Abstract
This chapter discusses the effects of prenatal cocaine exposure (PCE) on three adolescent behavioral outcomes: internalizing and externalizing behavior, substance use, and sexual risk behavior. Various studies from multiple longitudinal prospective birth cohorts collectively indicate that PCE is related to greater externalizing behavior problems and early onset of substance use and sexual behavior, after controlling for biological and environmental confounders such as prenatal exposure to other substances, lead exposure, suboptimal caregiving environment, and violence exposure. Less is known about the underlying mechanisms (i.e., indirect effects of PCE), gender differences (i.e., PCE by gender interaction), or the role of life stress in the link between PCE and adolescent behavioral outcomes, warranting further investigation. Continued studies into adulthood will also elucidate whether the behavioral problems and early indications of substance use and sexual risk behavior persist through early adulthood and affect social and vocational adjustment.
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