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Testing the programming of temperament and psychopathology in two independent samples of children with prenatal substance exposure

Published online by Cambridge University Press:  02 August 2018

Betty Lin*
University of Utah
Brendan D. Ostlund
University of Utah
Elisabeth Conradt
University of Utah
Linda L. Lagasse
Alpert Medical School of Brown University Women and Infants Hospital of Rhode Island
Barry M. Lester
Alpert Medical School of Brown University Women and Infants Hospital of Rhode Island
Address correspondence and reprint requests to: Betty Lin, Department of Psychology, University of Utah, Salt Lake City, UT 84112; E-mail:


Prenatal programming models have rarely been applied to research on children with prenatal substance exposure, despite evidence suggesting that prenatal drug exposure is a form of stress that impacts neurodevelopmental outcomes and risk for psychopathology. Utilizing data from two longitudinal multisite studies comprising children prenatally exposed to substances as well as a nonexposed comparison group (Maternal Lifestyle Study, n = 1,388; Infant Development, Environment, and Lifestyle study, n = 412), we tested whether early phenotypic indicators of hypothesized programming effects, indexed by growth parameters at birth and infant temperament, served as a link between prenatal substance exposure and internalizing and externalizing behavior at age 5. Latent profile analysis indicated that individual differences in reactivity and regulation for infants prenatally exposed to substances was best characterized by four temperament profiles. These profiles were virtually identical across two independent samples, and demonstrated unique associations with adjustment difficulties nearly 5 years later. Results of path analysis using structural equation modeling also showed that increased prenatal substance exposure was linked to poorer growth parameters at birth, profiles of temperamental reactivity in infancy, and internalizing and externalizing behavior at age 5. This pathway was partially replicated across samples. This study was among the first to link known individual-level correlates of prenatal substance exposure into a specific pathway to childhood problem behavior. Implications for the developmental origins of a child's susceptibility to psychopathology as a result of intrauterine substance exposure are discussed.

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The first two authors contributed equally to this paper.

This work was supported by the following NIH grants: National Institute of Child Health and Human Development (NICHD) Neonatal Research Network and an interinstitute agreement with the National Institute on Drug Abuse (NIDA) through cooperative agreements: U10-DA-024119-01 and U10-HD-27904 (to B.M.L.); NICHD contract N01-HD-2-3159 (to B.M.L) and 1RO1DA014918 (to L.L.); and a Career Development Award from the NIDA 7K08DA038959-02 (to E.C.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health, the NIDA, or the NIH.


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