Parental risk constellations and future alcohol use disorder (AUD) in offspring: A combined HUNT survey and health registries study

The role of parenting in developmental trajectories of risk for adolescent substance use: a bioecological systems cascade model

Parenting is a key influence and prevention target for adolescent substance use, and changes dramatically in form and function during adolescence. This theoretical synthesis reviews evidence of associations of substance use-specific parenting behaviors, dimensions, and styles with adolescent substance use, and integrates key developmental and family theories (e.g., bioecological, dynamical systems, family systems, developmental cascades) and methodological-conceptual advances to illustrate the complex role that parenting plays for the development of adolescent substance use in combination with child and contextual influences. The resulting bioecological systems cascade model centers the dynamic co-development of parenting and child influences in developmental cascades that lead to more or less risk for adolescent substance use. These trajectories are initiated by intergenerational influences, including genetics, parents' familial environments, and child-parent attachment. Culture and context influences are a holistic backdrop shaping parent-adolescent trajectories. Parenting is influences are conceptualized as a complex process by which specific parenting behaviors are informed by and accumulate into parenting dimensions which together comprise general parenting styles and are informed by the broader family context. The co-development of parenting and child biobehavioral risk is shaped by both parents and children, including by the genetics and environments they do and do not share. This co-development is dynamic, and developmental transitions of individuals and the family lead to periods of increased lability or variability that can change the longer-term trajectories of children's risk for substance use. Methodological avenues for future studies to operationalize the model are discussed.

Parental drinking, mental health and educational level, and offspring's subsequent prescription drugs treatment for sleep problems. A longitudinal HUNT survey and registry study

BACKGROUND

Parental drinking, mental health and family socioeconomic status are all associated with offspring sleep problems, but there is a paucity of research that considers the effect of risk factors, as they co-occur within and across families. Also, sleep problems are closely linked with mental health problems. Disentangling the effects on one or the other are important. We examined whether parental risk constellations are differently associated with offspring's subsequent prescription drug use for sleep problems during nine years with or without prescription drug use for anxiety and/or depression.

METHODS

The sample included 8773 adolescent offspring of 6696 two-parent families who participated in the Nord-Trøndelag Health Study in Norway. The exposures were five parental risk constellations, previously identified via Latent Profile Analysis, characterized by drinking frequencies and quantities, mental health, and years of education. The outcomes were dispensed prescription drugs in offspring during 2008-2016 for (a) only sleep problems (b) sleep problems and anxiety/depression or (c) only anxiety/depression. We used multinomial logistic regression to model the odds of the outcomes.

RESULTS

Compared to the overall low-risk parental constellation, none of the risky constellations were significantly associated with increased risk of being dispensed prescription drugs only for sleep problems. Offspring from two different risk profiles were at increased risk for being dispensed both sleep and anxiety/depression prescription drugs. These were parental profiles marked by (1) low education, symptoms of mental health problems and weekly binge drinking in both parents (OR 1.90, CI = 1.06;3.42); and (2) frequent heavy drinking in both parents and symptoms of mental health problems in fathers (OR 3.32, CI = 1.49;7.39). Offspring from the risk profile with lowest parental education had increased risk of only anxiety/depression prescription drugs (OR 1.25, CI = 1.05;1.49).

CONCLUSION

Our findings suggest that parental risk constellations are not associated with increased risk of offspring receiving sleep medications without also receiving anxiety/depression medications, as two risk constellations were associated with increased risk of dispensation of both sleep and anxiety/depression prescription drugs. Receiving both may be an indication of severity. The findings underscore the importance of including measures of mental health problems when investigating sleep problems to avoid misattribution of effects.

Parental drinking, mental health and education, and extent of offspring's healthcare utilisation for anxiety/depression: A HUNT survey and registry study

AIMS

Certain risk constellations of parental drinking, mental health and years of education are prospectively associated with offspring's risk for a diagnosis of anxiety/depression, but it remains unknown how they may relate to other aspects of offspring's mental health. We examined whether such risk constellations were also prospectively associated with the extent of offspring's utilisation of healthcare services for anxiety/depression.

METHODS

The sample included 8773 adolescent offspring of 6696 two-parent families who participated in the Nord-Trøndelag Health Study in Norway. The exposures consisted of five parental risk constellations characterised by drinking frequencies and quantities, years of education and mental health previously derived based on the parental self-reports using latent profile analysis. The outcomes were the number of years in contact, and the total number of consultations/visits, with healthcare services for anxiety/depression in adolescents and young adults as recorded in healthcare registries in the period 2008-2014. Associations were examined using zero-inflated negative binomial regression models, accounting for demographics and offspring's early mental health.

RESULTS

Parental risk constellations were not significantly associated with the extent of offspring's healthcare utilisation for anxiety/depression during the seven-year study period, neither in respect of number of years nor in number of contacts.

CONCLUSIONS

Offspring of four risky constellations were no more likely to use healthcare services for longer time periods or have more consultations/visits than offspring of the lowest-risk constellation. Parental risk constellations appear more informative for understanding disorder aetiology than for understanding management and treatment of anxiety and depression during adolescence and early adulthood.

Parental binge drinking and offspring's high school non-completion: A prospective HUNT survey and educational registry study

BACKGROUND

Alcohol-use disorders (AUD) in parents are associated with adverse outcomes in offspring. It is less known whether other forms of parental drinking such as binge drinking may also be a risk factor for offspring's outcomes -- specifically, high school non-completion.

METHODS

These questions were examined in a sample of 3101 offspring (M_age = 16.1 , SD = 1.68; 49.5% girls) from 2510 2-parent families who participated in the Nord-Trøndelag Health Study in Norway (HUNT3; Young-HUNT3) in 2006-08 and were followed-up through the National Education Database (NUDB) until 2014. Associations between maternal and paternal binge drinking patterns as reported in HUNT during offspring's adolescence and offspring's subsequent high school completion were examined using logistic regression models while accounting for a comprehensive set of socio-demographic, parental, and offspring characteristics as assessed at HUNT baseline. Effect modifications of these putative associations by offspring characteristics were also explored.

FINDINGS

Approximately 1 in 6 offspring (13.6% girls, 21.1% boys) failed to graduate high school within the officially designated time period, while roughly 1 in 5 mothers (20.4%) and 1 in 2 fathers (51.2%) reported any binge drinking. Weekly or more frequent binge drinking in fathers was prospectively associated with more than doubled odds of high school non-completion in offspring; OR = 2.23, 95% CI = 1.50-3.31. This effect remained substantively identical after adjustment for all covariates (aOR = 2.20, 95% CI = 1.38-3.50) and uniform across offspring characteristics such as gender, academic orientation and performance, anxiety and depression, typical alcohol consumption, and witnessing parental intoxication as assessed at HUNT baseline.

CONCLUSIONS

Weekly or more frequent binge drinking in fathers negatively affected high school graduation prospects in their offspring.