This study examined factors that may predict or moderate the relationship between maternal ratings of parenting stress and their infant's difficult temperament ratings in cocaine-exposed (CE) infants. Relations between neonatal behaviour and infant temperament ratings were moderated by mothers’ ratings of parenting stress. Relations between neonatal cry and parenting stress were moderated by maternal psychopathology ratings. Results were unrelated to drug exposure history. For mothers of at risk infants (with or without prenatal CE), psychological distress affects the degree to which infant behavioural characteristics are experienced as stressful or difficult.