Cognitive and Behavioral Impact on Children Exposed to Opioids During Pregnancy.

The developmental impact of opioid use during pregnancy is a subject of ongoing debate. Short-term neonatal outcomes, such as lower birth weight and neonatal abstinence syndrome, are the most well-recognized outcomes. However, knowledge gaps exist regarding longer-term neurocognitive and mental health outcomes. In this article, we summarize an expert panel discussion that was held in April 2018 by the Substance Abuse and Mental Health Services Administration and attended by national experts in the field of perinatal opioid exposure and its impact on child development. Despite the challenges with research in this area, there is emerging literature revealing an association between neonates exposed to opioids in utero and longer-term adverse neurocognitive, behavioral, and developmental outcomes. Although adverse sequalae may not be apparent in the neonatal period, they may become more salient as children develop and reach preschool and school age. Multiple variables (genetic, environmental, and biological) result in a highly complex picture. The next steps and strategies to support families impacted by opioid use disorder are explored. Model programs are also considered, including integrated care for the child and mother, parenting supports, and augmentations to home visiting.

Influence of caregivers' experiences on service use among children with attention-deficit hyperactivity disorder.

OBJECTIVE: This study examined how prior experiences of caregivers of children with attention-deficit hyperactivity disorder (ADHD) leading up to treatment related to later service use. METHODS: The investigators interviewed caregivers of 48 children with ADHD recruited from outpatient clinic settings and recorded the children's medication use and clinic attendance six and 12 months later. Interview transcripts were analyzed to identify characteristic experiences, or themes, felt by the caregivers before seeking treatment. The investigators also looked for patterns in the way themes were endorsed. RESULTS: Caregivers' experiences with the children's ADHD were characterized by six main themes-caregiver strain, attribution of meaning, perception of responsibility, problem-solving approach, beliefs about ADHD treatment, and response to societal influences. Based on distinct patterns in which they endorsed the six themes, caregivers were classified as motivated by observation (high on theme of perception of responsibility and low on theme of caregiver strain; 27%), motivated by experience (positive attribution of meaning and beliefs about ADHD treatment and low on strain; 19%), motivated by strain (high on strain, uncertain attribution of meaning, and contradictory societal influences; 23%), and struggling with meaning (high on strain, nonmedical attribution of meaning; 31%). At 12 months, children of caregivers who were motivated by experience were the most likely and those struggling with meaning were the least likely to attend clinic appointments (89% and 53%, respectively, p=.017). The groups did not vary in medication use. CONCLUSIONS: Early identification of the factors influencing caregivers' use of services for children with ADHD may have implications for treatment retention.

Depressive symptoms and bias in perceived social competence among young adults.

We examined associations between depressive symptoms and young adults' self-perceptions of social competence to explore whether higher symptoms are associated with self-evaluations that are more accurate (i.e., depressive realism), negatively biased (i.e., cognitive distortion), or less accurate (i.e., self-verification perspective). In 133 young adults, depressive symptoms and discrepancies between self- and peer ratings of social competence were assessed. Results demonstrated a linear relationship between depressive symptoms and self-peer discrepancies, such that higher symptoms were associated with underestimation of the self and low symptom levels were linked with overestimation of the self relative to peer evaluations. These findings suggest negative bias in dysphorics' self-perceptions, supporting cognitive distortion models, as well as positive bias in self-perceptions of those with low depressive symptoms.

Being close and being social: peer ratings of distinct aspects of young adult social competence.

The present study had three main objectives: (1) to develop and validate scales of young adult social competence in two domains, close relationships and social groups, using peer ratings of California Q-sort (Block, 1974; Kremen & Block, 2002) items; (2) to test the hypothesis that social competence is associated with young adult well-being and ego development; (3) to test the hypothesis that close relationship competence aligns more closely than social group competence with young adult functioning. Psychometric data on peer ratings of social competence are presented. For 133 young adults, peer ratings of social competence were correlated in expected directions with indices of functioning (e.g., self-worth, education, psychological distress, criminal behavior, and ego development). Associations were generally stronger for competence in close relationships than in social groups.