Comparing alternative methods of measuring cumulative risk based on multiple risk indicators: Are there differential effects on children’s externalizing problems?

ObjectivesTo estimate the prevalence of maternal substance use problems during the first 1000 days of children’s lives, to inform planning and resourcing of antenatal screening and substance use in pregnancy...

BackgroundPrenatal and perinatal complications are established risk factors for psychotic disorder, but far less is known about these measures and psychotic experiences (PEs). We investigated the longitudinal effect of prenatal risk factors (maternal behavior, medication complications) and perinatal risk factors (birth weight, medical complications) on frequency of PEs. We also examined the cumulative risk of prenatal/perinatal risk factors, and differences between transient PE, persistent PE, and controls.MethodsThe Adolescent Brain Cognitive Development study is a large child cohort (age 9–10 at baseline; n = 11 872 with PE data). PEs were measured longitudinally using the Prodromal Questionnaire-Brief, Child version, and included only if reported as distressing. Mixed-effects models were used for analysis, controlling for random effects, and a substantial number of fixed-effects covariates.ResultsUrinary tract infection (β = 0.11, 95% confidence interval [CI] 0.03–0.19) and severe anemia (β = 0.18, 95% CI 0.07–0.29) increased frequency of distressing PEs in childhood. Number of prenatal complications increased frequency of PEs (β = 0.03, 95% CI 0.01–0.06) and risk of persistent PEs (odds ratio [OR] = 1.08, 95% CI 1.01–1.15). Maternal smoking was associated with an increased frequency of PEs (β = 0.11, 95% CI 0.04–0.18) and persistent PEs (OR = 1.31, 95% CI 1.04–1.66). Maternal substance use was a risk factor for a 48% increased risk of persistent PEs (OR = 1.48, 95% CI 1.08–2.01). Perinatal complications showed no effect on PEs.ConclusionsThis study provides evidence that certain prenatal medical complications (severe nausea, severe anemia), cumulative number of prenatal medical complications, and maternal behaviors (smoking during pregnancy), increased frequency of distressing PEs in childhood. Maternal smoking and substance use, as well as cumulative number of prenatal complications increased risk of persistent PEs.

Introduction: The United States is responsible for the highest rate of incarceration globally. The impacts of incarceration extend beyond those incarcerated and can result in adverse outcomes for chosen romantic or life partners and the family unit. This study aimed to explore the impact of partner incarceration on maternal substance use and whether the relationship between partner incarceration and maternal substance use is mediated by financial support, emergency social support, or neighborhood cohesion. Methods: Using data from the Fragile Families and Child Wellbeing Study, a longitudinal cohort following new parents and children, this analysis quantifies the relationship between paternal incarceration and maternal substance use (N=2246). Responses from mothers at years 3 (2001-2003), 5 (2003-2006), 9 (2007-2010), and 15 (2014-2017) were assessed, restricted to mothers who responded across waves. The exposure, partner incarceration, was operationalized as mothers reporting their current partner or child’s father to be ever incarcerated at year 3. The outcome, substance use in the past year (yes vs. no), was assessed at each time point. Respondents were asked whether they used marijuana, sedatives, tranquilizers, amphetamines, prescription painkillers, inhalants, cocaine, hallucinogens, or heroin. Three mediators were investigated at years 5 and 9: neighborhood cohesion, financial support, and emergency social support. Confirmatory factor analysis (CFA) was employed to construct support-related mediators. Counting on someone to loan $200, providing a temporary place to stay, and providing emergency childcare were hypothesized to load onto one factor (emergency social support) and counting on someone to loan $1000, co-sign a bank loan for $1000 and co-sign a bank loan for $5000 were hypothesized to load onto a separate factor (financial support). Items were weighted by factor loadings and responses were summed to create a scale for financial support and emergency social support, with a higher score denoting greater degree of support. Impact of partner incarceration and maternal substance use was modeled using multilevel modeling to account for repeated measures, adjusting for appropriate confounders (age of mother at child’s birth, race, education, employment, and history of intimate partner violence). Results: Nearly half (42.7%, N=958) of participants reported partner incarceration. Among mothers who described partner incarceration, the odds of reporting substance use are 96% (adjusted Odds Ratio [aOR]: 1.96; 95% Confidence Interval (CI):1.56-2.46) greater in comparison to those who reported no partner incarceration. Financial support at year 5 mediated 17% of the relationship between partner incarceration at year 3 and substance use at year 9 (p-value = 0.006); financial support at year 9 was not a significant mediator of the relationship between partner incarceration at year 3 and substance use at year 15. Neither emergency social support nor neighborhood cohesion were significant mediators at either year 5 or year 9. Conclusions: These findings demonstrate that partner incarceration impacts maternal substance use. Financial support acts as a partial mediator in the short term, which has important implications for families disrupted by mass incarceration.

IntroductionProsocial behavior during childhood has been associated with numerous positive developmental and behavioral outcomes in adolescence and adulthood. Prosocial behavior, which includes cooperation and helping others, develops within a bioecological context. Considering it through such a lens enhances the understanding of the roles of different bioecological factors in its development.MethodsUsing data from a longitudinal study of adopted children and children reared with their biological parents, this paper examined if positive aspects of a child’s bioecological system at age 7 predict prosocial behavior in early adolescence (age 11), and whether these bioecological factors could offset risk due to biological family psychopathology and/or maternal prenatal substance use. The analyses incorporated variables from different levels of Bronfenbrenner’s bioecological model (the individual, microsystem, exosystem, and macrosystem) and examined the promotive, and potentially protective, effect of each contextual factor, while also considering their interplay with biological family psychopathology and prenatal substance use.ResultsResults from linear regression models indicated that the microsystem variable of parental warmth at age 7 had a promotive effect on age 11 prosocial behavior. Further, in addition to its main effect, parental warmth was protective against maternal substance use during pregnancy when children were raised with their biological parent (s). Household type (biological family) and biological family internalizing psychopathology were the only other significant predictors in the model, with each associated with lower prosocial behavior at age 11.DiscussionStudy results extend prior work on the benefits of parental warmth on child outcomes by employing a strength-based, bioecological approach to the development of prosocial behavior during early adolescence and examining “for whom” the effects of parental warmth are most protective.

Maternal use of illicit drugs, tobacco or alcohol and the risk of childhood cancer before 6 years of age

Prenatal cocaine exposure: The role of cumulative environmental risk and maternal harshness in the development of child internalizing behavior problems in kindergarten

Children of substance-dependent caregivers are at significantly increased risk for emotion regulation deficits, yet little is known about the role of parent emotion socialization in this process. Given the strong link between parent emotion socialization and child emotion regulation in both community and other at-risk samples, our goal was to examine this mechanism within the high-risk clinical context of maternal drug use. We examined parent emotion socialization as a risk mechanism underlying child emotion regulation deficits among young children of substance-dependent mothers. We focused on supportive, non-supportive, and degree of consistency in parental reactions to children’s emotions during episodes of maternal drug use. We employed a multisite design and conducted interviews with mothers in substance abuse treatment who had children ages 3–8 years. We employed structural equation modeling to test three unique dimensions of parent emotion socialization as mediators of the relation between maternal substance use and child emotion regulation. Findings supported a mediated risk mechanism such that more severe impairment related to maternal substance use predicted higher levels of non-supportive reactions to children’s negative emotions which, in turn, predicted poorer child emotion regulation. Furthermore, when controlling for the potential co-mediating effect of parenting behaviors more generally, we found that general parenting style did not co-mediate this relationship, indicating specificity in this risk mechanism uniquely related to parent emotion socialization. Prevention and treatment implications suggest that non-supportive emotion socialization behaviors may be an appropriate target for supporting children’s emotion regulation within contexts of maternal substance use.

INTRODUCTION: Prenatal substance exposure increases risk of neonatal abstinence syndrome (NAS). The objective of this study was to determine the concordance between documented maternal substance use history and neonatal results among mother-infant dyads at risk of NAS. METHODS: We performed a retrospective chart review of mother-infant dyads at risk for NAS, defined as those infants receiving neonatal withdrawal inventory scores. We included those dyads with available maternal charts and infant biological testing (meconium or cord toxicology results). Maternal substance use defined as maternal reported use or positive urine toxicology. We excluded multiple gestation and preterm infants (<37 weeks). We calculated positive predictive value (PPV), negative predictive value (NPV) and accuracy of maternal history of opioid, stimulant, marijuana and anti-depressant use with infant biological results. IRB approval was obtained. RESULTS: From May 2017–May 2018, 197 dyads met study criteria. Maternal opioid history (n=135, 69%) had PPV 83.7% (95% CI 78.6–87.8%), NPV 56.5% (95% CI 46.6–65.8%) and accuracy 75.1% (95% CI 68.5–81%). Maternal stimulant history (n=91, 46%) had PPV 58.2% (95% CI 51.2–64.9%), NPV 94.3% (95% CI 88.6–97.3%) and accuracy 77.6% (95% CI 72.2–83.3%). Maternal marijuana history (n=65, 33%) had PPV 42.4% (95% CI 35.7–49.3) and accuracy 80.7% (95% CI 74.5–85.9%) (NPV could not be calculated). Maternal anti-depressant history (n=52, 26%) had PPV 59.0% (95% CI 47.2–70.0%), NPV 99.4% (95% CI 95.8–99.9%) and accuracy 91.4% (95% CI 86.5–94.9%). CONCLUSION: Maternal history and infant biological testing accuracy varies by substance and may miss up to a quarter of infants at risk of NAS. Improved screening procedures for maternal substance use are needed.

Traditional evaluations of preventive violent extremism (PVE) programs often use variable-centered methods, treating variables rather than individuals as the unit of analysis, which may obscure individual differences and impacts. We propose person-centered approaches, such as latent profile analysis, to better understand the effects of these programs on participants. Using data from the Fénix Andalucía prevention program, the study identified three risk profiles among participants: low, medium, and high risk. The results showed that while most participants remained in their initial risk profile, some transitioned to lower or higher risk profiles after the intervention. The study highlights the importance of considering individual differences in PVE program evaluations and suggests that combining variable-centered and person-centered methods can provide a more comprehensive understanding of program impacts. The findings emphasize the need for more nuanced evaluation methods to accurately assess the effectiveness of PVE programs and address the ‘paradoxical effects’ of these interventions, where certain impacts may be hidden. The study concludes that person-centered approaches can reveal important individual-level impacts and improve the design and evaluation of PVE programs.

Our intent was to investigate the neurodevelopment of HIV-uninfected children exposed to combination highly active antiretroviral therapy in pregnancy compared with children not exposed to highly active antiretroviral therapy but with similar socioeconomic backgrounds. A prospective controlled cross-sectional study of the neurodevelopment of children exposed to highly active antiretroviral therapy versus those not exposed was performed by using the Bayley Scales of Infant Development and Vineland Adaptive Behavior Scales at 18 to 36 months of age. The highly active antiretroviral therapy-exposed children were born to HIV-infected women but were uninfected themselves. The control children were born to HIV-uninfected women with similar anticipated socioeconomic background (hepatitis C infected and high proportion of substance use). Sociodemographic, clinical, highly active antiretroviral therapy (antenatal, intrapartum, neonatal), and substance-use histories were collected. Results were compared by using analyses of covariance and chi2 analysis. Thirty-nine highly active antiretroviral therapy-exposed and 24 control children were assessed. All mean scores were lower for those in the highly active antiretroviral therapy-exposed group than those in the control group (Bayley Mental Development Index: 85.4 vs 94.3; Bayley Psychomotor Development Index: 93.4 vs 96.6; Vineland mean communication score: 90.1 vs 94.4; Vineland mean daily-living score: 91.2 vs 93.6; Vineland mean socialization score: 97.1 vs 98.4). However, when maternal substance use during pregnancy was controlled for, there were no significant differences between the groups in any domains assessed. Children in both groups exposed to maternal substance use scored significantly lower than children not exposed in all domains except communication skills. It is important to note that there were no differences between the highly active antiretroviral therapy-exposed children with no substance exposure and the control children with no substance exposure in any of the scores. HIV- and highly active antiretroviral therapy-exposed HIV-uninfected children had lower development and adaptive behavior scores when compared with children who had not been exposed. However, these differences were not significant after correcting for maternal substance use, which had a greater impact on neurodevelopment than highly active antiretroviral therapy exposure. These results suggest that perinatal highly active antiretroviral therapy exposure is not associated with altered development and behavior at 18 to 36 months of age.

Maternal Depression and Child Development: Clues to Causal Mechanisms From Potential Confounders.

Maternal stress and mental health challenges have increased since the coronavirus disease 2019 (COVID-19) pandemic began. Experts are concerned about elevated substance use given its well-known association with negative emotions, but existing research has not examined substance use among mothers during the COVID-19 pandemic. This is a crucial next step to inform policy and service supports given links between maternal substance use and adverse family experiences. Data were collected online between April 14 and 28, 2020. A total of 508 mothers (mean age = 34.8 years, SD = 5.1) with children 0-8 years old participated via the Parenting During the Pandemic study. Mothers self-reported substance use change and motivations for using substances, as well as mental health symptoms. Of participating mothers, 54.9% did not change, 39.2% increased, and 5.9% decreased their substance use. Findings indicated that mothers with an anxiety disorder or elevated anxiety symptoms were more likely to report increased substance use during the pandemic. Using substances to cope with anxiety, depression, and boredom was elevated among mothers self-reporting increased substance use during the pandemic versus those reporting no change or a decrease in usage. Using substances to cope with anxiety was a risk factor for increased substance use. Many mothers have increased their substance use since the onset of the COVID-19 pandemic. Results highlight the need to treat maternal anxiety and the importance of teaching mothers coping strategies, other than using substances, to reduce the incidence of increased substance use among mothers and its negative sequelae.

The coronavirus/COVID-19 pandemic has brought about significant changes in the lifestyle of students. However, despite an extensive study of students’ life stress using a non-comprehensive scale and variable-centered approach, it has been little studied with a comprehensive scale and person-centered approach. Using the Student-Life Stress Inventory-revised (SSI-R), we analyzed students’ latent stress profiles and examined differences in psychological resilience and emotional intelligence by comparing stress profiles from a sample of 418 undergraduate and graduate students (aged 18–36) in various departments of eight universities in Turkey. We identified five distinct stress profiles, defined as an extremely low stress group (ELSG), a low stress group (LSG), a medium stress group (MSG), a high stress group (HSG), and an extremely high stress group (EHSG). We found that (1) MSG and HSG were similar in terms of emotional intelligence, resilience, and possession of high standards, and they reported higher levels of physiological, emotional, and behavioral reactions than ELSG and LSG; (2) MSG felt more pressure than HSG; (3) ELSG reported higher levels of emotional intelligence (wellbeing, self-control, and emotionality) than others. Also, EHSG reported lower levels of emotional intelligence (specifically self-control) than others; (4) whereas resilience was highly positively correlated to wellbeing, resilience and wellbeing were moderately negatively correlated to stress. Extremely low stress group and LSG reported higher levels of resilience than others. Medium stress group, HSG, and EHSG did not differ with regard to resilience and wellbeing. Our results suggest that, university students are able to maintain their functionality by coping up with stress in some ways, no matter how stressful they are. These findings are discussed in relation to the relevant literature.

Cognitive abilities and interests both play an important role in guiding knowledge acquisition, but most previous studies have examined them separately. The current study used a large and representative dataset to integrate interests and abilities using a person-centered approach that examines how distinct profiles of interests and abilities relate to individual strengths and weaknesses in knowledge. Two key findings emerged. First, eight interest–ability profiles were generated from Latent Profile Analysis (LPA), which replicated and extended the interrelations of interests and abilities found in previous studies using variable-centered approaches. Second, each profile’s strongest knowledge scores corresponded to their strongest abilities and interests, highlighting the importance of interest–ability profiles for guiding the development of knowledge. Importantly, in some domains, the lower ability profiles were actually more knowledgeable than higher ability profiles. Overall, these findings suggest that people learn best when given opportunities to acquire knowledge relevant to both their interests and abilities. We discuss how interest–ability profiles inform integrative theories of psychological development and present implications for education and career development.

We examined 2 sleep-wake parameters as moderators of the associations between exposure to family stressors and adolescent cognitive functioning. Participants were 252 school-recruited adolescents (M = 15.79 years; 66% European American, 34% African American). Youths reported on 3 dimensions of family stress: marital conflict, harsh parenting, and parental psychological control. Cognitive functioning was indexed through performance on the Woodcock-Johnson III Tests of Cognitive Abilities. Sleep minutes and efficiency were measured objectively using actigraphy. Toward identifying unique effects, path models controlled for 2 family stress variables while estimating the third. Analyses revealed that sleep efficiency moderated the associations between negative parenting (harsh parenting and parental psychological control) and adolescents' cognitive functioning. The highest level of cognitive performance was predicted for adolescents with higher levels of sleep efficiency in conjunction with lower levels of either harsh parenting or psychological control. The effects of sleep were more pronounced at lower levels of negative parenting, in which adolescents with higher sleep efficiency performed better than their counterparts with poorer sleep. At higher levels of either harsh parenting or psychological control, similar levels of cognitive performance were observed regardless of sleep. Results are discussed in comparison with other recent studies on interrelations among family stress, sleep, and cognitive performance in childhood and adolescence.