Prenatal Drug Exposure and Adolescent Cortisol Reactivity: Association with Behavioral Concerns

Abstract

Purpose To examine stress reactivity in a sample of prenatally drug exposed (PDE) adolescents by examining the consequences of PDE on stress-related adrenocortical reactivity, behavioral problems and drug experimentation during adolescence. Methods Participants (76 PDE, 61 non-drug exposed [NE]; 99% African-American; 50% male; Mage=14.17 years, SD=1.17) provided a urine sample, completed a drug use questionnaire, and provided saliva samples (later assayed for cortisol) before and after a mild laboratory stress task. Caregivers completed the Behavior Assessment System for Children II and reported their relationship to the adolescent. Results The NE group was more likely to exhibit task-related cortisol reactivity, compared to the PDE group. Overall behavior problems and drug experimentation were comparable across groups with no differences between PDE and NE groups. In unadjusted mediation analyses, cortisol reactivity mediated the association between PDE and BASC II aggression scores (95% bootstrap CI: 0.04-4.28), externalizing problems scores (95% bootstrap CI: 0.03-4.50) and drug experimentation (95% bootstrap CI: 0.001-0.54). The associations remain with the inclusion of gender as a covariate but not when age is included. Conclusions Findings support and expand current research in cortisol reactivity and PDE by demonstrating that cortisol reactivity attenuates the association between PDE and behavioral problems (aggression) and drug experimentation. If replicated, prenatal drug exposure may have long lasting effects on stress-sensitive physiological mechanisms associated with behavioral problems (aggression) and drug experimentation in adolescence.

The Role of the Lateral Hypothalamus in Violent Intraspecific Aggression—The Glucocorticoid Deficit Hypothesis

“…Detrimental conditions acquired via the mother such as exposure to various illicit drugs, caffeine, nicotine, alcohol, as well as synthetic glucocorticoids (administered as medications) were all shown to inhibit HPA-axis function in adulthood (Kapoor et al, 2008 ; Vázquez et al, 2012 ; Zhang et al, 2014 ; Buckingham-Howes et al, 2016 ).…”

“…Albeit the studies reviewed above were primarily endocrinological in their scope, some of them did investigate the behavior of subjects. In all such studies, low HPA-axis function was associated with indices of aggression ( bullying : Ouellet-Morin et al, 2011 ; cocaine addicts with low stress responses : Buydens-Branchey et al, 1997 ; early life stress : Puetz et al, 2016 ; poor parental monitoring : Martin et al, 2014 ; prenatal drug exposure : Buckingham-Howes et al, 2016 ; prenatal synthetic glucocorticoids : Kapoor et al, 2008 ; schizophrenia : Strous et al, 2004 ; Das et al, 2018 ). In these studies, aggression was conceptualized as problem behavior, social and behavioral problems, externalizing behavior, high scores on aggression inventories, the display of aggression-related psychopathologies, and aggression histories.…”

Neuroendocrine and autonomic stress systems activity in young adults raised by mothers with mental health and substance abuse problems: A prospective cohort study

“…To identify stress reactive and nonreactive participants, we applied criteria used by Buckingham‐Howes et al. (2016). Participants with a reactive cortisol profile were required to meet both criteria: at least a 7.2% difference between baseline and peak cortisol levels (twice the intraassay coefficient of variation), and an absolute difference of at least 0.02 μg/dl between baseline level and peak level of cortisol (i.e., the lower limit of salivary cortisol assay sensitivity).…”

Neuroendocrine and immune pathways from pre- and perinatal stress to substance abuse

“…Comparable findings have also been observed in prenatally drug exposed adolescents who exhibited suppressed task-related cortisol reactivity compared to a control group. Notably, cortisol reactivity mediated the association between prenatal drug exposure and drug experimentation, in that adolescents with an attenuated cortisol response had increased likelihood of drug experimentation ( Buckingham-Howes et al, 2016 ).…”

“…Mixed results may be due to the age of the offspring, the type of stress paradigm, and differing drug exposure. Further, one study did find that hyporeactivity of the HPA-axis to a stressor was linked to drug experimentation in prenatally drug exposed youth ( Buckingham-Howes et al, 2016 ). It has been theorized that chronic stress initially leads to HPA-axis over-activity, but that, over time, the neuroendocrine system becomes down-regulated ( Miller et al, 2007 ).…”