title: Prenatal drug exposure and peer victimization in early adolescence:  testing childhood anxiety/depression and aggression as possible mediators.
abstract: OBJECTIVE
  Children who are prenatally exposed to drugs may be at risk for emotion dysregulation, including childhood anxiety/depression and aggression, potentially increasing their risk for peer victimization. The objectives of this study were to investigate how prenatal drug exposure relates to adolescent peer victimization and the mediating effects of childhood anxiety/depression and aggression.
  
  
  METHODS
  Seventy-six prenatally drug exposed (PDE) and 38 nonexposed (NE) adolescent-caregiver dyads followed since birth and middle childhood, respectively, participated in an evaluation during adolescence. In middle childhood, caregivers reported on their child's anxiety/depression and aggression, and children reported on violence exposure. In adolescence, caregivers and adolescents responded to a parallel single-item measure of peer victimization. Analyses were conducted using multivariate linear and logistic regression models, adjusting for covariates, including violence exposure.
  
  
  RESULTS
  One-third (33.3%, n = 35) of the sample endorsed peer victimization: 40.8% PDE and 17.6% NE, p = .01. In middle childhood, PDE youth had more aggressive behaviors (11.92 vs 7.45, p < .01) and anxiety/depression symptoms (3.43 vs 1.76, p < .01) than NE youth. Anxious/depressed behavior during childhood mediated the association between prenatal drug exposure and adolescent peer victimization. Aggression was not a significant mediator.
  
  
  CONCLUSIONS
  The consequences of prenatal drug exposure extend into adolescence. Prenatal drug exposure may interfere with emotion regulation, resulting in anxious/depressed behavior during childhood and significantly increasing the risk for peer victimization during adolescence, even in the presence of violence exposure. Strategies to reduce anxious/depressed behavior among children with a history of prenatal drug exposure may reduce adolescent peer victimization.
authors.affiliation: Division of Growth & Nutrition, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
authors.forename: Stacy
authors.initials: S
authors.lastname: Buckingham-Howes
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Oberlander
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Kim
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Black
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000523:psychology*; D000437:Alcoholism / Q000523:psychology; D001007:Anxiety / Q000209:etiology / Q000523:psychology*; D058445:Bullying / Q000523:psychology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D002652:Child Behavior / Q000523:psychology; D003863:Depression / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010379:Peer Group; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000523:psychology*; D012907:Smoking / Q000523:psychology; D019966:Substance-Related Disorders / Q000523:psychology*; D011795:Surveys and Questionnaires; D014754:Violence / Q000523:psychology