Parental substance and alcohol abuse: publications guide

Annotated bibliography

Below are some citations and abstracts from publications from the library’s database:

Arria, A. M., Mericle, A. A., Meyers, K., & Winters, K. C. (2012). Parental substance use impairment, parenting and substance use disorder risk. Journal of Substance Abuse Treatment, 43(1), 114-122.

Using data from a nationally representative sample, this study investigated substance use disorder (SUD) among respondents with ages 15–54 years as a function of their parents’ substance-related impairment and parents’ treatment history. In addition, associations among maternal and paternal substance-related impairment, specific parenting behaviors, and risk for SUD in the proband were examined. As expected, parental substance-related impairment was associated with SUD. Paternal treatment history was associated with a decreased risk for SUD in the proband but did not appear to be associated with positive parenting practices. Results of post hoc analyses suggested that parenting behaviors might operate differently to influence SUD risk in children where parents are affected by substance use problems compared with unaffected families. Future research is warranted to better understand the complex relationships among parental substance use, treatment, parenting behaviors, and SUD risk in offspring. Opportunities might exist within treatment settings to improve parenting skills.

Berg, L., Bäck, K., Vinnerljung, B., & Hjern, A. (2016). Parental alcohol‐related disorders and school performance in 16‐year‐olds—a Swedish national cohort study. Addiction, 111(10), 1795-1803.:

To study the links between parental alcoholrelated disorders and offspring school performance and, specifically, whether associations vary by gender of parent or child and whether associations are mediated by other adverse psychosocial circumstances commonly appearing together with parental alcohol problems, such as parental mental health problems or criminal behaviour. Register study in a national cohort. Sweden. A total of 740 618 individuals born in Sweden in 1990–96. Parental hospital admissions for alcoholrelated disorders and school performance in their offspring, in the final year of compulsory school at age 15–16 years was analysed in relation to sociodemographic confounders and psychosocial covariates, using linear and logistic regressions. Both mothers’ and fathers’ alcoholrelated hospital admissions were associated with lower Zscores of grades and national mathematics tests scores. After adjustment for parental education and sociodemographic confounders, betacoefficients of Zscores of grades were –0.42 [95% confidence interval (CI) = –0.45, –0.39] and –0.42 (95% CI =  –0.43, –0.40), and betacoefficients of mathematics tests scores were –0.36 (95% CI = –0.39, –0.33) and –0.31 (95% CI = –0.33, –0.29), for mothers’ and fathers’ alcoholrelated disorders, respectively. Adjusted odds ratios (ORs) for not being eligible for secondary school were 1.99 (95% CI = 1.84–2.15) and 2.04 (95% CI = 1.95–2.15) for mothers’ and fathers’ alcoholrelated disorders, respectively. Adjusting the analyses for psychosocial factors in the family almost eradicated the statistical effects of parental alcoholrelated disorders on offspring school performance to betacoefficients of 0.03 to –0.10 and ORs of 0.89–1.15. The effect of a mother’s alcoholrelated hospital admission on school performance was stronger in girls than in boys, whereas no gender differences were seen for a father’s alcoholrelated hospital admission. In Sweden, alcoholrelated disorders in both mothers and fathers are associated with lower school performance in their children at age 15–16 years, with most of the statistical effects being attributed to psychosocial circumstances of the family, such as parental psychiatric disorders, drug use and criminality and receipt of social or child welfare interventions.

Capaldi, D. M., Tiberio, S. S., Kerr, D. C., & Pears, K. C. (2016). The relationships of parental alcohol versus tobacco and marijuana use with early adolescent onset of alcohol use. Journal of Studies on Alcohol and Drugs, 77(1), 95-103.

Objective:This study examined whether the use of tobacco and marijuana by fathers or mothers predicted onset of alcohol use in their offspring over and above effects of parental alcohol use.Method:The present study included 146 children of 93 parents (90 fathers and 85 mothers). The fathers were originally recruited as boys to the Oregon Youth Study, a study of community, familial, and individual risk factors for delinquency.Results:Only mothers’ but not fathers’ alcohol use was associated with children’s age at onset. Children’s age at onset was predicted by mothers’ tobacco use and by the interaction of fathers’ marijuana use and alcohol use. These effects were observed when controlling for parental education, child’s gender, and also child’s antisocial behavior—a general developmental risk factor for substance use onset in adolescence.Conclusions:Mothers’ substance use played a major role in childhood onset of alcohol use, yet the role of maternal substance use as a risk factor for their children has previously received less attention than the role of paternal substance use. Also, findings imply that it may be important to identify children of polysubstance-using parents for targeted prevention programs.

Chuang, E., Wells, R., Bellettiere, J., & Cross, T. P. (2013). Identifying the substance abuse treatment needs of caregivers involved with child welfare. Journal of Substance Abuse Treatment, 45(1), 118-125.

Parental substance use significantly increases risk of child maltreatment, but is often under-identified by child protective services. This study examined how agency use of standardized substance use assessments and child welfare investigative caseworker education, experience, and caseload affected caseworkers’ identification of parental substance abuse treatment needs. Data are from a national probability sample of permanent, primary caregivers involved with child protective services whose children initially remained at home and whose confidential responses on two validated instruments indicated harmful substance use or dependence. Investigative caseworkers reported use of a formal assessment in over two thirds of cases in which substance use was accurately identified. However, weighted logistic regression indicated that agency provision of standardized assessment instruments was not associated with caseworker identification of caregiver needs. Caseworkers were also less likely to identify substance abuse when their caseloads were high and when caregivers were fathers. Implications for agency practice are discussed.

Douglas-Siegel, J. A., & Ryan, J. P. (2013). The effect of recovery coaches for substance-involved mothers in child welfare: Impact on juvenile delinquency. Journal of Substance Abuse Treatment, 45(4), 381-387.

Despite the documented relationship between parental substance abuse and youth delinquency, the effects of parental interventions on delinquency outcomes are unknown. Such interventions are particularly vital for families in the child welfare system who are at heightened risk for both parental substance involvement and youth delinquency. The current study tested the impact of intensive case management in the form of a recovery coach for substance-involved mothers on youth delinquency outcomes among a randomized sample of 453 families involved in a Title IV-E experimental waiver demonstration in Cook County, Illinois. In comparison to control group participants, families enrolled in the Alcohol and Other Drug Abuse (AODA) waiver demonstration experienced a lower rate of juvenile arrest, net of factors such as demographic characteristics, primary drug of choice, and time spent in substitute care. Findings support efforts to curb delinquency among child-welfare involved youth by providing recovery coaches to their substance abusing or dependent parents.

Handley, E. D., & Chassin, L. (2013). Alcohol-specific parenting as a mechanism of parental drinking and alcohol use disorder risk on adolescent alcohol use onset. Journal of Studies on Alcohol and Drugs, 74(5), 684-693.

Objective:The primary aim of the current study was to examine three dimensions of alcohol-specific parenting (anti-alcohol parenting strategies, parental legitimacy in regulating adolescent drinking, and parental disclosure of negative alcohol experiences) as mechanisms in the prospective relations between parental drinking and alcohol use disorder (recovered, current, and never diagnosed) and adolescent alcohol use initiation.Method:Participants were from an ongoing longitudinal study of the intergenerational transmission of alcoholism. Structural equation modeling was used to test a maternal model (n= 268 adolescents and their mothers) and a paternal model (n= 204 adolescents and their fathers) of alcohol-specific parenting.Results:Results indicated that higher levels of drinking among mothers and current alcohol use disorder among fathers were related to more frequent parental disclosure of personal negative experiences with alcohol. Maternal disclosure of negative alcohol experiences mediated the effect of maternal drinking on adolescent onset of alcohol use such that more disclosure predicted a greater likelihood of adolescent drinking initiation at follow-up over and above general parenting. In addition, currently alcoholic mothers were perceived as having less legitimate authority to regulate adolescent drinking, and low levels of legitimacy among fathers was predictive of drinking onset among adolescents.Conclusions:Alcohol-specific parenting is a distinct and influential predictor of adolescent alcohol use initiation that is partially shaped by parents’ own drinking experiences. Moreover, parental conversations about their own personal experiences with alcohol may not represent a form of parent–child communication about drinking that deters adolescent drinking.

Hedges, K. E. (2012). A family affair: contextual accounts from addicted youth growing up in substance using families. Journal of Youth Studies, 15(3), 257-272.

There are currently over 8 million children in the USA living in households where at least one parent is dependent on or abusing substances. Research has shown a link between parental substance use and children initiating substance use. This article uses qualitative data to give a contextual understanding of the experience of growing up in substance using homes. Results found that the habitusof homes was so immersed in substances that children’s initiation into substance use was expected and became a ‘rite of passage’ into full acceptance as an adult member of the family. Furthermore, in many cases youth described a role reversal between child and parent roles or parentification in the family. The conclusion calls for early identification in treatment of youth who use substances with family members to target new norms and behaviors for the entire family posttreatment and to enhance successful recovery when returning to the family.

McCutcheon, V. V., Agrawal, A., Kuo, S. I. C., Su, J., Dick, D. M., Meyers, J. L., … & Schuckit, M. A. (2018). Associations of parental alcohol use disorders and parental separation with offspring initiation of alcohol, cigarette and cannabis use and sexual debut in high‐risk families. Addiction, 113(2), 336-345.

Parental alcohol use disorders (AUDs) and parental separation are associated with increased risk for early use of alcohol in offspring, but whether they increase risks for early use of other substances and for early sexual debut is understudied. We focused on associations of parental AUDs and parental separation with substance initiation and sexual debut to (1) test the strength of the associations of parental AUDs and parental separation with time to initiation (age in years) of alcohol, tobacco and cannabis use and sexual debut and (2) compare the strength of association of parental AUD and parental separation with initiation. Prospective adolescent and young adult cohort of a highrisk family study, the Collaborative Study on the Genetics of Alcoholism (COGA). Six sites in the United States. A total of 3257 offspring (aged 14–33 years) first assessed in 2004 and sought for interview approximately every 2 years thereafter; 1945 (59.7%) offspring had a parent with an AUD. Diagnostic interview data on offspring substance use and sexual debut were based on first report of these experiences. Parental lifetime AUD was based on their own selfreport when parents were interviewed (1991–2005) for most parents, or on offspring and other family member reports for parents who were not interviewed. Parental separation was based on offspring reports of not living with both biological parents most of the time between ages 12 and 17 years. Parental AUDs were associated with increased hazards for all outcomes, with cumulative hazards ranging from 1.19 to 2.71. Parental separation was also an independent and consistent predictor of early substance use and sexual debut, with hazards ranging from 1.19 to 2.34. The strength of association of parental separation with substance initiation was equal to that of having two AUDaffected parents, and its association with sexual debut was stronger than the association of parental AUD in one or both parents. Parental alcohol use disorders (AUDs) and parental separation are independent and consistent predictors of increased risk for early alcohol, tobacco and cannabis use and sexual debut in offspring from families with a high risk of parental AUDs.

Meyers, J. L., Shmulewitz, D., Elliott, J. C., Thompson, R. G., Aharonovich, E., Spivak, B., … & Hasin, D. S. (2014). Parental alcohol history differentially predicts offspring disorders in distinct subgroups in Israel. Journal of Studies on Alcohol and Drugs, 75(5), 859-869.

Objective:The association between alcoholism in parents and related disorders in their offspring is well established in cultures with intermediate/high alcohol consumption, but not in those with low consumption, such as Israel. This study investigated differences in parental transmission of alcohol problems and related psychopathology between immigrants from the former Soviet Union (FSU) to Israel and other Israelis—two Israeli subgroups with differing alcohol consumption behaviors and social norms.Method:A total of 1,347 adults from a household sample were interviewed. Regression analyses were used to examine associations between parental alcohol problems and participant disorders: alcohol, nicotine, and cannabis use disorders (AUD, NUD, CUD); antisocial personality disorder (ASPD); major depressive disorder (MDD); and posttraumatic stress disorder (PTSD). We also examined the associations of parental alcohol problems with participant disorders characterized with two latent factors: externalizing (EXT: AUD, NUD, CUD, ASPD) and internalizing (INT: MDD, PTSD). Differential parental transmission of alcohol problems in FSU (n= 315) and non-FSU (n= 1,032) Israelis was examined with statistical interaction.Results:Among emigrants from the FSU, parental alcohol problems predicted AUD, NUD, CUD, ASPD, PTSD, EXT, and INT (mean ratios = 1.38–4.83). In non-FSU Israelis, parental alcohol problems predicted only ASPD and PTSD (mean ratios = 1.08–4.09). Significant interactions were observed for AUD, CUD, PTSD, and EXT; each relationship was stronger in FSU Israelis and null (AUD, CUD, EXT) or less robust (PTSD) in other Israelis.Conclusions:Parental alcohol problems were related to substance use and psychiatric disorders differently in FSU and other Israelis, two groups with different alcohol consumption levels and drinking norms. We propose that, in social contexts that vary in the degree to which they constrain alcohol behavior, underlying genetic predispositions may manifest as different disorders.

Moreland, A. D., & McRae-Clark, A. (2018). Parenting outcomes of parenting interventions in integrated substance-use treatment programs: A systematic review. Journal of Substance Abuse Treatment, 89, 52-59.:

The high prevalence of women in substance use treatment programs with children, and the co-occurring negative physical and mental health outcomes associated with substance use, led to the development of integrated substance use treatment programs that target a range of women-specific issues. Integrated programs typically offer some type of parenting component, although the level of parenting services varies widely. Existing reviews have found positive child and parent outcomes following integrated treatment programs in general, although studies were not selected on the basis of whether they included parenting interventions. Due to the large percentage of substance using parents and research that parenting interventions contribute to decreased maternal substance use, this critical review examines parental outcomes of published studies on integrated programs that specifically include a parenting intervention component, as well as moderators of parenting and parental substance use/relapse. Across the 15 studies identified, this systematic review primarily focused on 8 parenting outcomes, including program retention, substance use, parenting stress, psychosocial adjustment, depression, child abuse potential, parenting behaviors, and parent-child interaction; as well as 5 additional secondary outcomes. The review discusses results on each of these outcomes, as well as retention rates across the parenting interventions.

Rossow, I., Felix, L., Keating, P., & McCambridge, J. (2016). Parental drinking and adverse outcomes in children: A scoping review of cohort studies. Drug and Alcohol Review, 35(4), 397-405.

There is a growing interest in measuring alcohol’s harms to people other than the drinker themselves. ‘Children of alcoholics’ and foetal alcohol spectrum disorder have received widespread attention. Less is known about how children are affected by postnatal exposure to parental drinking other than alcohol abuse/dependence. In this scoping review, we aim to assemble and map existing evidence from cohort studies on the consequences of parental alcohol use for children, and to identify limitations and gaps in this literature. Systematic review methods were used. Electronic databases were searched (1980 to October 2013) and a total of 3215 abstracts were screened, 326 full text papers examined and 99 eligible for inclusion according to selection criteria including separation of exposure and outcome measurement in time and report of a quantitative effect size. The main finding is the large literature available. Adolescent drinking behaviour was the most common outcome measure and outcomes other than substance use were rarely analysed. In almost two of every three published associations, parental drinking was found to be statistically significantly associated with a child harm outcome measure. Several limitations in the literature are noted regarding its potential to address a possible causal role of parental drinking in children’s adverse outcomes. This study identifies targets for further study and provides a platform for more targeted analytic investigations which ascertain risk of bias, and which are capable of considering the appropriateness of causal inferences for the observed associations.

Thompson Jr, R. G., Alonzo, D., Hu, M. C., & Hasin, D. S. (2017). The influences of parental divorce and maternal‐versus‐paternal alcohol abuse on offspring lifetime suicide attempt. Drug and Alcohol Review, 36(3), 408-414

Research indicates that parental divorce and parental alcohol abuse independently increase likelihood of offspring lifetime suicide attempt. However, when experienced together, only parental alcohol abuse significantly increased odds of suicide attempt. It is unclear to what extent differences in the effect of maternal versus paternal alcohol use exist on adult offspring lifetime suicide attempt risk. This study examined the influences of parental divorce and maternal–paternal histories of alcohol problems on adult offspring lifetime suicide attempt. The sample consisted of participants from the 2001–2002 National Epidemiological Survey on Alcohol and Related Conditions. The simultaneous effect of childhood or adolescent parental divorce and maternal and paternal history of alcohol problems on offspring lifetime suicide attempt was estimated using a logistic regression model with an interaction term for demographics and parental history of other emotional and behavioural problems. Parental divorce and maternal–paternal alcohol problems interacted to differentially influence the likelihood of offspring lifetime suicide attempt. Experiencing parental divorce and either maternal or paternal alcohol problems nearly doubled the likelihood of suicide attempt. Divorce and history of alcohol problems for both parents tripled the likelihood. Individuals who experienced parental divorce as children or adolescents and who have a parent who abuses alcohol are at elevated risk for lifetime suicide attempt. These problem areas should become a routine part of assessment to better identify those at risk for lifetime suicide attempt and to implement early and targeted intervention to decrease such risk. 4.

Waldron, M., Bucholz, K. K., Lynskey, M. T., Madden, P. A., & Heath, A. C. (2013). Alcoholism and timing of separation in parents: Findings in a midwestern birth cohort. Journal of Studies on Alcohol and Drugs, 74(2), 337-348.

Objective:We examined history of alcoholism and occurrence and timing of separation in parents of a female twin cohort.Method:Parental separation (never-together; never-married cohabitants who separated; married who separated) was predicted from maternal and paternal alcoholism in 326 African ancestry (AA) and 1,849 European/other ancestry (EA) families. Broad (single-informant, reported in abstract) and narrow (self-report or two-informant) measures of alcoholism were compared.Results:Parental separation was more common in families with parental alcoholism: By the time twins were 18 years of age, parents had separated in only 24% of EA families in which neither parent was alcoholic, contrasted with 58% of families in which only the father was (father-only), 61% of families in which only the mother was (mother-only), and 75% in which both parents were alcoholic (two-parent); corresponding AA percentages were 59%, 71%, 82%, and 86%, respectively. Maternal alcoholism was more common in EA never-together couples (mother-only: odds ratio [OR] = 5.95; two parent: OR = 3.69). In ever-together couples, alcoholism in either parent predicted elevated risk of separation, with half of EA relationships ending in separation within 12 years of twins’ birth for father-only families, 9 years for mother-only families, and 4 years for both parents alcoholic; corresponding median survival times for AA couples were 9, 4, and 2 years, respectively. EA maternal alcoholism was especially strongly associated with separation in the early postnatal years (mother-only: birth—5 years, hazard ratio [HR] = 4.43; 6 years on, HR = 2.52; two-parent: HRs = 5.76, 3.68, respectively).Conclusions:Parental separation is a childhood environmental exposure that is more common in children of alcoholics, with timing of separation highly dependent on alcoholic parent gender.

 

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