Roger Hatcher

Prenatal Exposure to Cocaine and Other Drugs: Outcome at Four to Six Yearsa

ABSTRACT: In a longitudinal, prospective study, 95 children born to mothers who used cocaine and other drugs during pregnancy and 75 matched, nonexposed children born to mothers who had no evidence of alcohol or illicit substance use during pregnancy were evaluated for cognitive and behavioral outcome at 6 years of age. Prenatal exposure to cocaine and other drugs had no direct effect on the childs cognitive outcome (measured as IQ), but it had an indirect effect as mediated through the home environment. However, prenatal exposure to cocaine and other drugs did have a direct effect on the childs behavioral characteristics at 4–6 years of age, with the home environment having little impact. This study helps us to understand the fragile interaction of biological and environmental factors affecting the cognitive and behavioral development of children prenatally exposed to cocaine and other drugs.

Chemical dependence and clinical Depression in pregnancy

The Short Form of the Beck Depression Inventory (BDI) was administered to 54 chemically dependent pregnant women to assess the extent and depth of depression in the population. The women were divided into three groups by age: Teenagers, young adults, and older adults. Results suggested that this population, as a whole, scored very high on this depression scale. Further, results indicated that the older chemically dependent women scored significantly higher on the depression index than did either of the two younger groups, while the teenagers obtained a mean score comparable to that of the general adolescent population.

Prematurity and infant stimulation: A review of research

Morbidity risks continue to constitute a major problem for the premature infant, despite striking progress in neonatal care and technology. This article reviews the early stimulation literature over the past 15 years, and discusses the findings of improved weight gain, respiratory status and psychomotor development when infants are stimulated early in life. Although some authors have criticized this area of research because of methodological problems, the overwhelming evidence points to the beneficial consequences of tactile and vestibular stimulation programs in high-risk nurseries. Further research is, however, clearly indicated in order to more fully elucidate the major variables and mechanisms responsible for the experimental effects, and to elaborate a more standardized program of psychological care of premature infants.

Phencyclidine: effects on the fetus and neonate

As phencyclidine hydrochloride (PCP) has become one of the more frequently abused drugs in the United States, there has been increasing interest in its effect on the fetus and neonate of the pregnant abuser. Two groups of women enrolled in a comprehensive perinatal addiction program were studied: 7 women abused PCP prior to and during pregnancy, and these women were compared to a group of 27 drug-free women. No differences between the two groups were seen in maternal age, gravidity, gestational age or Apgar scores. At birth, there was no difference in birth weight, length, or head circumference between the two groups of neonates. The most characteristic features of the PCP-exposed infants were the sudden outbursts of agitation and rapid changes in level of consciousness, similar to responses described in adults intoxicated with PCP. Scores on the Brazelton Neonatal Behavioral Assessment Scale revealed a significant increase in lability of states and poor consolability in PCP-exposed infants. 3-month scores on the Bayley Scales of Infant Development revealed no significant difference between the two groups of infants.

Treatment of food refusal in a two-year-old child

Abstract This article presents a case study of the successful modification of solid food eating in a two-year old child. The treatment paradigm rested on the pairing of a high incidence behavior (liquid ingestion) with a low incidence behavior (solid food ingestion). The mother of the child was also seen during the treatment period for directive instruction in behavior modification and for supportive counseling. The entire treatment period spanned 13 weeks, and was managed in a psychiatric inpatient milieu. Follow-up weights at one, two and three months, and at two years are reported.

Psychosocial childbearing stress and metabolic control in pregnant diabetics.

The authors tested the relationship between psychosocial childbearing stress factors and metabolic control in a research sample of 39 pregnant insulin-dependent diabetic women. Subjects were selected using rigorous exclusion criteria from a population of more than 200 pregnant diabetic patients assessed in a University National Institutes of Health Center. Metabolic control was determined by plasma levels of preprandial day, night, and early morning fasting glucose, urinary ketones, and glycosylation of hemoglobin. Differences in plasma glucose concentrations and urinary ketone levels at several times during the day and night were associated with psychosocial stress factors. A similar relationship between stress and levels of diabetic control could not be demonstrated by hemoglobin A1 assay, a result contradicting most prior studies of adolescent populations. These findings are compatible with a biopsychosocial model of diabetes mellitus and emphasize the importance of using several different measures of diabetic control to determine stress-control relationships.

Pentazocine and Tripelennamine (T’s and Blue’s’): Effects on the Fetus and Neonate

Three groups of women enrolled in a comprehensive perinatal addiction program were studied. Group I (n = 13) were addicted to pentazocine and tripelennamine (Ts and blues), group II were low-dose methadone-maintained women (n = 46) and group III women were drug-free controls (n = 27). No differences were seen in maternal age, gravidity, obstetrical complications, gestational age or neonatal Apgar scores. Significant differences were observed between drug-exposed and drug-free neonates in birth weight, length and head circumference. An evaluation of neonatal behavior using the Brazelton Neonatal Behavioral Assessment Scale revealed that infants of mothers who used Ts and blues throughout pregnancy demonstrated interactive deficits and withdrawal similar to methadone-addicted newborns.

Neuroendocrine and Psychological Factors in Childhood Diabetes Mellitus

Research on biopsychological and psychosocial factors associated with type I diabetes mellitus (“juvenile diabetes”) is examined. Biopsychological aspects of diabetes are discussed, including stress-neuroendocrine interactions, accurate assessment of diabetic control, theories regarding the onset of diabetes, and new data on the development of infants of diabetic mothers. The psychosocial context of diabetes mellitus research presently centers on issues of ego development, self-esteem, depression, and the measurement of adherence (compliance) behaviors. An integrative model is used within a biopsychosocial framework

Developmental Assessment of Premature Infants

The response characteristics of premature infants at 8 weekly postconception age levels (33 to 40 weeks) were studied in a cross-sectional design. The consistency of behavioral and reflexive responses was assessed on the Brazelton Neonatal Behavioral Assessment Scale. Age-related (nonsignificant) trends were seen in behavioral responses such as orientation, alertness, motor maturity, and state control. On 12 elicited responses and 14 behavioral items, significant differences were obtained between 33− and 40-week exams. These results suggest that while the maturational processes of a preterm infant may be detected using this scale, it is not, without qualification, an appropriate clinical instrument for use with this group. However, the Brazelton scale may be useful in research on group differences in the developing capabilities of preterm infants.