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Biomedical subjects

P A Fried

Publications and source records attributed to P A Fried.

At least 19 recordsLinked to original sources
PubMed2006

Neurocognitive consequences of cigarette smoking in young adults--a comparison with pre-drug performance.

The present study examined effects of current and past regular cigarette smoking in young adult subjects. One hundred and twelve 17-21-year-old subjects, assessed since infancy, were evaluated using a battery of neurocognitive tests for which commensurate measures were obtained at 9-12 years of age, prior to the initiation of regular smoking. Smokers, determined by urinalysis and self-report, were categorized as heavy (>9 cigarettes per day) and light (<9 cigarettes per day) current smokers and former smokers, the latter having smoked cigarettes regularly in the past but not for at least 6 months. A third of the subjects were currently smoking cigarettes regularly with half of these being heavy smokers. Among former smokers, the average duration of smoking was slightly less than 2 years. Overall IQ, memory, processing speed, vocabulary, attention and abstract reasoning were the primary outcomes with comparisons being made between each of the three user groups and a control group who never smoked regularly. After accounting for potentially confounding factors including clinical assessment, marihuana use and pre-drug performance in the relevant cognitive domain, current regular smokers did significantly worse than non-smokers in a variety of cognitive areas predicated upon verbal/auditory competence including receptive and expressive vocabulary, oral arithmetic, and auditory memory. This impact of current smoking appears to behave in a dose-response and duration-related fashion. In contrast, former smokers differed from the non-smokers only in the arithmetic task. These results suggest that regular smoking during early adulthood is associated with cognitive impairments in selected domains and that these deficits may be reversed upon cessation. Together, the findings add to the body of evidence to be used in persuading adolescents and young adults against the initiation of smoking and, if currently smoking, the advantages of stopping.

Adolescent↗
PubMed2004

Neurocognitive consequences of marihuana--a comparison with pre-drug performance.

In determining the effects of regular marihuana use on neurocognition, abilities within specific relevant cognitive domains prior to regular drug use have not been available. The present study examined effects of current and past regular use of marihuana in subjects for whom pre-drug performance had been ascertained in a prospective, longitudinal fashion. A total of 113 young adults, assessed since infancy, were evaluated using neurocognitive tests for which commensurate measures were obtained prior to the initiation of marihuana smoking. Marihuana users, determined by urinalysis and self-report, were categorized as light (< 5 joints per week) and heavy (> or = 5 joints per week) current users and former users, the latter having used the drug regularly in the past (> or = 1 joint per week) but not for at least 3 months. A third of the subjects were using marihuana on a regular basis at the time of assessment with half being heavy users. Among former, regular users, approximately half had been smoking 5 or more joints per week. Overall IQ, memory, processing speed, vocabulary, attention, and abstract reasoning were assessed. After accounting for potentially confounding factors and pre-drug performance in the appropriate cognitive domain, current regular heavy users did significantly worse than non-users in overall IQ, processing speed, immediate, and delayed memory. In contrast, the former marihuana smokers did not show any cognitive impairments. It was concluded that residual marihuana effects are evident beyond the acute intoxication period in current heavy users after taking into account pre-drug performance but similar deficits are no longer apparent 3 months after cessation of regular use, even among former heavy using young adults.

Adult↗
PubMed2002

Conceptual issues in behavioral teratology and their application in determining long-term sequelae of prenatal marihuana exposure.

BACKGROUND: Behavioral teratology, particularly as it is applied to the evaluation of cognition and behavior of children beyond the toddler stage, has become an area of burgeoning activity. In the area of drug abuse, children exposed in utero are often at developmental peril because of non-drug pre- and postnatal risk factors that make a causal association between the drug of interest and a behavioral teratogenic outcome increasingly problematic as the child gets older. METHODS: In the first portion of this review, the strategies that behavioral teratologists have undertaken to investigate the putative consequences of in utero exposure are discussed in terms of research design, statistical methods and interpretative approaches. In the second part of the paper, the relatively limited literature dealing with the behavioral teratological consequences of prenatal marihuana exposure, particularly in school age offspring, is reviewed. RESULTS: An emergent theme arising from primarily two longitudinal investigations is that in utero cannabis exposure does not impact upon standardized derived IQ scores but is negatively associated with attentional behavior and visual analysis/hypothesis testing. These findings are interpreted as supporting the hypothesis that, among offspring beyond the toddler stage, prenatal marihuana exposure has a negative influence on aspects of executive function. Executive function is a 'top-down', multifaceted cognitive construct involved in organizing and integrating specific cognitive and output processes over a interval of time and is largely mediated by the late developing, prefrontal region of the brain. CONCLUSIONS: The results and the interpretation of the prenatal marihuana findings are discussed in terms of the behavioral teratogenic effects (or lack of effects) during the various developmental stages of the offspring, the non-unitary nature of executive function, cannabis receptors, and the consequences of chronic marihuana use in the non-pregnant population.

Adolescent↗
PubMed1995

Prenatal exposure to marihuana and tobacco during infancy, early and middle childhood: effects and an attempt at synthesis.

Both marihuana and cigarettes appear implicated, in a differential fashion, in the neurobehaviour of infants and children born to women who used these substances during pregnancy. In a low-risk upper middle class sample, marihuana use was associated, in the newborn, with mild withdrawal symptoms and some autonomic disruption of nervous system state regulation. However, between 6 months and 3 years of age no behavioural consequences of marihuana exposure (once confounding factors were controlled) were noted. At four years of age, although global tests of intelligence did not differentiate exposed from non-marihuana exposed children, verbal ability and memory were associated with in utero marihuana exposure. At five and six years of age these general areas were also noted to be associated with maternal cannabis use as was sustained attention. These areas of neurobehavior that appear affected by marihuana exposure during fetal development are ones that are consistent with the cognitive construct of 'executive functioning' which is thought to be a marker of prefrontal lobe functioning. Consistent with the observations derived from these children is that prefrontal functioning may not be apparent until approximately four years of age and that executive functioning is disassociated from measures of global intelligence. Exposure to cigarettes during pregnancy appears to be associated with neurobehavioural deficits in the auditory domain. In the newborn this is manifested by decreased responsivity to sound and altered auditory habituation. Between the ages of one and 11 years the performance on auditory related tasks (verbal memory, language, auditory processing) were consistently the domains that differentiated the cigarette exposed from the non exposed children. The possible role of the cholinergic mediated efferent auditory system is discussed. Also associated with in utero exposure to cigarettes were general cognitive performance and parental reports and objectively derived measures of impulsivity. The striking degree of consistency over the years lends strength to the interpretation that the observations in childhood have, at least as their partial etiology, the prenatal exposure to cigarettes. However, in interpreting the evidence presented it must be recognized that the alterations in the child's behaviour may well affect the parenting behaviour. This potential transactional interaction must remain an integral part of drawing conclusions about both marihuana and cigarette's effects.

Behavior↗
PubMed1995

Association between creatinine-adjusted and unadjusted urine cotinine values in children and the mother's report of exposure to environmental tobacco smoke.

OBJECTIVE: To examine the association between parents' report of their child's secondhand smoke exposure and various adjustments of cotinine concentrations in random urine samples. METHODS: Urine cotinine and creatinine were measured in 109 six to 11-year-old children from predominantly upper middle-class families. Cotinine values were considered as: (a) unadjusted, (b) as a cotinine/creatinine ratio, (c) as adjusted based on a regression relationship between cotinine and creatinine, and (d) and (e) as a cotinine/creatinine ratio adjusted for age and sex. RESULTS: Little overlap in cotinine values occurred between exposed and nonexposed children, and a dose-response relationship was noted between the parental report and the urine cotinine values (r = 0.67). A modest improvement occurred in the correlation when the cotinine/creatinine ratio was considered. Considering exposure to cigarette smoke outside the home as well as in the household only improved the correlation when the former exposure was heavy. A high degree of concordance exists between the parents' report of exposure and the child's urine cotinine. CONCLUSIONS: The value of adjusting this biochemical parameter by various means may be a function of the particular sample being investigated, suggesting no one method is universally appropriate.

Child↗
PubMed1995

The Ottawa Prenatal Prospective Study (OPPS): methodological issues and findings--it's easy to throw the baby out with the bath water.

In the OPPS we have been studying the effects of marihuana used during pregnancy since 1978. The subjects are primarily middle-class, low risk women who entered the study early in their pregnancy. Extensive demographic and life-style information was gathered several times during pregnancy and postnatally. The offspring have been assessed repeatedly during the neonatal period, at least annually until the age of 6 and less frequently thereafter. The outcome measures include a variety of age appropriate standardized global measures as well as a large battery of neuropsychological tests attempting to assess discrete functioning within particular domains including language development, memory, visual/perceptual functioning, components of reading and sustained attention. The results suggest that in the neonate, state alterations and altered visual responsiveness may be associated with in utero exposure to marihuana. Global measures, particularly between the ages of 1 and 3 years, did not reveal an association with prenatal marihuana exposure. However, this initial, apparent absence of effect during early childhood should not be interpreted as in utero marihuana exposure having only transient effects for, as the children became older, aspects of neuropsychological functioning did discriminate between marihuana and control children. Domains associated with prenatal marihuana exposure at four years of age and older included increased behavioral problems and decreased performance on visual perceptual tasks, language comprehension, sustained attention and memory. The nature and the timing of the appearance of these deficits is congruent with the notion of prenatal marihuana exposure affecting 'executive functioning'--goal directed behavior that includes planning, organized search, and impulse control. Such an interpretation would be consistent with the extant literature with animals and non-pregnant adult users suggesting that chronic marihuana use may impact upon prefrontal lobe functioning.

Child, Preschool↗
PubMed1992

60- and 72-month follow-up of children prenatally exposed to marijuana, cigarettes, and alcohol: cognitive and language assessment.

Cognitive and receptive language development were examined in 135 60-month-old and 137 72-month-old children for whom prenatal exposure to marijuana, cigarettes, and alcohol had been ascertained. Discriminant Function analysis revealed an association between prenatal cigarette exposure and lower cognitive and receptive language scores at 60 and 72 months. This paralleled and extended observations made with this sample at annual assessments at 12 to 48 months of age. Unlike observations made at 48 months, prenatal exposure to marijuana was not associated with the cognitive and verbal outcomes. Relatively low levels of maternal alcohol consumption did not have significant relationships with the outcome variables. The importance of assessing subtle components rather than global cognitive and language skills to detect potential behavioral teratogenic effects of the drugs being examined is discussed.

Alcohol Drinking↗
PubMed1991

Developmental items on children's human figure drawings: a replication and extension of Koppitz to younger children.

In 1968, Koppitz described the human figure drawings of 5- to 12-year-old children and established normative data for these age groups. The present work consisted of two parts. The first confirmed the observations of Koppitz to a very considerable degree in a sample of predominantly middle-class, White children between 5 and 7 years of age. Concordance was observed by employing Koppitz's categorization schema of Expected, Common, Not Unusual, and Exceptional items by males and females. The second aspect of the work examined the drawings of 3- and 4-year-old children utilizing Koppitz's categories.

Aptitude↗
PubMed1990

36- and 48-month neurobehavioral follow-up of children prenatally exposed to marijuana, cigarettes, and alcohol.

Aspects of neurobehavioral development were examined in 133 36-month- and 130 48-month-old children for whom prenatal exposure to marijuana, cigarettes, and alcohol had been previously ascertained and who have been assessed since birth. Parallelling earlier observations made with this sample at 12 and 24 months, prenatal exposure to cigarette smoking was significantly associated with poorer language development and lower cognitive scores at both 36 and 48 months after statistically controlling for confounding factors. Relatively low levels of maternal alcohol consumption, which had measurable effects at 24 and 36 months, no longer had significant relationships with outcome variables at 48 months of age. At 48 months, significantly lower scores in verbal and memory domains were associated with maternal marijuana use after adjusting for confounding variables. This negative relationship is the first reported association beyond the neonatal stage, and may represent a long-term effect of the drug upon complex behavior that, at a younger age, had not developed and/or could not be assessed.

Child Development↗
PubMed1989

Maternal smoking during pregnancy affects children's vigilance performance.

Aspects of attentional behaviour in 4--7-year-olds, as assessed by auditory and visual vigilance tasks, were related to prenatal exposure to cigarettes. Data on 76--79 children born to healthy, white, predominantly middle-class women were analyzed using multiple regression techniques controlling for potentially confounding variables including postnatal second hand smoke exposure. Cigarette smoking during pregnancy was related to an increased activity level of the children during the tasks and increased errors of commission in the auditory task and, to a lesser degree, in the visual task. After controlling for confounding factors, the relationship between prenatal smoking and errors of omission did not retain significance. The combination of results suggest that the deficits in attention may reflect impulsive responding and increased overall activity.

Arousal↗
PubMed1989

Cigarettes and marijuana: are there measurable long-term neurobehavioral teratogenic effects?

Since 1978, a prospective investigation has been underway to study the consequences of prenatal exposure to a number of widely used drugs. Data are presented describing some of the associations between maternal use of cigarettes and marijuana and effects upon the offspring beyond the newborn stage. At one month of age, prenatal cigarette exposure was associated with hypertonicity and increased nervous system excitation while prenatal marijuana exposure was associated with symptoms similar to mild narcotic withdrawal. At 12 months of age, maternal cigarette smoking was significantly associated with lower mental scores and altered responses to auditory items. At 24 months, similar associations were noted although the unique predictive power of maternal smoking was overshadowed by the influence of the postnatal environment. In the one and two year old offspring of the marijuana users, no association was noted between drug use and motor, mental or language outcome variables. At three years of age a dose response relationship between lower language scores, lowered cognitive scores and prenatal cigarette exposure was noted. At this age, some cognitive and language deficits were also observed with prenatal marijuana exposure. Overall, it appears that at one, two and three years of age, there are persistent effects of prenatal exposure to cigarettes but the effects of prenatal marijuana exposure, if present, are not as readily ascertained.

Behavior↗
PubMed1987

Neonatal neurological status in a low-risk population after prenatal exposure to cigarettes, marijuana, and alcohol.

The neurological status of 9- and 30-day-old infants, as assessed by the Prechtl neurological examination, was significantly and differentially related to prenatal exposure of cigarettes, marijuana, and alcohol. Data on approximately 250 babies, born to healthy, white, predominantly middle-class women, were analyzed using discriminant function analyses controlling for potentially confounding variables. Prenatal cigarette exposure was associated with hypertonicity and increased nervous system excitation, particularly at 30 days, prenatal marijuana exposure was associated with symptoms similar to mild narcotic withdrawal, and prenatal exposure to relatively low levels of alcohol was associated with slightly lowered nervous system arousal at 9 days of age. The results were related to behavioral observations on neonates exposed to drugs prenatally.

Alcohol Drinking↗
PubMed1985

Soft drug use after pregnancy compared to use before and during pregnancy.

With the use of information gathered through the course of pregnancy and data collected after delivery, the changing patterns of alcohol, nicotine, and marijuana use of 288 women participating in the Ottawa Prenatal Prospective Study were investigated. The time periods considered were the year before pregnancy, each trimester of pregnancy, and 1, 6, and 12 months post partum. Alcohol use showed the most marked reduction of the three drugs during pregnancy, but a year after delivery prepregnancy drinking patterns (including binging) had been reestablished. An exception to this was a continued reduction of alcohol consumption by those categorized as heavy social drinkers prior to pregnancy. Although not as marked as the alcohol reduction, nicotine use was reduced during pregnancy and continued to remain at the reduced level 1 year post partum. Heavy marijuana use was the least reduced of the drugs during pregnancy and consumption returned to prepregnancy levels a year after the birth of the baby.

Alcohol Drinking↗