The Effect of Smoking during Pregnancy on Severity and Directionality of Externalizing and Internalizing Symptoms: A Genetically Informed Approach

Mikael O. Ekblad, Kristine Marceau, Emily Rolan, Rohan H. C. Palmer, Alexandre Todorov, Andrew C. Heath and Valerie S. Knopik
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Mikael O. Ekblad: Department of General Practice, Institute of Medicine, Turku University and Turku University Hospital, 20014 Turku, Finland
Kristine Marceau: Department of Human Development and Family Studies, Purdue University, West Lafayette, IN 47906, USA
Emily Rolan: Department of Psychology, Michigan State University, East Lansing, MI 48824, USA
Rohan H. C. Palmer: Department of Psychology, Behavioral Genetics of Addiction Laboratory, Emory University, Atlanta, GA 30322, USA
Alexandre Todorov: Department of Psychiatry, Midwest Alcoholism Research Center, Washington University School of Medicine, Saint Louis, MO 63110, USA
Andrew C. Heath: Department of Psychiatry, Midwest Alcoholism Research Center, Washington University School of Medicine, Saint Louis, MO 63110, USA
Valerie S. Knopik: Department of Human Development and Family Studies, Purdue University, West Lafayette, IN 47906, USA

IJERPH, 2020, vol. 17, issue 21, 1-12

Abstract: The objective was to examine the association between maternal smoking during pregnancy (SDP) and (I) severity and (II) directionality of externalizing and internalizing symptoms in a sample of sibling pairs while rigorously controlling for familial confounds. The Missouri Mothers and Their Children Study is a family study (N = 173 families) with sibling pairs (aged 7 to 16 years) who are discordant for exposure to SDP. This sibling comparison study is designed to disentangle the effects of SDP from familial confounds. An SDP severity score was created for each child using a combination of SDP indicators (timing, duration, and amount). Principal component analysis of externalizing and internalizing behavior, assessed with the Child Behavior Checklist and Teacher Report Form, was used to create symptom severity and directionality scores. The variance in severity and directionality scores was primarily a function of differences between siblings (71% and 85%, respectively) rather than differences across families (29% and 15%, respectively). The severity score that combines externalizing and internalizing symptom severity was not associated with SDP. However, a significant within-family effect of SDP on symptom directionality (b = 0.07, p = 0.04) was observed in the sibling comparison model. The positive directionality score indicates that SDP is associated with differentiation of symptoms towards externalizing rather than internalizing symptoms after controlling for familial confounds with a sibling comparison model. This supports a potentially causal relationship between SDP and externalizing behavior.

Keywords: genetically-informed designs; prenatal exposure; tobacco; health consequences; sibling comparison (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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