Cynthia Larkby - Academia.edu (original) (raw)

Papers by Cynthia Larkby

Neurotoxicology and Teratology, 2016

We examined direct and indirect pathways between adverse environmental exposures during gestation... more We examined direct and indirect pathways between adverse environmental exposures during gestation and childhood and drinking in mid-adolescence. Mothers and their offspring (n=917 mother/child dyads) were followed prospectively from second trimester to a 16-year follow-up assessment. Interim assessments occurred at delivery, 6, 10, and 14years. Adverse environmental factors included gestational exposures to alcohol, tobacco, and marijuana, exposures to childhood maltreatment and violence, maternal psychological symptoms, parenting practices, economic and home environments, and demographic characteristics of the mother and child. Indirect effects of early child behavioral characteristics including externalizing, internalizing activity, attention, and impulsivity were also examined. Polytomous logistic regression analyses were used to evaluate direct effects of adverse environmental exposures with level of adolescent drinking. Structural equation modeling (SEM) was applied to simultaneously estimate the relation between early adversity variables, childhood characteristics, and drinking level at age 16 while controlling for significant covariates. Level of drinking among the adolescent offspring was directly predicted by prenatal exposure to alcohol, less parental strictness, and exposures to maltreatment and violence during childhood. Whites and offspring with older mothers were more likely to drink at higher levels. There was a significant indirect effect between childhood exposure to violence and adolescent drinking via childhood externalizing behavior problems. All other hypothesized indirect pathways were not significant. Thus most of the early adversity measures directly predicted adolescent drinking and did not operate via childhood behavioral dysregulation characteristics. These results highlight the importance of adverse environmental exposures on pathways to adolescent drinking.

Addictive Behaviors, 2007

The goal of this study was to examine the effects of early and adverse experiences with sex and a... more The goal of this study was to examine the effects of early and adverse experiences with sex and alcohol on adolescent drinking the year before and during pregnancy. Pregnant adolescents, recruited at an outpatient prenatal clinic, were interviewed about their substance use. A subsample was asked about their first sexual experiences. Associations among early experiences with alcohol and sex and drinking before and during pregnancy were examined. Early age at first alcoholic drink predicted problem alcohol use before pregnancy and drinking during pregnancy. Coercive first coitus was not associated with alcohol use, but drinking during first coitus predicted problem alcohol use before pregnancy as well as drinking during the first trimester of pregnancy. In sum, early use of alcohol and use of alcohol during first coitus may be risk factors for problematic alcohol use before pregnancy and during pregnancy among childbearing teenagers. Implications for the health of adolescent mothers and their offspring are discussed.

Journal of Women's Health, 2010

Background: Among adult women an association between childhood sexual abuse (CSA) and obesity has... more Background: Among adult women an association between childhood sexual abuse (CSA) and obesity has been observed. Research with lesbian women has consistently identified high rates of obesity as well as frequent reports of CSA, but associations between sexual abuse and obesity have not been fully explored. Our aim was to investigate the relationship between sexual abuse (SA) history and obesity among heterosexual (n ¼ 392) and lesbian (n ¼ 475) women (age 35-64) who participated in the Epidemiologic STudy of HEalth Risk in Women (ESTHER) Project in Pittsburgh, Pennsylvania. Methods: Obesity was defined as body mass index (BMI) !30. Covariates included self-reported SA, sexual orientation, demographic factors, and history of a depression or anxiety diagnosis. SA history was assessed by three factors: (1) SA experienced under the age of 18 by a family member or (2) by a nonfamily member and forced, unwanted sexual experience(s) at age !18. Data were analyzed using chi-square tests and logistic regression models. Results: Multiple logistic regression analyses revealed that obesity was associated with African American race, lesbian sexual orientation, intrafamilial CSA, and history of mental health diagnosis. Protective factors were having a household income of at least $75,000 and having a bachelor's degree or higher. Conclusions: Results suggest that lesbian women may be at greater risk of obesity than heterosexual women and that intrafamilial CSA-regardless of sexual orientation-may play a role in the development of obesity.

Journal of Substance Abuse Treatment, 2014

Aims: The aim of this study is to assess the effect of brief motivational enhancement interventio... more Aims: The aim of this study is to assess the effect of brief motivational enhancement intervention postpartum alcohol use. Design: This study is a single-blinded, randomized controlled effectiveness trial in which pregnant women were assigned to receive usual care or up to 5 face-to-face brief motivational enhancement sessions lasting 10-30 minutes each and occurring at study enrollment, 4 and 8 weeks after enrollment, 32 weeks of gestation, and 6 weeks postpartum. Setting: The setting is in a large, urban, obstetrics clinic. Participants: Participants were women who were ≥18 years old, b 20 weeks of gestation, and consumed alcohol during pregnancy. Of 3438 women screened, 330 eligible women were assigned to usual care (n = 165) or intervention (n = 165). Due to missing data, we analyzed 125 in the intervention group and 126 in the usual care group. Measurements: The measurements were the proportion of women with any alcohol use and the number of drinks per day, reported via follow-up telephone interviews at 4 and 8 weeks after enrollment, 32 weeks of gestation, and 6 weeks, 6 months, and 12 months postpartum. Findings: In random effects models adjusted for confounders, the intervention group was less likely to use any alcohol (odds ratio 0.50; 95% confidence interval [CI], 0.23-1.09; P = 0.08) and consumed fewer drinks per day (coefficient −0.11; 95% CI − 0.23-0.01; P = 0.07) than, the usual care group in the postpartum period but these differences were non-significant. Missing data during the prenatal period prevented us from modeling prenatal alcohol use. Conclusions: Brief motivational enhancement intervention delivered in an obstetrical outpatient setting did not conclusively decrease alcohol use during the postpartum period.

Journal of Women's Health, 2010

Psychological medicine, Jan 23, 2014

Studies have demonstrated that an early age of onset of marijuana use (EAOM) is associated with a... more Studies have demonstrated that an early age of onset of marijuana use (EAOM) is associated with a higher risk of developing psychotic symptoms (PS) compared to initiating marijuana use at a later age or not at all. Research has also found that prenatal marijuana exposure (PME) predicts EAOM. This report evaluates the relationships among PME, EAOM, and PS. Subjects were initially interviewed in their fourth prenatal month. Women and offspring who completed the birth assessment (n = 763) were selected for follow-up. Women and their offspring were followed until the offspring were 22 years of age: 596 offspring were evaluated. At age 22, PS were assessed in the offspring with the Diagnostic Interview Schedule using DSM-IV criteria. Analyses controlled for significant covariates including other prenatal substance exposures, race, gender, and offspring substance use at 22 years. PME and EAOM significantly predicted increased rates of PS at 22 years controlling for other significant covar...

Alcohol health and research world, 1997

Exposure to alcohol during gestation can cause persistent abnormalities in physical and cognitive... more Exposure to alcohol during gestation can cause persistent abnormalities in physical and cognitive development. Children who meet the clinical definition of fetal alcohol syndrome (FAS) are small for their age, exhibit characteristic facial anomalies, and demonstrate deficits in central nervous system development. Alcohol effects in children with prenatal exposure, but not FAS, are similar, although of smaller magnitude and not necessarily present in all three systems. The degree to which a person is affected by prenatal alcohol exposure depends on the amount, timing, and duration of the mother's alcohol consumption during pregnancy as well as maternal characteristics (e.g., age and comorbid psychiatric disorders) and environmental factors (e.g., socioeconomic status and family problems). Some exposure-related effects, such as growth deficits, are directly related to the amount of alcohol consumed, however, so that even a small amount of alcohol may affect child development. Ther...

Neurotoxicology and Teratology, 2007

Alcoholism: Clinical and Experimental Research, 2002

Growth deficits are among the cardinal features for the diagnosis of fetal alcohol syndrome. Grow... more Growth deficits are among the cardinal features for the diagnosis of fetal alcohol syndrome. Growth deficits have also been noted among those who were exposed to alcohol prenatally but who do not have fetal alcohol syndrome. Few studies have observed subjects past early and middle childhood, however, to evaluate the longer-term effects of prenatal alcohol exposure on growth in adolescence. This is a report of the effects of alcohol exposure during gestation on the size of the offspring at 14 years of age. Women were recruited in their fourth prenatal month. These women were interviewed in the fourth and seventh months of pregnancy and at delivery. The women and their children were seen when the offspring were 14 years of age. Growth deficits associated with prenatal alcohol exposure were identified among the offspring at 14 years of age. Weight, height, head circumference, and skinfold thickness continued to be significantly affected by prenatal alcohol exposure after controlling for other significant predictors of size. These effects exhibited a dose-response pattern, and significant effects were found at levels below one drink per day. For example, first trimester alcohol exposure predicted weights of 152 lbs for the offspring of abstainers, 149 lbs for the offspring of light drinkers (>0 and <0.2 drinks per day), 143 lbs for the offspring of moderate drinkers (>0.2 and <0.89 drinks per day), and 136 lbs for the offspring of heavy drinkers (>0.89 drinks per day). Prenatal alcohol exposure continues to affect size at age 14 years in this cohort of children followed since their fourth month of gestation.

Journal of Interpersonal Violence, 2011

Study aims were to examine the relations between multiple forms of childhood maltreatment (CM) an... more Study aims were to examine the relations between multiple forms of childhood maltreatment (CM) and adult violent victimization (AVV) and to explore other significant covariates of the relations between CM and AVV. Data were collected from women (n = 477) who participated in two longitudinal studies in the Maternal Health Practices and Child Development Project. Women with a history of CM were more than twice as likely to experience AVV as women with no history of CM. Those who experienced one or two forms of CM were significantly more likely to report any AVV compared to women with no CM. The relationship between CM and AVV remained significant after controlling for illicit drug use at baseline. Among low-income women, a history of CM exposure increased the risk of AVV. Having had any CM exposure was more important that the specific form or combination of forms, of CM exposure (e.g., sexual abuse or physical abuse).

Neurotoxicology and Teratology, 2016

Addictive Behaviors, 2007

Journal of Women's Health, 2010

Journal of Substance Abuse Treatment, 2014

Journal of Women's Health, 2010

Psychological medicine, Jan 23, 2014

Alcohol health and research world, 1997

Neurotoxicology and Teratology, 2007

Alcoholism: Clinical and Experimental Research, 2002

Journal of Interpersonal Violence, 2011