The relationships of prenatal cocaine exposure, postnatal lead exposure, and victimization to aggressive behavior/delinquency in adolescence.

INTRODUCTION

Prenatal cocaine exposure (PCE) can alter the monoaminergic neurotransmitter system in the fetal brain related to emotional and behavioral regulation. PCE has been associated with high rates of aggression and delinquency, risk for victimization, and multiple environmental stressors associated with a disadvantaged environment, including postnatal lead exposure. While postnatal lead exposure has also been linked to aggressive behavior/delinquency, little is known about the combined impacts of PCE and lead on behavior, nor how they interact with environmental stressors such as victimization.

OBJECTIVES

Assess the relationships of PCE, postnatal lead levels, and victimization to adolescent self-report of aggressive behavior/delinquency, controlling for other prenatal drug exposures and the quality of the caregiving environment.

METHODS

At age 17, 336 adolescents (50 % PCE, 46 % male) reported their aggressive behavior/delinquency (AGG) on the Problem-Oriented Screening Instrument for Teenagers, and type of lifetime victimization on the Juvenile Victimization Questionnaire. Blood lead levels were measured at 2-4 years, and the Home Observation for the Measurement of the Environment - Early Adolescence at 15 years. Binomial logistic, multiple regression and mediation analyses examined group differences and relationships among variables.

RESULTS

PCE, victimization (child maltreatment and peer/sibling victimization), and postnatal lead levels were each associated with higher AGG. Girls with PCE reported higher AGG than non-exposed girls while boys did not differ, and all adolescents with PCE reported more child maltreatment and peer/sibling victimization. Child maltreatment partially mediated the relationship between PCE and aggressive behavior/delinquency.

CONCLUSIONS

Recognition of the higher rates of maltreatment and peer/sibling victimization with PCE is important for intervention efforts, as each contributes to higher AGG. As PCE may be associated differentially with higher AGG in girls, gender-focused interventions should be considered while addressing the increased impact of victimization and postnatal lead levels on AGG in both PCE and NCE boys and girls.