This study examined the association between maternal cocaine use and maternal behavior and tested a conceptual model predicting maternal insensitivity during mother-infant interactions. Participants included 130 mother-infant dyads (68 cocaine-exposed and 62 noncocaine-exposed) who were recruited after birth and assessed at 4-8 weeks of infant age. Results of model testing indicated that when the effects of prenatal cocaine use were examined in the context of polydrug use, maternal psychopathology, maternal childhood history, and infant birth weight, only postnatal cocaine use and maternal depression/anxiety were unique predictors of maternal insensitivity during mother-infant interactions.
Keywords cocaine; depression; maternal behavior; substance useThe teratological impact of prenatal cocaine exposure on specific aspects of development is still under study. However, there is a growing recognition that one pathway to later developmental problems among cocaine-exposed infants may be through problematic maternal behavior or parenting difficulties. For instance, cocaine-using mothers have been reported to be more disengaged and passive during mother-infant interactions in the neonatal period (Gottwald & Thurman, 1994;Molitor, Mayes, & Ward, 2003), to have lower responsiveness and enthusiasm in later infancy (Burns, Chethik, Burns, & Clark, 1991, to be less positively reinforcing and use more threats of physical discipline in
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Author ManuscriptPsychol Addict Behav. Author manuscript; available in PMC 2011 May 11.
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript the toddler/preschool period (Bauman & Dougherty, 1983), and to be more hostile and intrusive and less supportive in a structured teaching situation at 3 years of age (Johnson et al., 2002). Others have specifically measured behavior during feeding, a naturalistic context for interactions in infancy. These results indicate that cocaine-using mothers are less flexible and engaged during feeding interactions with their 1-month-old infants compared with the control group (LaGasse et al., 2003) and have higher dyadic conflict with their infants (Eiden, 2001). However, the literature is by no means unequivocal. Several studies have noted no association between maternal cocaine use and parenting difficulties (M. Black, Schuler, & Nair, 1993;Johnson & Rosen, 1990;Neuspiel, Hamel, Hochberg, Greene, & Campbell, 1991). These disparate findings may be explained not only by differences in timing of measurement and varying sample sizes but also by the large within-group heterogeneity on variables such as placement in foster care and other maternal and infant risk characteristics. Notable among these risk characteristics are comorbid maternal psychopathology, use of other substances, continued postnatal substance abuse, and compromised infant growth outcomes.Several studies have noted the association between maternal cocaine use and higher postpartum psychological distress (Singer et al., 1995), higher depression and an...