Multiple jeopardy: Risk and protective factors among addicted mothers' offspring

Abstract

Objectives of this study were to ascertain risk and protective factors in the adjustment of 78 school-age and teenage offspring of opioid- and cocaine-abusing mothers. Using a multimethod, multiinformant approach, child outcomes were operationalized via lifetime psychiatric diagnoses and everyday social competence (each based on both mother and child reports), and dimensional assessments of symptoms (mother report). Risk/protective factors examined included the child sociodemographic attributes of gender, age, and ethnicity, aspects of maternal psychopathology, and both mother's and children's cognitive functioning. Results revealed that greater child maladjustment was linked with increasing age, Caucasian (as opposed to African American) ethnicity, severity of maternal psychiatric disturbance, higher maternal cognitive abilities (among African Americans) and lower child cognitive abilities (among Caucasians). Limitations of the study are discussed, as are implications of findings for future research.

Treatment Issues for Aboriginal Mothers with Substance Use Problems and Their Children

“…In a study of preschool-aged children of mothers in addiction treatment who completed on-site child development evaluations, cognitive limitations were diagnosed in 69%, speech/language impairments in 68%, emotional or behavioural problems in 16%, and medical problems in 83% (Shulman, Shapira, & Hirshfield, 2000). In a study of 78 adolescent offspring of substance-abusing mothers, Luthar et al (1998) found that 65% had a psychiatric disorder.…”

“…Women with substance use issues often have high levels of comorbid psychopathology, especially post-traumatic stress, depression, and anxiety (Luthar, Cushing, Merikangas, & Rounsaville, 1998;Najavits, Weiss, & Shaw, 1997;Singer et al, 1997). Although substance use frequently coexists with trauma and mental health problems, the link with substance abuse for women remains under-acknowledged in addictions research and practice Poole & Greaves, 2007).…”

Relational Psychotherapy Mothers' Group: A randomized clinical trial for substance abusing mothers

“…These findings are especially noteworthy because the major therapeutic components of the RPMG treatment do not explicitly target substance use whereas the comparison condition, RT, provided an "extra dose" of substance abuse treatment. RPMG is grounded in beliefs that (a) drug abusing women reflect a constellation of problems of which their addiction is only one part; (b) their psychiatric and interpersonal difficulties warrant at least as much therapeutic attention as do issues of abstinence (Brooks & Tseng, 1995;Hawley, Halle, Drasin, & Thomas, 1995;Howard, Beckwith, Espinosa, & Tyler, 1995;Millar & Stermac, 2000;Luthar et al, 1998;Najavits, Sullivan, Schmitz, Weiss, & Lee, 2004); and (c) as this is an "add-on" treatment, the women do, in fact, receive issues of abstinence in their methadone clinics. The results of this study at treatment completion provide some support for the reasoning above, and also resonate with arguments by Brunswick and colleagues (Brunswick, Lewis, & Messeri, 1991;Brunswick, Messeri, & Titus, 1992) that working with drug abusing women on their interpersonal and psychological needs can have substantial spillover effects on their capacities to abstain from drug use.…”

“…At the level of the community, a pronounced risk is exposure to stigma (El-Bassel et al, 2000;Eliason & Skinstad, 1995;Hogan, 1998;Luthar et al, 1998;Najavits et al, 1995); in clinical settings, the fallout of such stigmas is wariness of strictly didactic treatment approaches that seem to emphasize addicted women's deficits as parents (Levy & Rutter, 1992). The effort in RPMG, therefore, is to discuss child-rearing issues in the context of nonjudgmental, supportive experiences using insight-oriented therapy.…”

Treating paternal drug abuse using Learning Sobriety Together: Effects on adolescents versus children

“…CBCL raw scores were used in the second set of analyses, because they do not correct for child gender. However, because COSA research has not shown child adjustment to differ as a function of child gender (e.g., Luthar et al, 1998;Stanger et al, 1999), nor has child gender moderated the effects of parenting and interparental conflict, we did not have any explicit hypotheses about child gender main effects or moderation. Consistent with previous research (e.g., Kelley and Fals-Stewart, 2002;Puttler et al, 1998), the models predicting CBCL raw scores revealed no significant main effect or interactions for child gender.…”