Sydney L. Hans

Relation of maternal responsiveness during infancy to the development of behavior problems in high-risk youths.

Although problematic parenting has been consistently associated with behavior problems in youths, prospective links between early parenting and childhood behavior problems are less well established. This study examined the association of maternal responsiveness (MRes) during infancy and behavior problems in middle childhood (N = 77). MRes was significantly associated with disruptive behavior problems but was unrelated to attention problems. Absence of MRes during infancy increased the risk of disruptive behavior problems in middle childhood, even with concurrent parenting and established risk factors for disruptive behavior controlled. MRes also interacted with concurrent family risk to predict disruptive behavior symptoms. These findings underscore the importance of early parenting for developmental pathways to disruptive behavior disorders in high-risk youths. The identification of a relatively modifiable early risk factor for disruptive behavior problems has important implications for prevention.

The role of psychopathology in the parenting of drug-dependent women

This paper explores the parenting of drug-dependent women and the contributions of comorbid psychopathology to their parenting. A sample of 32 children whose mothers were dependent on opioid drugs during pregnancy and 37 children whose mothers were not drug users were followed from birth to middle childhood. Multivariate regression analyses were conducted contrasting whether maternal substance abuse or psychopathology was more closely linked to parenting behaviors and continuity in parenting over time. Maternal drug dependence was related to whether mothers were able to remain primary caregivers for their children over time, even after controlling for psychopathology. Maternal drug use was related to unresponsive and negative parenting behavior during mother-infant interaction, but this relation was largely accounted for by the effects of comorbid maternal psychopathology on parenting, particularly symptoms of antisocial and related personality disorders. For those children whose mothers continued to care for them into middle childhood, perceptions of their mothers as rejecting were related to maternal antisocial personality and maternal depression. Substance-abuse treatment for women should be integrated with interventions addressing their mental health and parenting needs.

Developmental consequences of prenatal exposure to methadone.

This paper has presented evidence of growth and behavioral effects related to prenatal methadone exposure. The data suggest that methadone may have a small direct teratological effect reflected in reduced head circumference, poorer motor coordination, increased body tension, and delayed acquisition of motor milestones in methadone-exposed toddlers. In the sample as a whole, there are no direct effects of methadone exposure on mental development. However, methadone-exposed infants reared in extremely poor environmental circumstances show very delayed mental development. They function more poorly than nonexposed infants reared in such environments and more poorly than methadone-exposed infants reared in more adequate (although still economically poor) environments. This finding is important because it suggests that in the cognitive domain, methadone may not cause a behavioral deficit, but instead create a vulnerability in these children that then makes them more susceptible to impoverished environments. The results from this study indicate that a large subgroup of methadone-exposed children are clearly at risk for poor early intellectual development and that the source of the risk is to a large degree related to environmental factors. These findings suggest that preventive interventions--focused both on enriching the early experiences of such children (e.g., high-quality infant day care) and improving the quality of caregiving provided in the homes--might be particularly effective.

Maternal smoking during pregnancy and conduct problems in high-risk youth: A developmental framework

Smoking during pregnancy is associated with adverse consequences for children. Most recently, it has been established as a risk factor for developmental psychopathology, specifically Conduct Disorder (CD). Although this association has been shown to be robust, developmental pathways from exposure to CD have not been established. We examined how prenatal exposure to cigarettes interacts with child and family factors to increase risk of CD symptoms in a longitudinal study of 10-year-old urban, African-American youth (N = 77). The effects of prenatal exposure at school age were moderated by child sex. Boys whose mothers smoked during pregnancy were significantly more likely to develop CD symptoms, but exposure did not increase risk in girls. A similar trend was found during infancy: prenatal smoking was associated with low sociability/negative emotionality only for boys. The effects of smoking during pregnancy were also moderated by the quality of the early caregiving environment. Exposed boys whose mothers were unresponsive during infancy were at increased risk of CD symptoms, but exposed boys with early responsive mothers were not. Prospective studies, with developmentally based measures of behavior across time, are critical for further elucidating pathways from prenatal exposure to cigarettes to the development of clinical disorder. The identification of a potentially modifiable, prenatal risk factor for early onset developmental psychopathology has important implications for prevention.

Social Adjustment of Adolescents at Risk for Schizophrenia: The Jerusalem Infant Development Study

OBJECTIVE To better understand whether poor social adjustment, a core characteristic of schizophrenic illness, may also be an indicator of vulnerability in young people who are at genetic risk for schizophrenia, but who do not have schizophrenia. METHOD Between 1992 and 1996, 27 Israeli adolescents with a schizophrenic parent, 29 adolescents with no mentally ill parent, and 30 adolescents with a parent having a nonschizophrenic mental disorder were assessed on multiple domains of social adjustment measured using the Social Adjustment Inventory for Children and Adolescents and the Youth Self-Report. RESULTS Young people with a schizophrenic parent showed poor peer engagement, particularly heterosexual engagement, and social problems characterized by immaturity and unpopularity with peers. These social adjustment difficulties in youths at risk for schizophrenia could not be attributed solely to the presence of early-onset mental disorders, although problems were greater in those with disorders in the schizophrenia spectrum. Young people whose parents had other disorders showed different patterns of social maladjustment characterized by difficult, conflictual relationships with peers and family. CONCLUSION Adolescents at risk for schizophrenia have social deficits that extend beyond early-onset psychopathology and that may reflect vulnerability to schizophrenic disorder.

Interpersonal behavior of children at risk for schizophrenia

Investigations of the childhood antecedents of adult schizophrenia may clarify our understanding of the etiology of the disease, provide guidelines for meaningful classification of subtypes of schizophrenic illness, point to strategies for identifying those individuals in need for early intervention, and suggest appropriate techniques for early intervention. Among the more salient characteristics of schizophrenic illness are disturbances in interpersonal relations, especially withdrawal from normal social interaction.

Maternal psychotropic medication and neonatal behavior

A sample of 29 psychiatrically ill women and a non-ill comparison group were recruited during pregnancy. Twelve of the ill mothers were receiving antipsychotic and anti-anxiety medication during the final trimester of pregnancy. The behavior of their infants was assessed at 3 and 14 days of age using the Brazelton Neonatal Behavioral Assessment Scale. Compared to infants of non-ill mothers and infants of ill nonmedicated mothers, infants whose mothers received antipsychotic drugs--particularly those in the phenothiazine family--showed a stable pattern of poor neonatal motor functioning that included tremulousness, hypertonicity, and poor motor maturity. It was speculated that this behavior was symptomatic of a neonatal abstinence or withdrawal syndrome.

Studies of prenatal exposure to drugs: focusing on parental care of children.

A considerable body of research suggests that children who are prenatally exposed to alcohol and other drugs are also at risk for receiving poor quality parental care. Previous research in human behavioral teratology has focused on postnatal environment as a potential confounding factor. Yet, developmental theory suggests that development proceeds as a series of transactions between childrens characteristics and their environments. In order that possible teratologic effects not be underestimated, future work needs to give more consideration to ways in which parental care may be influenced by child behavior and to ways in which postnatal environment might moderate the expression of teratologic effects. Studies must focus on the role of prenatal drug exposure within a broader system of variables that includes factors present in childrens environments over time.

A Longitudinal Study of Offspring Born to Methadone-Maintained Women. III. Effects of Multiple Risk Factors on Development at 4, 8, and 12 Months

Infants exposed to methadone in utero were compared to infants of drug-free women at 4, 8, and 12 months on two aspects of their behavior: motor coordination and attention. The purpose of this paper is to discuss how differences between the methadone and comparison infants were affected by other family and medical risk factors. No matter what the level of other risk factors, methadone infants showed poorer motor coordination at 4 months and poorer attention at 12 months as a group than comparison infants. Family risk factors, however, did modulate the strength and direction of differences between methadone and comparison infants. After 4 months, methadone infants continued to show poorer motor coordination than comparison infants only in families with poorer resources (such as low SES, maternal psychopathology and low intelligence, absence of father). Poorer early medical resources (pre- and perinatal complications) heightened the differences between methadone and comparison infants at early ages, but by the end of the first year no longer played a role in modulating the drug effect. The authors tentatively conclude that methadone exposure in utero has very limited teratological effects per se on the long-term development of infants, and that the pathology seen in some individual children is probably due to an interaction with other factors.

Behavior of neonates exposed in utero to methadone as assessed on the Brazelton scale

Abstract Twenty-nine infants exposed in utero to methadone and 37 comparison infants were examined on the Neonatal Behavioral Assessment Scale at early and late neonatal ages. All infants were full-term at birth, over 2500 g, and not yet circumcised at the early assessment. None of the methadone-exposed infants were breast-fed or were being treated pharmacologically for withdrawal. During the first week of life, methadone-exposed neonates differed from comparison ones in motoric behavior. Relative to comparison-group infants, they were jerkier and more tremulous, tense, active, and better able to put hand in mouth. By the end of the first month these differences diminished, although there was still a tendency for the methadone-exposed infants to have elevated body tonus. Neither perinatal complications, birth weight, nor sex of infant could explain the early neonatal differences between the methadone and comparison groups. Past the early stage of acute withdrawal, neonates exposed prenatally to methadone behave not unlike their nonexposed peers.