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Dimension- and context-specific expression of preschoolers' disruptive behaviors associated with prenatal tobacco exposure.
Neurotoxicology and Teratology ( IF 2.9 ) Pub Date : 2020-07-18 , DOI: 10.1016/j.ntt.2020.106915
Suena H Massey 1 , Caron A C Clark 2 , Michael Y Sun 3 , James L Burns 3 , Daniel K Mroczek 4 , Kimberly A Espy 5 , Lauren S Wakschlag 1
Affiliation  

Objective

Precise phenotypic characterization of prenatal tobacco exposure (PTE)–related disruptive behavior (DB) that integrates nuanced measures of both exposures and outcomes is optimal for elucidating underlying mechanisms. Using this approach, our goals were to identify dimensions of DB most sensitive to PTE prior to school entry and assess contextual variation in these dimensions.

Methods

A community obstetric sample of N = 369 women (79.2% lifetime smokers; 70.2% pregnancy smokers) from two Midwestern cities were assessed for PTE using cotinine-calibrated interview-based reports at 16, 28, and 40 weeks of gestation. A subset of n = 244 who completed observational assessments with their 5-year-old children in a subsequent preschool follow-up study constitute the analytic sample. Using two developmentally-meaningful dimensions previously associated with emergent clinical risk for DB—irritability and noncompliance—we assessed children with 2 parent-report scales: the Multidimensional Assessment Profile of Disruptive Behavior (MAP-DB) and the Early Childhood Inventory (ECI). We also assessed children by direct observation across 3 interactional contexts with the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). We used generalized linear models to examine between-child variability across behavioral dimensions, and mixed effects models to examine directly observed within-child variability by interactional context.

Results

Increasing PTE predicted increasing impairment in preschoolers' modulation of negative affect (irritability), but not negative behavior (noncompliance) across reported (MAP-DB) and observed (DB-DOS) dimensional measures. Moreover, children's PTE-related irritability was more pronounced when observed with parents than with the examiner. The ECI did not detect PTE-related irritability nor noncompliance.

Conclusions

Nuanced, dimension- and context-specific characterization of PTE-related DB described can optimize early identification of at-risk children.



中文翻译:

学龄前儿童与产前烟草暴露相关的破坏性行为的维度和特定情境表达。

客观的

产前烟草暴露 (PTE) 相关破坏性行为 (DB) 的精确表型表征结合了暴露和结果的细微差别测量,是阐明潜在机制的最佳选择。使用这种方法,我们的目标是在入学前确定对 PTE 最敏感的 DB 维度,并评估这些维度的上下文变化。

方法

 来自两个中西部城市的N = 369 名妇女(79.2% 终生吸烟者;70.2% 怀孕吸烟者)的社区产科样本在妊娠 16、28 和 40 周时使用可替宁校准的基于访谈的报告评估 PTE。 在随后的学前随访研究中,n = 244 名完成了对 5 岁儿童的观察评估的子集构成了分析样本。使用先前与 DB 的紧急临床风险相关的两个具有发展意义的维度——易怒不依从— 我们使用 2 个家长报告量表评估儿童:破坏性行为的多维评估概况 (MAP-DB) 和幼儿期量表 (ECI)。我们还通过破坏性行为诊断观察计划 (DB-DOS) 在 3 个交互环境中的直接观察来评估儿童。我们使用广义线性模型来检查跨行为维度的儿童之间的变异性,并使用混合效应模型来检查通过交互上下文直接观察到的儿童内部变异性。

结果

增加 PTE 预测学龄前儿童对负面影响(烦躁)的调节受损程度增加,但在报告(MAP-DB)和观察(DB-DOS)维度测量中预测负面行为(不遵守)。此外,与父母一起观察时,儿童的 PTE 相关易怒性比与考官一起观察时更为明显。ECI 未检测到 PTE 相关的易怒或不依从。

结论

所描述的 PTE 相关 DB 的细微差别、维度和特定于上下文的特征可以优化对有风险儿童的早期识别。

更新日期:2020-07-31
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