Risk-taking behavior among adolescents with prenatal drug exposure and extrauterine environmental adversity.
OBJECTIVE
High-risk environments characterized by familial substance use, poverty, inadequate parental monitoring, and violence exposure are associated with an increased propensity for adolescents to engage in risk-taking behaviors (e.g., substance use, sexual behavior, and delinquency). However, additional factors such as drug exposure in utero and deficits in inhibitory control among drug-exposed youth may further influence the likelihood that adolescents in high-risk environments will engage in risk-taking behavior. This study examined the influence of prenatal substance exposure, inhibitory control, and sociodemographic/environmental risk factors on risk-taking behaviors in a large cohort of adolescents with and without prenatal cocaine exposure (PCE).


METHODS
Risk-taking behavior (delinquency, substance use, and sexual activity) was assessed in 963 adolescents (433 cocaine-exposed, 530 nonexposed) at 15 years of age.


RESULTS
Prenatal cocaine exposure predicted later arrests and early onset of sexual behavior in controlled analyses. Associations were partially mediated, however, by adolescent inhibitory control problems. PCE was not associated with substance use at this age. In addition, male gender, low parental involvement, and violence exposure were associated with greater odds of engaging in risk-taking behavior across the observed domains.


CONCLUSIONS
Study findings substantiate concern regarding the association between prenatal substance exposure and related risk factors and the long-term outcomes of exposed youth. Access to the appropriate social, educational, and medical services is essential in preventing and intervening with risk-taking behaviors and the potential consequences (e.g., adverse health outcomes and incarceration), especially among high-risk adolescent youth and their families.
*Department of Psychology, University of Miami, Coral Gables, FL; †Department of Statistics and Epidemiology, RTI International, Research Triangle Park, NC; ‡Department of Pediatrics, University of Miami, Miller School of Medicine, Miami, FL; §Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI; ‖Department of Pediatrics, University of Kentucky Hospital, Lexington, KY; ¶Department of Pediatrics, Brown Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Women and Infants Hospital of Rhode Island, Providence, RI; **Department of Pediatrics, Boling Center for Developmental Disabilities, University of Tennessee Health Science Center, Memphis, TN; ††Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
Brittany L
BL
Lambert
Carla M
CM
Bann
Charles R
CR
Bauer
Seetha
S
Shankaran
Henrietta S
HS
Bada
Barry M
BM
Lester
Toni M
TM
Whitaker
Linda L
LL
LaGasse
Jane
J
Hammond
Rosemary D
RD
Higgins
D000293:Adolescent; D000294:Adolescent Behavior / Q000187:drug effects / Q000523:psychology*; D003042:Cocaine / Q000009:adverse effects*; D056344:Executive Function / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D007604:Juvenile Delinquency / Q000523:psychology; D016487:Parenting / Q000523:psychology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000503:physiopathology / Q000523:psychology*; D012307:Risk Factors; D012309:Risk-Taking; D012737:Sex Factors; D012725:Sexual Behavior / Q000187:drug effects / Q000523:psychology; D012931:Social Environment; D019966:Substance-Related Disorders / Q000209:etiology / Q000523:psychology; D014754:Violence / Q000523:psychology
D003042:Cocaine