پروفایل واکنش پذیری در کودکان در معرض کوکائین

Abstract This study explored the possibility that specific, theoretically consistent profiles of reactivity could be identified in a sample of cocaine-exposed infants and whether these profiles were associated with a range of infant and/or maternal characteristics. Cluster analysis was used to identify distinct groups of infants based on physiological, behavioral and maternal reported measures of reactivity. Five replicable clusters were identified which corresponded to 1) Dysregulated/High Maternal Report Reactors, 2) Low Behavioral Reactors, 3) High Reactors, 4) Optimal Reactors and 5) Dysregulated/Low Maternal Report Reactors. These clusters were associated with differences in prenatal cocaine exposure status, birthweight, maternal depressive symptoms, and maternal negative affect during mother-infant interactions. These results support the presence of distinct reactivity profiles among high risk infants recruited on the basis of prenatal cocaine exposure and demographically similar control group infants not exposed to cocaine.

Conclusions In conclusion, the findings of this study indicated that there are distinct regulatory profiles among a group of high risk children recruited on the basis of prenatal cocaine exposure and a demographically similar control group. These patterns are similar to patterns found in low risk samples of children and both maternal and infant characteristics can differentiate membership in these groups. It is not clear, however, if these profiles would persist beyond infancy into the preschool or school-aged years. Although studies with low risk infants have demonstrated substantial stability in temperament profiles and in profiles of disruptive behavior during infancy and early childhood (Degnan et al., 2008 and Janson and Mathieson, 2008) and frustration reactivity is thought to be stable during childhood, it is not clear if this type of stability would be found among high-risk substance-exposed children. Subsequently, future studies should explore whether there is stability in regulatory profiles across infancy and into childhood. Furthermore, numerous studies have identified distinct patterns of regulatory processes that differentiate children with internalizing and externalizing disorders. For example, studies have indicated that a combination of higher reactivity to frustration and lower regulation is associated with externalizing behavior problems (Diener and Kim, 2004, Eisenberg et al., 2000 and Stifter et al., 1999). In fact, Janson and Mathieson (2008) argue that studies should explore the association between temperamental profiles and internalizing/externalizing behavior problems in high-risk samples. As such, future studies should explore whether regulatory profiles among these high risk children predict externalizing or internalizing disorders in childhood.