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Journal of Pediatric Psychology Advance Access originally published online on March 31, 2005
Journal of Pediatric Psychology 2006 31(1):85-97; doi:10.1093/jpepsy/jsj020
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© The Author 2005. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oupjournals.org

Mental Health Outcomes of Cocaine-Exposed Children at 6 Years of Age

Teresa J. Linares, MA1, Lynn T. Singer, PhD2,3,4, H. Lester Kirchner, PhD2, Elizabeth J. Short, PhD1, Meeyoung O. Min, PhD2, Patrick Hussey5 and Sonia Minnes, PhD3

1 Department of Psychology, Case Western Reserve University, 2 Department of Pediatrics, School of Medicine, Case Western Reserve University, 3 Department of General Medical Sciences, School of Medicine, Case Western Reserve University, 4 Department of Psychiatry, School of Medicine, Case Western Reserve University, and 5 Department of Psychology, Kent State University

All correspondence concerning this article should be addressed to Teresa J. Linares, The Triangle Building, 11400 Euclid Avenue Suite 250A, Cleveland, Ohio 44106. E-mail: teresa.linares{at}case.edu

Objective To assess 6-year-old cocaine- and noncocaine-exposed children’s mental health outcomes controlling for potential confounders. Methods The sample consisted of 322 children [169 cocaine exposed (CE) and 153 noncocaine exposed (NCE)] enrolled in a longitudinal study since birth. At age 6, children were assessed for mental health symptoms using the Dominic Interactive (DI), a child self-report measure, and the Child Behavior Checklist (CBCL), a caregiver report of behavioral problems. Results CE children were more likely to self-report symptoms in the probable clinical range for oppositional defiant disorder (ODD) and attention deficit hyperactivity disorder (ADHD). In contrast, prenatal cocaine exposure was not related to child behavior based on the CBCL. After control for exposure, CE children in adoptive or foster care were rated as having more problems with aggression, externalizing behaviors, and total behavioral problems than NCE children and CE children in maternal or relative care. Also, CE children in adoptive or foster care self-reported more externalizing symptoms than CE children in maternal or relative care and NCE children. Findings could not be attributed to caregiver intelligence or depressive symptoms, or to the quality of the home environment. Conclusions CE children report more symptoms of ODD and ADHD than nonexposed children. Adoptive or foster caregivers rated their CE children as having more behavioral problems than did maternal or relative caregivers of CE children or parents of NCE children. Although further studies are needed to understand the basis for the more negative ratings by adoptive or foster caregivers of their CE children, the self-report of CE children indicates a need for psychological interventions.

Key words: ADHD; adoptive or foster care; CBCL; Dominic Interactive; mental health outcomes; oppositional defiant disorder; prenatal cocaine exposure.


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H. S. Bada, A. Das, C. R. Bauer, S. Shankaran, B. Lester, L. LaGasse, J. Hammond, L. L. Wright, and R. Higgins
Impact of Prenatal Cocaine Exposure on Child Behavior Problems Through School Age
Pediatrics, February 1, 2007; 119(2): e348 - e359.
[Abstract] [Full Text] [PDF]


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