Caregiver psychological distress and child outcome among cocaine-exposed children

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)

First Committee Member

Peter Mundy - Committee Chair


The present study investigated the effect of caregiver psychological distress and related caregiver variables on the cognitive, language, and behavioral outcome of cocaine exposed children. A sample of 91 caregivers of cocaine exposed children enrolled in the Linda Ray Intervention Center were interviewed using the Symptom Checklist 90-Revised, the Parenting Stress Index/Short Form, and the Family Support Scale. Complete child outcome data on the Bayley Scales of Infant Development-II, the Reynell Developmental Language Scales, and the Child Behavior Checklist-2-3 for 53 caregiver-child pairs were used in the analysis of outcome effects. Partial data was available for 75 caregiver-child pairs.As in an earlier analysis of a subset of this data (Collins, et al., 1996), the results of this study also indicated that a disproportionate number of the biological mothers in the sample displayed clinical levels of psychological distress. Similarly, this study replicated earlier findings of a positive relation between caregiver psychological distress and parenting stress. However, the results of the present study indicated that caregiver psychological distress did not significantly impact child outcome among cocaine exposed children. Also contrary to expectations, caregiver social support was generally not found to significantly moderate the relation between caregiver psychological distress and child outcome. On the other hand, caregiver education and child gestational age emerged as better predictors of child outcome than did caregiver psychological distress. Additionally, the intervention that the children received was found to positively relate to child outcome. Among the types of intervention provided, which ranged from high quality day care to home-based instruction to routine medical care and social services, the intensive center-based day care was found to be related to better child language development.These results are discussed in terms of the their utility in illuminating the particular relations among critical variables specific to the caregiving environment of cocaine exposed children and the nature of their influence on child outcome. Further, the implications of these findings for directing more comprehensive and efficient intervention efforts are highlighted.


Health Sciences, Mental Health; Health Sciences, Obstetrics and Gynecology; Health Sciences, Public Health; Psychology, Developmental; Psychology, Clinical; Psychology, Cognitive

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