The impact of maternal alcohol and illicit drug use on children's behavior problems: evidence from the children of the national longitudinal survey of youth

The effect of parental smoking on children's cognitive and non-cognitive skills

Economic research emphasises the importance of cognitive and non-cognitive skills in children for long-term labour market, health and social outcomes. In contrast to previous studies that focus on the effects of maternal smoking during pregnancy, we contribute to the literature by examining whether parental current smoking impacts on children's cognitive and non-cognitive development. We exploit data from the Longitudinal Study of Australian Children and address potential endogeneity and self-selectivity bias using robust estimation methods. Overall, we find evidence that parental smoking results in worse development outcomes in children. Specifically, our fixed-effects estimates indicate that children living with parents who are smokers exhibit lower cognitive outcomes ranging between 0.09 and 0.17 standard deviation, while the impacts on non-cognitive outcomes range between 0.06 and 0.80 standard deviation. We also provide insights on some of the mechanisms of transmission. Our findings suggest that campaigns, programs and policies that reduce tobacco consumption may have positive externalities in terms of improving children's cognitive and non-cognitive development, and long-term labour market outcomes.

The Association between Caregiver Substance Abuse and Mental Health Problems and Outcomes for Trauma-Exposed Youth

Trauma-exposed youth with impaired caregivers (i.e., due to substance use and/or mental health problems) may be at particular risk for negative outcomes. This study utilized data from the National Child Traumatic Stress Network Core Data Set to examine the impact of caregiver impairment on youth outcomes. Trauma-exposed youth with an impaired caregiver due to either: substance use (n = 498), mental health problems (n = 231), or both substance use and mental health problems (n = 305) were compared to youth without a reported impaired caregiver (n = 2282) to determine if impaired caregiver status is independently associated with increased likelihood of negative behavioral and mental health outcomes and service utilization after accounting for demographics and exposure to traumatic events. Youth with impaired caregivers compared to those without were more likely to display PTSD, emotional and behavioral problems, suicidality, self-injury, and substance abuse and had higher rates of service utilization (p < 0.05). Differential patterns were observed based on the type of caregiver impairment. Findings support the importance of family-centered assessment and intervention approaches for youth affected by trauma.

Parental alcohol consumption and adult children's educational attainment

This study analyses whether an excessive parental alcohol consumption during childhood can affect long run children's educational attainments. Using 19 waves of the Russia Longitudinal Monitoring Survey (RLMS), where individuals and their families are followed from childhood to adulthood, this study analyses parental alcohol consumption during childhood (between 1994 and 2001) and its relation with children's educational attainment about twelve years later (from 2005 to 2014). Panel estimations show that mother's excessive alcohol consumption during childhood is consistently negatively associated with children educational outcomes, as years of education, the highest education grade achieved and the probability of having a tertiary education degree, a finding that is robust to possible endogeneity issues. In particular, while moderate drinking is not an issue, an additional standard glass of vodka (15.57 g of pure alcohol) consumed by the mother per day, reduces years of education by almost one year (0.88), and by 5.8 percentage points (or about 27%) the probability of having a university degree. The study also explores the transmission mechanisms suggested by the literature, identifying a significant role for prenatal exposure to alcohol and, to a lesser extent, for intergenerational transmission of drinking habits.

Psychosocial problems in children of women entering substance use disorder treatment: A longitudinal study

BACKGROUND

While parental substance use disorder (SUD) has been recognized as a risk factor for child outcomes, past research seldom focused specifically on children whose mothers suffer from alcohol and drug use disorders. Are these children at risk for elevated psychosocial problems, and would such risk be reduced if maternal substance use was reduced?

AIMS

Children of substance-abusing mothers (COSAM, N=130) were compared to a demographically matched comparison sample, and examined soon after their mothers entered SUD treatment and in the 18months after treatment entry. We expected to observe elevated symptomatology among COSAM at baseline assessment, followed by a decreasing trend after maternal treatment in general, and remission in particular.

RESULTS

Children's psychosocial problems were assessed through maternal reports on the Pediatric Symptom Checklist. Soon after their mothers entered SUD treatment, COSAM exhibited significantly greater overall and clinical-level psychosocial problems than the children from the matched comparison sample. However, at the end of the 18-months study period, these two groups no longer differed in terms of problems. Results from the longitudinal growth models revealed reductions in COSAM's overall and clinical-level problems following their mothers' SUD treatment. However, these reductions were similar for all COSAM, regardless of whether their mothers relapsed or remitted.

CONCLUSION

Psychosocial problems were significantly reduced in COSAM following maternal SUD treatment, such that COSAM did not significantly differ from children from the matched comparison sample by the end of the 18-month study period.

Childhood Trauma and Illicit Drug Use in Adolescence: A Population-Based National Comorbidity Survey Replication-Adolescent Supplement Study

OBJECTIVE

Although potentially traumatic events (PTEs) are established risk factors for substance use disorders among adults, little is known about associations with drug use during adolescence, an important developmental stage for drug use prevention. We examined whether childhood PTEs were associated with illicit drug use among a representative sample of US adolescents.

METHOD

Data were drawn from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A), which included adolescents aged 13 to 18 years (N = 9,956). Weighted logistic regression models estimated risk ratios for lifetime use of marijuana, cocaine, nonmedical prescription drugs, other drugs, and multiple drugs.

RESULTS

Exposure to any PTE before age 11 years was reported by 36% of the sample and was associated with higher risk for use of marijuana (risk ratio [RR] = 1.50), cocaine (RR = 2.78), prescription drugs (RR = 1.80), other drugs (RR = 1.90), and multiple drugs (RR = 1.74). A positive monotonic relationship was observed between number of PTEs and marijuana, other drug, and multiple drug use. Interpersonal violence was associated with all drug use outcomes. Accidents and unspecified events were associated with higher risk for marijuana, cocaine, and prescription drug use.

CONCLUSION

Potentially traumatic events in childhood are associated with risk for illicit drug use among US adolescents. These findings add to the literature by illustrating a potentially modifiable health behavior that may be a target for intervention. The results also highlight that adolescents with a trauma history are a high-risk group for illicit drug use and may benefit from trauma-focused prevention efforts that specifically address traumatic memories and coping strategies for dealing with stressful life events.

Are natural disasters in early childhood associated with mental health and substance use disorders as an adult?

Understanding factors that influence risk for mental health and substance use disorders is critical to improve population health and reduce social costs imposed by these disorders. We examine the impact of experiencing a natural disaster-a serious fire, tornado, flood, earthquake, or hurricane-by age five on adult mental health and substance use disorders. The analysis uses data from the 2004 to 2005 National Epidemiologic Survey of Alcohol and Related Conditions. The analysis sample includes 27,129 individuals ages 21-64 years. We also exploit information on parenting strategies to study how parents respond to natural disasters encountered by their children. We find that experiencing one or more of these natural disasters by age five increases the risk of mental health disorders in adulthood, particularly anxiety disorders, but not substance use disorders. Parents alter some, but not all, of their parenting strategies following a natural disaster experienced by their children. It is important to provide support, for example through counseling services and financial assistance, to families and children exposed to natural disasters to mitigate future mental health and substance use problems attributable to such exposure.

Substance Use Disorders, Comorbidity, and Arrest among Indigenous Adolescents

Indigenous adolescents are overrepresented at multiple stages of the justice system, but we know very little about the role that mental health, particularly substance use disorder, plays in Indigenous pathways to arrest. This study examined the association between substance use disorder, its comorbidity with other disorders, and arrest using a longitudinal sample of Indigenous youth from the Northern Midwest and Canada. Of the 16% of youth who reported at least one arrest at Wave 5, half met criteria for substance abuse/dependence, and slightly more for conduct disorder. Substance abuse/dependence and conduct disorder were each associated with an increased risk of arrest, although co-occurring disorders were not. The reciprocal effects of arrest and mental disorder are discussed.

"The Whole Family Suffered, so the Whole Family Needs to Recover": Thematic Analysis of Substance-Abusing Mothers' Family Therapy Sessions

Substance abusing mothers and their children are more likely to experience a range of social, behavioral, and psychological difficulties. Despite the significant challenges faced by these families, little is known about their experiences in treatment. The current study analyzed 12 sessions of family therapy using thematic analysis to identify common themes that arose during substance abusing mothers and their children's discussion during family therapy. Mothers' ages ranged from 28 to 35 years and the children's ages ranged from 12 to 14 years. Four therapy sessions from three families were coded for a total of 12 therapy sessions. An ecological framework was used to classify themes, in which themes related to each level of the families' ecological systems were identified. Thematic analysis of the therapy sessions indicated that mothers and their children primarily discussed topics related to their relational and emotional needs. The findings indicated that substance use disordered mothers and their children have unique treatment needs that should be addressed when the mother seeks treatment. More research is needed to further clarify and confirm the observations in this study. In particular, future research should include a larger sample and quantitative methodology.

Perceived neighborhood safety, recovery capital, and successful outcomes among mothers 10 years after substance abuse treatment

This study examines perceived neighborhood characteristics associated with successful outcome among mothers 10 years after being treated for substance use disorders. Data were obtained from 713 mothers first studied at admission to drug treatment in California in 2000-2002 and followed up in 2009-2011. At follow-up, 53.6% of mothers had a successful outcome (i.e., no use of illicit drugs and not involved with the criminal justice system). Perceived neighborhood safety almost doubled the odds of success. Perceived neighborhood safety interacted with social involvement, decreasing the odds of success among mothers who reported more versus less neighborhood social involvement. Perceived neighborhood climate is associated with long-term outcomes among mothers with substance use disorders independent of individual-level characteristics, underscoring the need for further efforts to understand its interaction with recovery capital in ways that promote and impede health.

Children of treated substance-abusing mothers: a 10-year prospective study

This study examined children of substance-abusing mothers approximately 10 years after mothers' admission to drug abuse treatment, and identified maternal characteristics that may be risk factors for child behavior problems on the Child Behavior Checklist. Data were obtained from 396 mothers who were included in a sample consecutively admitted to 44 treatment programs in 13 California counties during 2000-2002. The Addiction Severity Index was administered at both intake and follow-up. Each mother reported on one child 6-17 years of age. All of the children had been exposed to drugs, either in utero or postnatally. At follow-up about 22% of the children demonstrated borderline or clinical range problem behaviors. Child behavior problems were related significantly to the mothers' ethnicity (lower among Hispanics relative to white), and problem severity in family/social relationship and mental health, marginally related to her prior medical/health problem, and not related to severity of alcohol, drug, legal and employment problems. Assisting mothers to address their family/social relationship and psychological problems may have an added value to prevent or reduce behavioral problems of their children.

Maternal post-traumatic stress disorder, depression and alcohol dependence and child behaviour outcomes in mother-child dyads infected with HIV: a longitudinal study

OBJECTIVES

HIV and psychiatric disorders are prevalent and often concurrent. Childbearing women are at an increased risk for both HIV and psychiatric disorders, specifically depression and post-traumatic stress disorder (PTSD). Poor mental health in the peripartum period has adverse effects on infant development and behaviour. Few studies have investigated the relationship between maternal PTSD and child behaviour outcomes in an HIV vertically infected sample. The aim of this study was to investigate whether maternal postpartum trauma exposure and PTSD were risk factors for child behaviour problems. In addition, maternal depression, alcohol abuse and functional disability were explored as cofactors.

SETTING

The study was conducted in Cape Town, South Africa.

PARTICIPANTS

70 mother-child dyads infected with HIV were selected from a group of participants recruited from community health centres.

DESIGN

The study followed a longitudinal design. Five measures were used to assess maternal trauma exposure, PTSD, depression, alcohol abuse and functional disability at 12 months postpartum: Life Events Checklist (LEC), Harvard Trauma Scale (HTS), Alcohol Use Disorders Identification Test (AUDIT), Center for Epidemiological Studies Depression (CESD) Scale and the Sheehan Disability Scale (SDS). Child behaviour was assessed at 42 months with the Child Behaviour Checklist (CBCL).

RESULTS

The rate of maternal disorder was high with 50% scoring above the cut-off for depression, 22.9% for PTSD and 7% for alcohol abuse. Half of the children scored within the clinical range for problematic behaviour. Children of mothers with depression were significantly more likely to display total behaviour problems than children of mothers without depression. Maternal PTSD had the greatest explanatory power for child behaviour problems, although it did not significantly predict child outcomes.

CONCLUSIONS

This study highlights the importance of identifying and managing maternal PTSD and depression in mothers of children infected with HIV. The relationship between maternal PTSD and child behaviour warrants further investigation.

Explaining long-term outcomes among drug dependent mothers treated in women-only versus mixed-gender programs

Specialized substance abuse treatment for parenting women is thought to improve outcomes, but long-term impacts and how they occur are poorly understood. Utilizing a sample of 789 California mothers followed for 10 years after admission to women-only (WO) or mixed-gender (MG) drug treatment, we examine the relationship between WO treatment and outcomes and whether it is mediated by post-treatment exposures to criminal justice and health services systems. At follow-up, 48% of mothers had a successful outcome (i.e., no use of illicit drugs, not involved with the criminal justice system, alive). Controlling for patient characteristics, WO (vs. MG) treatment increased the odds of successful outcome by 44%. In the structural equation model WO treatment was associated with fewer post-treatment arrests, which was associated with better outcomes. Women-only substance abuse treatment has long-term benefits for drug-dependent mothers, a relationship that may be partially explained by post-treatment exposure to the criminal justice system. Findings underscore additional leverage points for relapse prevention and recovery-supportive efforts for drug-dependent mothers.

Youth's narratives about family members smoking: parenting the parent- it's not fair!

BACKGROUND

Successful cancer prevention policies and programming for youth must be based on a solid understanding of youth's conceptualization of cancer and cancer prevention. Accordingly, a qualitative study examining youth's perspectives of cancer and its prevention was undertaken. Not surprisingly, smoking (i.e., tobacco cigarette smoking) was one of the dominant lines of discourse in the youth's narratives. This paper reports findings of how youth conceptualize smoking with attention to their perspectives on parental and family-related smoking issues and experiences.

METHODS

Seventy-five Canadian youth ranging in age from 11-19 years participated in the study. Six of the 75 youth had a history of smoking and 29 had parents with a history of smoking. Youth were involved in traditional ethnographic methods of interviewing and photovoice. Data analysis involved multiple levels of analysis congruent with ethnography.

RESULTS

Youth's perspectives of parents and other family members' cigarette smoking around them was salient as represented by the theme: It's not fair. Youth struggled to make sense of why parents would smoke around their children and perceived their smoking as an unjust act. The theme was supported by four subthemes: 1) parenting the parent about the dangers of smoking; 2) the good/bad parent; 3) distancing family relationships; and 4) the prisoner. Instead of being talked to about smoking it was more common for youth to share stories of talking to their parents about the dangers of smoking. Parents who did not smoke were seen by youth as the good parent, as opposed to the bad parent who smoked. Smoking was an agent that altered relationships with parents and other family members. Youth who lived in homes where they were exposed to cigarette smoke felt like a trapped prisoner.

CONCLUSIONS

Further research is needed to investigate youth's perceptions about parental cigarette smoking as well as possible linkages between youth exposed to second hand smoke in their home environment and emotional and lifestyle-related health difficulties. Results emphasize the relational impact of smoking when developing anti-tobacco and cancer prevention campaigns. Recognizing the potential toll that second-hand smoke can have on youth's emotional well-being, health care professionals are encouraged to give youth positive messages in coping with their parents' smoking behaviour.

Children born small for gestational age are not at special risk for preschool emotion and behaviour problems

Despite the wealth of literature examining long term outcomes of preterm low birthweight children, few studies have directly assessed the developmental impact of being born full term but small for gestational age (SGA). We aim to determine whether (i) being SGA increases preschool behavioural problems and (ii) other risk factors operate differently in SGA and appropriate for gestational age (AGA) controls. 550 New Zealand European mothers and their 3.5 year old children participated in this study. All children were born at full term (>37 weeks' gestation) and approximately half were SGA (≤sex specific 10th percentile for gestation) the remainder were AGA controls. Extensive data were collected at the child's birth, 1 year and 3.5 years. Behavioural problems were measured when children were 3.5 years, using the Strengths and Difficulties Questionnaire (SDQ). Multiple regression analyses were used to examine the associations between risk factors and behavioural problems; statistical weighting was used for analyses of the total study group. There was no significant difference in behavioural problems between SGA and AGA groups. In the total sample the significant predictors of behavioural problems included: mothers' school leaving age; smoking during pregnancy; maternal alcohol use during pregnancy; and absence of the father. Predictors of behavioural problems were found to be the same for SGA and AGA groups. These results do not support the view that SGA is a risk for behavioural preschool difficulties or that SGA children are sensitised to risks known to be associated with such difficulties in the preschool years.

Learning from the ground up: responding to children affected by parental incarceration

Beginning in the fall of 2007, Illinois' Division of Mental Health began piloting an early intervention program targeting children of incarcerated parents. The pilot program was situated within a community-based agency on the Westside of Chicago with a high number of currently and formerly incarcerated community members. This article describes the program theory upon which the pilot program was based, the perceived benefits from the perspective of participants and the service provider agency, lessons learned, and recommendations for making incarceration-sensitive interventions a routine part of children's mental health services.

A three-generational study of risk factors for childhood externalizing behavior among African Americans and Puerto Ricans

This is the first prospective study to examine the precursors of child externalizing behavior across three generations of African Americans and Puerto Ricans. Participants comprised a community cohort of male and female African Americans and Puerto Ricans (N = 366, X⁻ age = 29.4 years), who are part of an ongoing study of drug use and problem behaviors, and who had a child. Data were collected at four time waves, spanning the participants' adolescence to adulthood. Questionnaires were initially self-administered in schools in East Harlem, NY, USA (time 1). Subsequently, structured interviews were conducted by trained interviewers (times 2 and 3), and self-administered via mail (time 4). The independent variables consisted of the participants' prospective reports of their (a) relationships with their parents during adolescence, (b) depressive mood and drug use (adolescence to adulthood), (c) relationship with their oldest child between the ages of 6-13, and (d) perceptions of neighborhood crime and deterioration (in adulthood). The dependent variable was externalizing behavior in the participant's oldest child (X⁻ age = 9.6 years; SD = 2.0). Structural equation modeling showed that the parent-child relationship during participants' adolescence was linked with the participants' depressive mood and drug use which, in turn, were associated with the participants' relationship with their own child, as well as with neighborhood crime and deterioration when participants were adults. The participants' depressive mood, and relationship with their own child, as well as neighborhood crime and deterioration, each had a direct pathway to externalizing behavior in the participant's child. Findings suggest that intervention programs and public policy should address parental attributes, neighborhood factors, and, especially, parenting skills, to reduce risk factors for the intergenerational transmission of externalizing behavior.

Demographic and perinatal factors for behavioral problems among children aged 4-9 in Taiwan

AIM

To investigate the effects of age, gender, prenatal/perinatal factors, and maternal psychological distress on childhood emotional/behavioral problems, and the gender difference in the patterns of comorbid emotional/behavioral problems.

METHODS

The sample included 1391 children aged 4-9 in Taipei using a multi-stage sampling method. Their mothers completed questionnaires including demographics, prenatal/perinatal variables, the Child Behavior Checklist, and the Chinese Health Questionnaire. The linear and non-linear mixed model was used for data analysis.

RESULTS

Boys scored higher on externalizing problems, and girls scored higher on internalizing problems. Gender also modified the comorbid patterns of emotional/behavioral problems. Aggressive behaviors decreased, but attention and thought problems increased with age. Prenatal/perinatal exposure to alcohol and coffee, vaginal bleeding, and gestational diabetes, low birthweight, and postnatal incubation and resuscitation, and maternal psychological distress predicted the risk for several childhood emotional/behavioral problems.

CONCLUSION

Prenatal/perinatal and maternal care, and gender-specific measures are important for prevention of childhood emotional/behavioral problems.

The relationship between frequency of family dinner and adolescent problem behaviors after adjusting for other family characteristics

OBJECTIVE

To examine the association between frequency of family dinners (FFD) and selected problem behaviors for adolescents after adjusting for family connectedness, parental awareness, other family activities, and other potentially confounding factors.

METHODS

Data are drawn from the National Longitudinal Survey of Youth, 1997. The primary variable of interest is self-reported FFD in a typical week. Problem behaviors studied are substance-use, physical violence, property-destruction, stealing, running away from home, andgang membership. Multivariate logistic models are estimated for each behaviors. Linear regression models are estimated for behavior-frequency for the sub-samples engaging in them. Analysis is done separately by gender.

RESULTS

FFD is negatively associated with substance-use and running away for females; drinking, physical violence, property-destruction, stealing and running away for males.

CONCLUSION

Family meals are negatively associated to certain problem behaviors for adolescents even after controlling rigorously for potentially confounding factors. Thus, programs that promote family meals are beneficial.

Illicit drug use among women with children in the United States: 2002-2003

PURPOSE

Given research that shows youth exposed to maternal addiction have increased rates of cognitive, socioemotional, and behavioral problems, we examined the prevalence and correlates of past year illicit drug abuse or dependence among women with children younger than 18 years of age in the home to identify maternal risk factors.

METHODS

Data were from the 2002 and 2003 National Survey on Drug Use and Health, a nationally representative sample of the U.S. civilian population. The current analysis utilized a subsample of women (N=19,300) who reported having children younger than 18 years in the home. Past year abuse or dependence on cocaine, heroin, marijuana, stimulants, and hallucinogens as well as nonmedical use of prescription medications were assessed.

RESULTS

The prevalence of illicit drug abuse or dependence was 1.9%. Mothers reporting drug abuse or dependence had increased odds of being unmarried, controlling for other demographics. They also were more likely to report stress, poorer health status, and meet the criteria for serious mental illness (SMI).

CONCLUSIONS

Prevention and intervention strategies should focus on developing and testing methods to screen for both risk factors associated with maternal drug abuse and actual substance abuse in primary and emergency care settings to reduce youth exposure and improve child developmental outcomes.

Alcohol consumption and health among elders

PURPOSE

This article estimates the effects of alcohol consumption on self-reported overall health status, injuries, heart problems, emergency room use, and hospitalizations among persons older than the age of 65.

DESIGN AND METHODS

We analyzed data from the first wave of the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative study. We used multivariate regression and instrumental variables methods to study the associations between alcohol consumption (current drinking, binge drinking, and average number of drinks consumed) and several indicators of health status and health care utilization.

RESULTS

Alcohol consumption by women was associated with better self-perceived health status, improved cardiovascular health, and lower rates of hospitalizations. We detected no significant negative or positive associations for older men.

IMPLICATIONS

These findings suggest that light to moderate alcohol use by older women may have beneficial health effects. Experimental trials, however, are needed to more rigorously assess the potential benefits of alcohol use by elders due to the inherent biases of observational studies.

Smoking during pregnancy and offspring externalizing problems: an exploration of genetic and environmental confounds

Previous studies have documented that smoking during pregnancy (SDP) is associated with offspring externalizing problems, even when measured covariates were used to control for possible confounds. However, the association may be because of nonmeasured environmental and genetic factors that increase risk for offspring externalizing problems. The current project used the National Longitudinal Survey of Youth and their children, ages 4-10 years, to explore the relations between SDP and offspring conduct problems (CPs), oppositional defiant problems (ODPs), and attention-deficit/hyperactivity problems (ADHPs) using methodological and statistical controls for confounds. When offspring were compared to their own siblings who differed in their exposure to prenatal nicotine, there was no effect of SDP on offspring CP and ODP. This suggests that SDP does not have a causal effect on offspring CP and ODP. There was a small association between SDP and ADHP, consistent with a causal effect of SDP, but the magnitude of the association was greatly reduced by methodological and statistical controls. Genetically informed analyses suggest that unmeasured environmental variables influencing both SDP and offspring externalizing behaviors account for the previously observed associations. That is, the current analyses imply that important unidentified environmental factors account for the association between SDP and offspring externalizing problems, not teratogenic effects of SDP.

Neighborhood and individual factors in marijuana and other illicit drug use in a sample of low-income women

Few studies have systematically evaluated whether contextual variables differ in their ability to explain the use of different drugs in the same sample. Our objective was to examine correlates of use for different illicit drugs at the individual and neighborhood level in a tri-ethnic sample of low-income women, an underrepresented sample in drug research. Women 18-31 were recruited from a low-cost family planning clinic in southeast Texas from December 2001 to May 2003. Neighborhood level indicators of disadvantage, family structure, and nativity status from U.S. Census 2000 were linked with individual survey data. Multilevel logistic regression was used to examine the effect of individual and neighborhood level measures on lifetime use of marijuana only and of other illicit drugs in 594 women. Only individual level variables (younger age, non-Hispanic White ethnicity, not being married, greater peer acceptance of substance use) increased odds of exclusive marijuana use, controlling for neighborhood level factors. However, both neighborhood and individual level variables significantly predicted other illicit drug use. Residence in less disadvantaged neighborhoods, non-Hispanic White ethnicity, higher levels of education, greater acceptance of substance use by peers, and a larger number of perceived neighborhood problems increased odds of illicit drug use. Use of other illicit drugs with or without marijuana may be more closely tied to area level factors whereas factors driving exclusive marijuana use may not rely on localized structures to the same extent. Thus, community-level interventions may need to customize their approaches according to the type of drug use targeted. The implication of using neighborhood level variables in substance use research is also discussed.

Depressive symptoms in low-income mothers and emotional and social functioning in their preschool children

OBJECTIVE

To determine which factors modify the relationship between maternal depressive symptoms and emotional and social functioning in low-income preschool children.

METHODS

A cross-sectional, self-administered survey of 295 low-income (< or =185% poverty level) mothers of 3- and 4-year-old children. Both child emotional functioning and social functioning were measured with the Pediatric Quality of Life Inventory. Low emotional functioning and social functioning were defined as scores in the lowest tertile for each measure. Maternal depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D).

RESULTS

Of the children, 92% were white and 55% were boys. Of the mothers, 31% had clinically significant depressive symptoms (CES-D scores > or =16) and 30% were smokers. Among girls, the percentage with low emotional functioning was significantly higher in those whose mothers had clinically significant depressive symptoms than in those whose mothers did not (62% vs 27%, P <.001), but the same was not true among boys (36% vs 30%, P = NS). When mothers were smokers, the percentage of children with low social functioning was higher if mothers had clinically significant depressive symptoms (54% vs 29%, P =.02); however, this was not the case when mothers were nonsmokers (25% vs 28%, P =.69). Maternal education, marital status, and age did not modify the relationship between maternal depressive symptoms and child emotional or social functioning.

CONCLUSIONS

Among low-income preschool children, both the sex of the child and the smoking status of the mother appear to influence the relationship between maternal depressive symptoms and children's emotional and social functioning.

The relationship between parental substance abuse and child maltreatment: findings from the Ontario Health Supplement

OBJECTIVE

This study examined the relationship between reported exposure to child abuse and a history of parental substance abuse (alcohol and drugs) in a community sample in Ontario, Canada.

METHOD

The sample consisted of 8472 respondents to the Ontario Mental Health Supplement (OHSUP), a comprehensive population survey of mental health. The association of self-reported retrospective childhood physical and sexual abuse and parental histories of drug or alcohol abuse was examined.

RESULTS

Rates of physical and sexual abuse were significantly higher, with a more than twofold increased risk among those reporting parental substance abuse histories. The rates were not significantly different between type or severity of abuse. Successively increasing rates of abuse were found for those respondents who reported that their fathers, mothers or both parents had substance abuse problems; this risk was significantly elevated for both parents compared to father only with substance abuse problem.

CONCLUSIONS

Parental substance abuse is associated with a more than twofold increase in the risk of exposure to both childhood physical and sexual abuse. While the mechanism for this association remains unclear, agencies involved in child protection or in treatment of parents with substance abuse problems must be cognizant of this relationship and focus on the development of interventions to serve these families.