Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Mary Lou Kelley


This study evaluated the long-term effects of prenatal cocaine exposure on child behavioral outcome at age 5 years, while considering the influence of the postnatal caregiving environment indicated by maternal drug use, maternal psychological functioning, and parenting quality. Behavioral outcome was measured by parent-reported behavior problems on the Achenbach Child Behavior Checklist. Subjects were 210 preschoolers (107 cocaine-exposed and 103 nondrug-exposed) and their biological mothers drawn from a larger cohort of mother-child pairs enrolled at birth in a longitudinal study evaluating the neurodevelopmental outcomes of children prenatally exposed to cocaine. The relationships among prenatal cocaine exposure, maternal adaptation (i.e., maternal drug use and psychological functioning), parenting, and behavioral functioning were evaluated through a series of correlations, group comparisons, and multiple regression analyses. Severity of prenatal cocaine exposure was not related to behavioral functioning at age 5 years. However, significant relationships were found between indicators of maternal adaptation and quality of parenting. Specifically, maternal psychological functioning at 5-year follow-up was positively correlated with Negative Parenting, indicating more physical punishment, scolding, and unresponsiveness by mothers with greater psychological distress. In multiple regression analyses, maternal psychological functioning with maternal education accounted for 9% of variance in Negative Parenting. In addition, maternal drug use at 5-year follow-up was negatively associated with Parental Control. That is, mothers with higher drug use were more permissive in their approach to parenting. Maternal drug use and maternal education accounted for 4% variance in Parental Control in multiple regression analyses. Despite a relationship between poor maternal adaptation and ineffective parenting, parenting was not in turn related to child behavioral functioning. Exploratory correlation analyses indicated a positive association between maternal psychological functioning and childhood externalizing behavior problems, although maternal psychological functioning did not significantly predict externalizing problems in follow-up regression analyses. The significance of study findings in relation to existing literature and future directions in prenatal cocaine exposure research are discussed.