Objective Examined effects of prenatal cocaine exposure (PCE) on tobacco, alcohol, marijuana and cocaine use by age 15. Methods Adolescent (n = 358; 183 PCE, 175 non-prenatally cocaine exposed; NCE) drug use was assessed using urine, hair, and/or blood spot samples and self-report (Youth Risk Behavior Surveillance System; YRBSS) at ages 12 and 15. Logistic regression assessed effects of PCE on drug use controlling for other drug exposures, environment and blood lead levels (BLL). Results Adjusted percentages of drug use (PCE vs. NCE) were: tobacco 35% vs. 26% (p < .04), marijuana 33% vs. 23% (p < .04), alcohol 40% vs. 35% (p < .01), and any drugs 59% vs. 50% (p < .005). PCE adolescents were twice as likely to use tobacco (OR = 2.02, 95% CI = 1.05–3.90, p < .04), 2.2 times more likely to use alcohol (OR = 2.16, 95% CI = 1.21–3.87, p < .01) and 1.8 times more likely to use marijuana (OR = 1.81, 95% CI = 1.02–3.22, p < .04) than NCE adolescents. A race-by-cocaine-exposure interaction (p < .01) indicated PCE non-African American adolescents had greater probability of tobacco use (65%) than NCE non-African American youth (21%). PCE was associated with any drug use (OR = 2.16, CI = 1.26–3.69, p < .005), while higher BLL predicted alcohol use (p < .001). Violence exposure was a predictor of tobacco (p < .002), marijuana (p < .0007) and any drug (p < .04). Conclusions PCE and exposure to violence increased the likelihood of tobacco, marijuana or any drug use by age 15, while PCE and higher early BLL predicted alcohol use. Prevention efforts should target high risk groups prior to substance use initiation.

Resilience following childhood maltreatment has received substantial empirical attention, with the number of studies on this construct growing exponentially in the past decade. While there is ample interest, inconsistencies remain about how to conceptualize and assess resilience. Further, there is a lack of consensus on how developmental stage influences resilience and how protective factors affect its expression. The current systematic review uses a developmental lens to synthesize findings on resilience following child maltreatment. Specifically, this article consolidates the body of empirical literature in a developmentally oriented review, with the intention of inclusively assessing three key areas—the conceptualization of resilience, assessment of resilience, and factors associated with resilience in maltreatment research. A total of 67 peer-reviewed, quantitative empirical articles that examined child maltreatment and resilience were included in this review. Results indicate that some inconsistencies in the literature may be addressed by utilizing a developmental lens and considering the individual’s life stage when selecting a definition of resilience and associated measurement tool. The findings also support developmental variations in factors associated with resilience, with different individual, relational, and community protective factors emerging based on life stage. Implications for practice, policy, and research are incorporated throughout this review.

While many studies have identified a significant relation between child maltreatment and adolescent substance use, the developmental pathways linking this relation remain sparsely explored. The current study examines posttraumatic stress (PTS) symptoms, mother-child relationships, and internalizing and externalizing problems as potential longitudinal pathways through which child maltreatment influences adolescent substance use. Structural equation modeling was conducted on 883 adolescents drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). The pathways of PTS symptoms linked physical and sexual abuse to substance use, and the pathways of mother-child relationships linked emotional abuse and neglect to substance use. None of the four types of maltreatment affected substance use via internalizing or externalizing problems. The findings suggest that intervention efforts aimed at addressing posttraumatic stress symptoms and improving mother-child relationship quality may be beneficial in reducing substance use among adolescents with child maltreatment histories.

Aggression continues to be a serious problem among children, especially those children who have experienced adverse life events such as maltreatment. However, there are many maltreated children who show resilient functioning. This study investigated potential protective factors (i.e., child prosocial skills, child internalizing well-being, and caregiver well-being) that promoted positive adaptation and increased the likelihood of a child engaging in the healthy, normative range of aggressive behavior, despite experiencing physical maltreatment. Logistic regression analyses were conducted using two waves of data from the National Survey of Child and Adolescent Well-Being (NSCAW-I). Children who were physically maltreated were more likely to exhibit clinical levels of aggressive behavior at Time 1 than children who were not physically maltreated. Children’s internalizing well-being, children’s prosocial behavior, and caregivers’ well-being were associated with lower likelihood of clinical levels of aggressive behavior at Time 1. Children’s internalizing well-being and children’s prosocial behavior remained significantly associated with nonclinical aggression 18 months later. These findings highlight the role of protective factors in fostering positive and adaptive behaviors in maltreated children. Interventions focusing on preventing early aggression and reinforcing child prosocial skills, child internalizing well-being, and caregiver well-being may be promising in promoting healthy positive behavioral adjustment.

Purpose To assess the direct effects of prenatal cocaine exposure (PCE) on adolescent internalizing, externalizing and attention problems, controlling for confounding drug and environmental factors. Method At 12 and 15 years of age, 371 adolescents (189 PCE, 182 non-cocaine exposed (NCE)), primarily African-American and of low socioeconomic status, participating in a longitudinal, prospective study from birth were assessed for behavioral adjustment using the Youth Self-Report (YSR). Results Longitudinal mixed model analyses indicated that PCE was associated with greater externalizing behavioral problems at ages 12 and 15 and more attention problems at age 15, after controlling for confounders. PCE effects were not found for internalizing behaviors. PCE adolescents in adoptive/foster care reported more externalizing and attention problems than PCE adolescents in biological mother/relative care at age 12 or NCE adolescents at both ages. No PCE by gender interaction was found. Prenatal marijuana exposure, home environment, parental attachment and monitoring, family conflict, and violence exposure were also significant predictors of adolescent behavioral adjustment. Conclusions Prenatal cocaine exposure is a risk factor for poor behavioral adjustment in adolescence.

The effect of prenatal cocaine exposure (PCE) on externalizing behavior and substance use related problems at 15 years of age was examined. Participants consisted of 358 adolescents (183 PCE, 175 non-cocaine exposed (NCE)), primarily African-American and of low socioeconomic status, prospectively enrolled in a longitudinal study from birth. Regression analyses indicated that the amount of PCE was associated with higher externalizing behavioral problems (β=.15, p=.02). Adolescents with PCE were also 2.8 times (95% CI=1.38–5.56) more likely to have substance use related problems than their NCE counterparts. No differences between PCE adolescents in non-kinship adoptive or foster care (n=44) and PCE adolescents in maternal/relative care (n=139) were found in externalizing behavior or in the likelihood of substance use related problems. Findings demonstrate teratologic effects of PCE persisting into adolescence. PCE is a reliable marker for the potential development of problem behaviors in adolescence, including substance use related problems.

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Although there is a well-established connection between father involvement and children’s positive behavioral development in general, this relation has been understudied in more vulnerable and high-risk populations. The aims of this study were to examine how the quantity (i.e., the amount of shared activities) and quality (i.e., perceived quality of the father-child relationship) of father involvement are differently related to internalizing and externalizing behavior problems among preadolescents at risk of maltreatment and test if these associations are moderated by father type and child maltreatment. A secondary data analysis was conducted using data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Generalized estimating equations analysis was performed on a sample of 499 preadolescents aged 12 years. The results indicated that higher quality of father involvement was associated with lower levels of internalizing and externalizing behavior problems whereas greater quantity of father involvement was associated with higher levels of internalizing and externalizing behavior problems. The positive association between the quantity of father involvement and behavior problems was stronger in adolescents who were physically abused by their father. The association between father involvement and behavior problems did not differ by the type of father co-residing in the home. The findings suggest that policies and interventions aimed at improving the quality of fathers’ relationships and involvement with their children may be helpful in reducing behavior problems in adolescents at risk of maltreatment.