title: Caregiver and self-report of mental health symptoms in 9-year old children with prenatal cocaine exposure.
abstract: OBJECTIVE
  To assess the effect of prenatal cocaine exposure on mental health symptoms in 9-year old children controlling for potential confounders.
  
  
  METHODS
  332 children (170 prenatally cocaine-exposed (PCE), 162 non cocaine-exposed (NCE) were assessed using self (Dominic Interactive; DI) and caregiver report (Child Behavior Checklist; CBCL).
  
  
  RESULTS
  Higher levels of PCE were associated with caregiver report of clinically elevated aggressive and delinquent behavior. With each increased unit of PCE, children were 1.3 times more likely to be rated as aggressive (OR=1.30, 95% CI: 1.02-1.67, p<0.04). For each increased unit of PCE, girls were 2 times more likely to be rated as having delinquent behavior (OR=2.08, 95% CI: 1.46-2.96, p<0.0001). PCE status was also associated with increased odds of delinquent behavior (OR=2.41; 95% CI: 1.16-4.97, p=0.02), primarily due to the increased risk among girls with PCE. While girls with PCE status were 7 times more likely than NCE girls to have delinquent behaviors (OR=7.42; 95% CI: 2.03-27.11, p<0.002) boys with PCE did not demonstrate increased risk (OR=0.98; 95% CI: 0.36-2.65, p>0.97). Foster or adoptive parents were more likely to rate their PCE children as having more thought problems, inattention, delinquent behavior, aggression, externalizing and overall problems (p<0.05) than biologic mothers or relative caregivers. Higher 2nd trimester tobacco exposure was associated with increased odds of caregiver reported anxiety (OR=1.73; 95% CI 1.06-2.81, p<0.03) and marijuana exposure increased the odds of thought problems (OR=1.68; 95% CI 1.01-2.79, p<0.05). Children with PCE self-reported fewer symptoms of oppositional defiant disorder (ODD) compared to NCE children (OR=0.44, 95% CI: 0.21-0.92, p<0.03). Greater tobacco exposure was associated with increased odds of child reported ODD (OR=1.24; 95% CI 1.03-1.78, p<0.03).
  
  
  CONCLUSIONS
  Higher PCE was associated with disruptive behaviors including aggression and delinquent behavior among girls by caregiver report, but not child report. These findings highlight the need for early behavioral assessment using multiple informants in multi-risk children.
authors.affiliation: Department of Psychology, College of Arts and Sciences, United States.
authors.forename: Annamaria Aguirre
authors.initials: AA
authors.lastname: McLaughlin
authors.forename: Sonia
authors.initials: S
authors.lastname: Minnes
authors.forename: Lynn T
authors.initials: LT
authors.lastname: Singer
authors.forename: Meeyoung
authors.initials: M
authors.lastname: Min
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Short
authors.forename: Teresa Linares
authors.initials: TL
authors.lastname: Scott
authors.forename: Sudtida
authors.initials: S
authors.lastname: Satayathum
mesh_terms: D000328:Adult; D017028:Caregivers / Q000523:psychology*; D002648:Child; D003042:Cocaine / Q000633:toxicity*; D003071:Cognition; D004777:Environment; D005260:Female; D006801:Humans; D007854:Lead / Q000097:blood; D008297:Male; D001523:Mental Disorders / Q000097:blood / Q000175:diagnosis* / Q000523:psychology*; D010290:Parents / Q000523:psychology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000097:blood / Q000523:psychology*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D057566:Self Report
chemical_list: D007854:Lead; D003042:Cocaine