Health and Developmental Consequences of Youth Drug Abuse

Research Findings from May, 1998 Director's Report

This section lists selected summaries from NIDA funded research projects that investigate the developmental implications of drug use. The summaries provided were selected from recent issues of the Director's Report to the National Advisory Council on Drug Abuse. For a more comprehensive listing of NIDA funded projects see the Director's Report.

Amount of Prenatal Cocaine Exposure and Birth Outcomes

Two recent publications from researchers at the University of Florida add to the growing body of evidence for the importance of studying the amount of exposure when examining developmental outcomes associated with use of drugs during pregnancy. In this prospective, longitudinal project, 154 women were identified during pregnancy as using cocaine, and 154 comparison women as not using cocaine, but matched on race, parity, socioeconomic status, and location of prenatal care (which related to level of pregnancy risk). Data analyses included control for marijuana, alcohol, and tobacco use. Although there were no overall differences between the two groups on gestational age, birth weight, or birth length, there was a significant relationship between the amount of cocaine used in the third trimester, and newborn length and head circumference. Similarly, the reported amount of cocaine use in the third trimester was negatively associated with measures of state regulation, alertness, and the ability of the infant to orient to the environment. These findings raise concerns about later developmental abilities of these infants. The researchers are continuing to follow the development of these children. Eyler, F.D., Behnke, M., Conlon, M., Woods, N.S., Wobie, K. Birth Outcome from a Prospective, Matched Study of Prenatal Crack/Cocaine Use: I. Interactive and Dose Effects on Health and Growth. Pediatrics, 101, pp. 229-237, 1998; Eyler, F.D., Behnke, M., Conlon, M., Woods, N.S., Wobie, K. Birth Outcome from a Prospective, Matched Study of Prenatal Crack/ Cocaine Use: II. Interactive and Dose Effects on Neurobehavioral Aassessment. Pediatrics, 101, pp. 237-241, 1998.

ERP Amplitude Anomalies in Children at Risk for Substance-use Disorders

Previous research has considered event-related potentials (ERPs) in relation to liability for alcohol and other substance use. This study explored ERPs in preadolescent boys at elevated risk for substance use due to paternal history of substance abuse or dependence. Sons (age 10-12) of fathers with an alcohol-use disorder (ALC, n = 29) were matched by age, IQ, education and parental alcohol use with sons of fathers with a polysubstance abuse or dependence diagnosis (POLY, n = 37). These two groups were matched with a low-risk comparison group (LOW, n = 29) of boys whose fathers had no substance-use disorder diagnosis. No boy in the study met criteria for a substance-use disorder. ERPs were collected from midline (Fz, Ct, Pt) and parietal (P3, P4) electrode leads during an auditory oddball task. ERPs of boys from the ALC and POLY groups showed a slow negative shift prominent at Ct and Pz. This negative shift, evident by 100 ms post-stimulus and lasting for the duration of the 1000-ms recording period, overlapped temporally with N1, N2 and P3 amplitude differences distinguishing the ALC and POLY groups from the LOW group. The ALC and POLY groups differed from each other in N2 amplitude at Ct, which was larger for ALC subjects. These findings offer a possible alternative explanation for previously observed amplitude anomalies noted in children at risk for substance-use disorders and suggest new avenues of inquiry. Brigham, J., Moss, H.B., Murrelle, E.L., Kirisci, L., and Spinelli, J.S. Psychiatry Research, 73(3), pp. 133-146, 1997.

The Effect of Home Environment on Adolescent Substance Use and Depressive Symptoms

Researchers at the National Opinion Research Center (NORC) used data from the screening phase and first two waves of a panel study to compare the home environments of families with a substance abusing parent, families with a depressed parent, and families in a comparison group. They diagnosed substance use disorder and affective disorder by administering the Structural Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (3rd edition, revised) to each participating parent.The data suggested that families in which parents display a substance use disorder are very similar to those in which parents suffer from affective disorder, in terms of negative life events and lower family cohesion. The results of structural equation modeling indicated that parental substance use disorder and parental affective disorder influence adolescent substance use and depressive symptoms. In addition, parental substance use disorder were found to have a direct influence on adolescent substance use at the time the first-wave data were collected, but this effect does not persist over time. Su, S.S., Hoffman, J.P., Gerstein, D.R., and Johnson, R.A. J of Drug Issues, pp. 851-878, 1997.

The Association of Early Risk Factors to Opiate Addiction and Psychological Adjustment

Family/parental, peer and individual risk factors that appear early in life contribute to increased susceptibility to addiction. This study aimed to determine the relationship between risk factors, the development of opiate addiction, and the development of psychological maladjustment in addicts. A total of 252 addict subjects, age 12-39 years at the onset of opiate addiction and 342 nonaddict controls from the same neighborhood, matched for age, race and place of residence were selected. Ten risk factors related to family disruption, peer deviance, personal deviance and psychological symptoms were studied. White addicts scored significantly higher than African American addicts on all of the risk factors, whereas African American addicts scored significantly higher than African American nonaddicts on risk factors. Addicted individuals with a diagnosable psychiatric disorder on a standardized psychological instruments as young adults had also experienced related symptoms during the adolescent years prior to addiction. Thus, in addition to problems directly attributable to addiction, there were many problems that either coincided with, or pre-dated, severe drug abuse. Nurco, D.N., Hanlon, T.E., O'Grady, K.F., & Kinlock, T.W. Risk Factors for Opiate Addiction. Criminal Behavior and Mental Health, 7, pp. 213-228, 1997.

Longitudinal Study of Co-occuring Psychiatric Disorders and Substance Use

The objective of this study was to examine the temporal priority in the relation between psychiatric disorders and drug use. Psychiatric assessments and drug use were completed at three different points in time, spanning nine years, Structured interviews were administered to a cohort of youths and their mothers. Structureed interviews were administered to a cohort of youths and their mothers. Subjects were selected on the basis of their residence in either or two counties in upstate NewYork. The sample was predominantly white male and female youth, aged 1-10 upon initial collction of data. Psychiatric diagnoses were assessed by a supplemented version of the DISC 1, using computer algorithms designed to match DSM III-R criteria to combine information from mothers and youth. Substance use information was obtained in the interviews. A significant relationship was found to exist between earlier adolescent drug use and later depressive and disruptive disorders in young adulthood, not of earlier psychiatric disorders. Psychiatric disorders did not predict changes in young adult drug use. Implications for policy, prevention, and treatment include: (1) more medical attention needs to be given to the use of legal and illegal drugs: and (2) a decrease in the use of drugs may result in a decrease in the incidence of later psychiatric disorders. Brook, J.S., Cohen P., and Brook, D.W. Journal of American Academy of Child and Adolescent Psychiatry, 37, pp. 322-330, 1998.

Risk Factors for Teenage Fatherhood

The study of teen parenthood has become almost synonymous with the study of teen mothers, but relatively little research attention has been devoted to the study of teen fathers. Nevertheless, because it appears that becoming a teen father has negative developmental consequences for both the teen father and his children, it is an important area of inquiry. This article uses data from the Rochester Youth Development Study, an ongoing panel study of urban youth, to identify early risk factors for the likelihood of becoming a teen father. The study is well suited to this task because the prevalence of teen fatherhood in this sample is quite high, and the project has collected extensive data in a range of developmental domains. Teen fatherhood is related to a variety of risk factors, such as social class, educational performance, precocious sexual activity, and drug use. Perhaps most important is the finding that teen fatherhood is strongly related to the cumulation of risk factors across many domains. Thornberry, T.P., Smith, C.A., and Howard, G.J. Journal of Marriage and the Family, 59, pp. 505-522, 1997.

Methylphenidate Use and Dysfunctional Causal Attributions

Researchers affiliated with CEDAR investigated the effects of 0.3 mg/kg methylphenidate (MPH) and expectancy regarding medication on the performance and task persistence of 60 boys with attention deficit hyperactivity disorder (ADHD). In a balanced-placebo design, boys in 4 groups (received placebo/drug crossed with told placebo/drug) completed the task in success and failure conditions. Medication improved participants' task persistence following failure. Participants' task performance was not affected by whether they thought they had received medication or placebo. Children made internal attributions for success and made external attributions for failure, regardless of medication or expectancy. These findings confirm previous reports that it is the pharmacological activity of MPH that affects ADHD children's self-evaluations and persistence. The results contradict anecdotal reports that MPH causes dysfunctional attributions and confirm previous studies showing that medication does not produce adverse effects on the causal attributions of children with ADHD. Pelham, W.E., Hoza, B., Kipp, H.L., Gnagy, E.M., Trane, S.T. Experimental and Clinical Psychopharmacology, 5(1), pp. 3-13, 1997.

Effect of Parental Mental Health Status on Adolescents' Dietary Behaviors

In a study by NORC, investigators examined whether adolescents of substance-abusing and depressed parents were more likely to have poor dietary behaviors that those in the health comparison families the examined 841 adolescents in families of substance-abusing parents, depressed parents, and parents without diagnosable psychiatric disorder. All adolescents were given a food frequency questionnaire. Adolescents whose parents had substance abuse disorder had lower intakes of fruits and higher intakes of high fat foods, and also ate more frequently at fast-food restaurants and purchased more snacks. Adolescents whose parents were depressed had lower intakes of all food groups. Mothers' mental health status impacted more on adolescents dietary behaviors than did the father's mental health status. This research suggests that at-risk behaviors among youth of psychiatrically impaired parents may extend to food behaviors. Su, L.J., Story, M., and Su., S.S. Journal of Adolescent Health, 20, pp. 426-433, 1997.

A Test of Reciprocal Causal Relationships Among Parental Supervision, Affective Ties, and Delinquency

Current family-delinquency research suggests that the relationships between parenting and delinquency should be viewed from interactional and developmental perspectives. The relationship between parent and child is thought to change over time, partly as a function of reciprocal causal influences between them. In this study, using panel data from a representative sample of 838 urban adolescents, the authors test the hypothesis that parenting and delinquency are reciprocally related. They also hypothesize that two central parenting dimensions, affective ties and supervision, are bidirectionally related. It is found that delinquency and parental supervision are reciprocally related, whereas affective ties appear to be a consequence rather than a cause of delinquency, at least by middle adolescence. In general, the interrelationships among these variables are more complex than those suggested by earlier unidirectional theories, and they underline the importance of interactional perspectives in understanding the interrelationship of adolescent behavior and parenting. Jang, S.J., and Smith, C.A. Journal of Research in Crime and Delinquency, 34(3), pp. 307-336, 1997.

Childhood, Adolescent, Familial, and Peer Antecedents of Cigarette Smoking in Young Adults

This study examined the interrelation of personality, family, and peer determinants and their effects on tobacco use by young adults. Mothers were first interviewed about their children when they were between the ages of 1 and 10 years old. Three subsequent interviews were conducted with the children when they reached adolescence and young adulthood. Results show support for the mediational model, which is derived from the family interactional theory framework to examine pathways that may lead to adolescent legal and illegal drug use and other problem behavior. There was a sequence in patterning: from parenting during early adolescence, to personality and peer factors, extending to smoking in late adolescence and culminating in smoking in adulthood. With a developmental approach, a number of psychosocial measures appear related in both younger and older children. Developmental differences also emerged, suggesting four possible targets for therapeutic or preventive intervention: the parent, the child, the adolescent, and the peer group. Brook, J.S., et al. Cigarette Smoking in Young Adults: Childhood and Adolescent Personality, Familial, and Peer Antecedents, J. Genetic Psychology, 158(2), pp. 172-188, 1997.

Standardized Test Performance of Children with a History of Prenatal Exposure to Mutiple Drugs/Cocaine

Children with histories of prenatal polydrug exposure which included cocaine scored significantly lower on standardized test measures of language development (Receptive and Expressive subtests of the Sequenced Inventory of Communicative Development -Revised) than nonexposed children. Clinically, 45.8% of the children in the drug-exposed group qualified for early intervention services. Significant differences between groups were also noted on the Bayley Scales of Infant Development. No differences were found on the Peabody Picture Vocabulary Test - Revised. Each group had 24 children, age 14 to 50 months, and included 13 males and 11 females. All children were living in stable, drug-free environments (foster/adoptive/natural homes). Tests were administered by a certified Speech-Language Pathologist and language samples were taken from 30 minute videotaping sessions showing the child and caregiver playing. Results indicate that, due to the cumulative effects of prenatal history, children with histories of prenatal drug exposure should be considered at-risk for language delay. Johnson, J.M., Seikel, J.A., Madison, C.M., Foose, S.M., and Rinard, K.D. Journal of Communication Disorders, 30, pp. 45-73, 1997.