Elucidating Early Mechanisms of Developmental Psychopathology: The Case of Prenatal Smoking and Disruptive Behavior


  • The Family Health and Development Project was supported by grant K08 DA00330 from the National Institute of Drug Abuse to Dr Wakschlag. Support for Drs Wakschlag, Leventhal, and Pickett was also provided by National Institute of Drug Abuse grant R01 DA15223 during the writing of this paper. In addition, Drs Leventhal and Wakschlag received support from The Walden and Jean Young Shaw Foundation, the Irving B. Harris Center for Developmental Studies and the Children's Brain Research Foundation. We are indebted to Sydney Hans, PhD, Richard Campbell, PhD, Vince Smeriglio, PhD, and Neal Benowitz, MD, for generous mentorship and wise counsel on study design and methodology. Penny Tenzer, MD, importantly facilitated the conduct of the study. We are very appreciative of our research team and the clinic physicians and staff whose assistance in study recruitment was invaluable. In particular, we acknowledge the outstanding efforts of Laura Walton, RN, MEd, and Radiah Smith-Donald. Portions of this paper were presented at the Meetings of the American Psychiatric Association, New York, NY, May 2004.

concerning this article should be addressed to Lauren S. Wakschlag, Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, 1747 W. Roosevelt Rd, MC 747, Room 155, Chicago, IL 60608. Electronic mail may be sent to lwakschlag@psych.uic.edu.


There is a robust association between prenatal smoking and disruptive behavior disorders, but little is known about the emergence of such behaviors in early development. The association of prenatal smoking and hypothesized behavioral precursors to disruptive behavior in toddlers (N=93) was tested. Exposed toddlers demonstrated atypical behavioral patterns, including (1) escalating externalizing problems from 18 to 24 months and (2) observed difficulty modulating behavior in response to social cues. Specification of exposure-related behaviors is a first step toward generating testable hypotheses about putative mechanisms of effect. While it remains unclear whether prenatal exposure plays an etiologic role in the emergence of disruptive behavior, atypical exposure-related behavioral patterns are evident in the first years of life and demonstrate developmental coherence.