title: Psychological Distress Among School-Aged Children with and Without Intrauterine Cocaine Exposure: Perinatal Versus Contextual Effects.
abstract: Whether intrauterine cocaine exposure (IUCE) explains unique variance in psychiatric functioning among school age children, even after controlling for other biological and social risk factors, has not been fully delineated. As part of a longitudinal birth cohort study of children with and without IUCE, we conducted and analyzed data based on structured clinical interviews with 105 children (57% male) and their caregivers when the child was approximately 8.5 years old; 47% of the children had experienced IUCE. Interviews included past and current major psychological disorders and sub-threshold mental health symptoms. Potential covariates were ascertained by interviews of birth mothers and other caregivers from shortly after the child's birth until the 8.5-year visit. More than one-third of children met DSM-IV criteria for one or more mood, anxiety, attention deficit, or disruptive behavior disorders. IUCE was not significantly associated with children's history of psychological distress, in either bivariate or multiple logistic regressions. In contrast, birth mothers' acknowledgement of greater psychiatric distress at baseline and higher levels of alcohol consumption during pregnancy, and at 8.5 years caregivers' reports of their own psychological distress, and children's lower IQ were predictors of higher rates of psychological morbidity. Findings are consistent with prior reports suggesting that, regardless of IUCE status, children from low-income, urban backgrounds are at heightened risk for psychological distress. Results underscore the need for closer monitoring of the mental health of children living in low-income households, with or without intrauterine substance exposures, to facilitate access to appropriate services.
authors.affiliation: Division of Psychiatry, Boston University School of Medicine, Boston, MA, USA. markrich@bu.edu.|Department of Psychological and Brain Sciences, Boston University, 648 Beacon Street, 2nd floor, Boston, MA, 02215, USA. markrich@bu.edu.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Richardson
authors.affiliation: Private Practice, Wheaton, IL, USA.
authors.forename: Wanda
authors.initials: W
authors.lastname: Grant-Knight
authors.affiliation: Department of Psychology, Wayne State University, Detroit, MI, USA.|Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Beeghly
authors.affiliation: Division of Developmental and Behavioral Medicine, Boston Medical Center, Boston, MA, USA.|Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Rose-Jacobs
authors.affiliation: Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Clara A
authors.initials: CA
authors.lastname: Chen
authors.affiliation: Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Danielle P
authors.initials: DP
authors.lastname: Appugliese
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Cabral
authors.affiliation: General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, MA, USA.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Liebschutz
authors.affiliation: Division of Developmental and Behavioral Medicine, Boston Medical Center, Boston, MA, USA.|Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Frank
mesh_terms: D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000523:psychology; D003042:Cocaine; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology; D011203:Poverty; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*
chemical_list: D003042:Cocaine
keywords: Caregiver psychiatric history; Children; Intrauterine alcohol exposure; Intrauterine cocaine exposure