcing effectiveness of cocaine also increased during morphine withdrawal. In addition, extended exposure to drug self-administration and/or exposure to the morphine regimen produced long-term increases in demand for both drugs.     

The role of sustained attention,maternal sensitivity,and infant temperament in the development of early self-regulation

This study investigated infant predictors of early cognitive and emotional self-regulation from an intrinsic and caregiving environmental perspective. Sustained attention, reactive aspects of infant temperament, and maternal sensitivity were assessed at 10 months (n = 124) and early self-regulation (including executive functions, EF, and emotion regulation) was assessed at 18 months. The results indicated that sustained attention predicted early EF, which provide empirical support for the hierarchical framework of EF development, advocating early attention as a foundation for the development of cognitive self-regulation. Maternal sensitivity and surgency predicted emotion regulation, in that infants of sensitive mothers showed more regulatory behaviours and a longer latency to distress, whereas high levels of surgency predicted low emotion regulation, suggesting both the caregiving environment and temperament as important in the development of self-regulation. Interaction effects suggested high sustained attention to be a protective factor for children of insensitive mothers, in relation to emotion regulation. In addition, high levels of maternal sensitivity seemed to foster development of emotion regulation among children with low to medium levels of sustained attention and/or surgency. In all, our findings point to the importance of both intrinsic and extrinsic factors in infant development of self-regulation.     

Interpersonal Trauma and Physical Health Symptoms in College Students: Mediating Effects of Substance Use and Self-Blame

The present study examined the mediating effect of two coping mechanisms (substance use and self-blame) on the relationship between interpersonal trauma (IPT) exposure and self-reported physical health symptoms in college students. Participants included 365 trauma-exposed college students. We used multigroup structural equation modeling to test our hypothesized model and to determine whether the hypothesized relationships were moderated by gender. Results indicated that IPT exposure was associated with increased substance-use coping and self-blame. These two coping mechanisms, in turn, predicted increased physical health symptoms. The results of the moderation analysis indicated no significant gender differences in the hypothesized relationships.     

Effects of prenatal cocaine and genotype on intermale agonistic behavior in Mus musculus

We exposed the pups of three F₁ genotypes of mice to a daily regime of cocaine by injecting their mothers (all C57BL/10J strain) on days 7–18 of gestation with 20 mg/kg subcutaneously. Pups of the cocaine and control groups did not differ on measures of maternal and pup health or size. Male pups were weaned and isolated at 21 days of age and their behaviors measured in an intermale aggression situation at about 80 days of age. Treated and untreated males of each F₁ genotype were paired in dyads with either a C3H/HeJ (hawk-like) or AKR/J (retaliator-like) standard tester male. Standard tester males were not exposed to cocaine. Cocaine treatment alone reduced the overall level of aggression in dyads, and in interaction with genotype or the standard tester it altered the behavior of dyads in all phases of social interaction: the initiation, content, and outcome. Standard testers used as behavioral probes, differentiated cocaine and control males with respect to their stimulus and behavioral qualities. Aggr. Behav. 23:183–196, 1997.© 1997 Wiley-Liss, Inc.     

Prenatal depression effects on early development: A review

This review of recent research on prenatal depression suggests that it is a strong predictor of postpartum depression and is more common than postpartum depression. Prenatal depression has been associated with excessive activity and growth delays in the fetus as well as prematurity, low birthweight, disorganized sleep and less responsiveness to stimulation in the neonate. Infants of depressed mothers have difficult temperament, and later in development attentional, emotional and behavioral problems have been noted during childhood and adolescence, as well as chronic illnesses in adulthood. Several variables have confounded the effects of prenatal depression including comorbid anxiety and anger as well as stressful life events. Potential mediating variables are low prenatal maternal dopamine and serotonin levels and elevated cortisol and norepinephrine. The associated intrauterine artery resistance may limit blood flow, oxygen and nutrients to the fetus. Some studies also suggest the heritability of developmental problems for the children of prenatally depressed mothers, including ADHD and antisocial behavior. Multivariate, longitudinal research is needed to disentangle these confounding and mediating variables.     

Associations between symptoms of maternal postpartum depression,gestational age and infant social withdrawal: A longitudinal study in a community cohort

Infant social withdrawal is a risk factor for non-optimal child development; thus, it is important to identify risk factors associated with withdrawal. In a large community sample (N = 19,017), we investigate whether symptoms of maternal and partner postpartum depression (PPD; measured with the Edinburgh Postnatal Depression Scale) and prematurity are predictors of infant social withdrawal (measured with the Alarm Distress Baby Scale). Withdrawal was assessed at 2–3, 4–7 and 8–12 months postpartum. Linear regressions showed that prematurity predicted higher infant social withdrawal at all time points, and maternal symptoms of PPD were positively associated with withdrawal at 2–3 months. Logistic regressions showed that odds for elevated social withdrawal were increased with elevated levels of maternal symptoms of PPD at 2–3 and 8–12 months. Partner's symptoms of PPD were not associated with withdrawal. Future studies should investigate how PPD symptoms and prematurity may impact the individual development of social withdrawal.