title: Prenatal substance exposure: What predicts behavioral resilience by early adolescence?
abstract: Understanding behavioral resilience among at-risk adolescents may guide public policy decisions and future programs. We examined factors predicting behavioral resilience following intrauterine substance exposure in a prospective longitudinal birth-cohort study of 136 early adolescents (ages 12.4-15.9 years) at risk for poor behavioral outcomes. We defined behavioral resilience as a composite measure of lack of early substance use initiation (before age 14), lack of risky sexual behavior, or lack of delinquency. Intrauterine substance exposures included in this analysis were cocaine, tobacco, alcohol, and marijuana. We recruited participants from Boston Medical Center as mother-infant dyads between 1990 and 1993. The majority of the sample was African American/Caribbean (88%) and 49% female. In bivariate analyses, none and lower intrauterine cocaine exposure level predicted resilience compared with higher cocaine exposure, but this effect was not found in an adjusted model. Instead, strict caregiver supervision (adjusted odds ratio [AOR] = 6.02, 95% confidence interval (CI) [1.90, 19.00], p = .002), lower violence exposure (AOR = 4.07, 95% CI [1.77, 9.38], p < .001), and absence of intrauterine tobacco exposure (AOR = 3.71, 95% CI [1.28, 10.74], p = .02) predicted behavioral resilience. In conclusion, caregiver supervision in early adolescence, lower violence exposure in childhood, and lack of intrauterine tobacco exposure predicted behavioral resilience among a cohort of early adolescents with significant social and environmental risk. Future interventions should work to enhance parental supervision as a way to mitigate the effects of adversity on high-risk groups of adolescents. (PsycINFO Database Record
authors.affiliation: Clinical Addiction Research and Education Unit, Boston Medical Center.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Liebschutz
authors.affiliation: Department of Family Medicine, Boston Medical Center.
authors.forename: Denise
authors.initials: D
authors.lastname: Crooks
authors.affiliation: Department of Pediatrics, Boston Medical Center.
authors.forename: Ruth
authors.initials: R
authors.lastname: Rose-Jacobs
authors.affiliation: Department of Biostatistics, Boston University School of Public Health.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Cabral
authors.affiliation: Data Coordinating Center, Boston University School of Public Health.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Heeren
authors.affiliation: Abt Associates, Inc.
authors.forename: Jessie
authors.initials: J
authors.lastname: Gerteis
authors.affiliation: Data Coordinating Center, Boston University School of Public Health.
authors.forename: Danielle P
authors.initials: DP
authors.lastname: Appugliese
authors.affiliation: Clinical Addiction Research and Education Unit, Boston Medical Center.
authors.forename: Orlaith D
authors.initials: OD
authors.lastname: Heymann
authors.affiliation: Clinical Addiction Research and Education Unit, Boston Medical Center.
authors.forename: Allison V
authors.initials: AV
authors.lastname: Lange
authors.affiliation: Department of Family Medicine, Boston Medical Center.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Frank
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D000294:Adolescent Behavior / Q000502:physiology; D002188:Cannabis / Q000009:adverse effects; D003042:Cocaine / Q000009:adverse effects; D000431:Ethanol / Q000009:adverse effects; D008137:Longitudinal Studies; D016487:Parenting / Q000523:psychology; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced; D055500:Resilience, Psychological / Q000187:drug effects; D014754:Violence / Q000523:psychology; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
chemical_list: D003042:Cocaine; D000431:Ethanol; D014028:Tobacco Smoke Pollution