Child Behavior Problems: Role of Cocaine Use, Parenting, and Child Exposure to Violence

Objective: Studies examining the association between prenatal cocaine exposure (PCE) and child behavior problems have yielded mixed results, suggesting a need to identify additional mediating and moderating influences. We hypothesized that the relation between PCE and behavior problems in kindergarten would be mediated/moderated by child exposure to violence and that maternal warmth/sensitivity and harshness would moderate the association between violence exposure and behavior problems. Methods: Participants consisted of 216 (116 cocaine-exposed and 100 noncocaine-exposed) mother-child dyads participating in an ongoing longitudinal study of PCE. Results: Results yielded no direct or mediated/moderated association between PCE and child behavior problems and no significant interaction effects between PCE and parenting quality. However, higher exposure to violence in kindergarten was significantly associated with higher child behavior problems. This association was moderated by maternal warmth/sensitivity and harshness. High maternal warmth/sensitivity buffered the association between violence exposure and behavior problems whereas high maternal harshness exacerbated this association. Conclusion: This study highlights the role of violence exposure in the development of behavior problems among high-risk children and emphasizes the significance of parenting quality in buffering or exacerbating this risk among these children. Implications for prevention include targeting the potential role of maternal warmth/sensitivity as a protective influence among children exposed to violence.