Prenatal cocaine exposure and trajectories of externalizing behavior problems in early childhood: examining the role of maternal negative affect.

This study examined the association between prenatal cocaine exposure (PCE) and developmental trajectories of externalizing behavior problems from 18 to 54 months of child age. A hypothesized indirect association between PCE and externalizing trajectories via maternal negative affect was also examined. Caregiving environmental risk and child sex were evaluated as moderators. This study consisted of 196 mother-child dyads recruited at delivery from local area hospitals (107 PCE, 89 non-PCE) and assessed at seven time points across the toddler to preschool periods. Results revealed no direct associations between PCE and externalizing behavior problem trajectories. However, results did indicate that PCE shared a significant indirect relationship with externalizing behavior problem trajectories via higher levels of maternal negative affect. The association between PCE and externalizing problem trajectories was also moderated by caregiving environmental risk such that PCE children in high-risk caregiving environments did not experience the well-documented normative decline in externalizing behavior problems beginning at around 3 years of age. This study suggests potential pathways to externalizing behavior problems among high-risk children.