Gender roles and alcohol abuse across the transition to parenthood

High-intensity drinking by parental status: Differences by age and sex

AIMS

To examine differences in high-intensity drinking (HID) by parental status, parent age, and parent sex, including two- and three-way interaction effects of these parent demographic categories.

METHODS

The present study included individuals ages 18-50 from the National Epidemiologic Study of Alcohol and Related Conditions-III (2012-13), a sample of non-institutionalized adults in the US (N = 22,278). We calculated weighted estimates of past-year HID (≥10/≥8 standard drinks for men/women on a single occasion) for each parental status group (parents of young children <5, parents of children 5-17, not parents of children <18) overall and stratified by sex and stratified by age. We then examined the overall association of parental status and HID and tested for interactions of parental status × sex, parental status × age, and parental status × age × sex, while controlling for other relevant sociodemographic characteristics.

RESULTS

Prevalence of HID varied considerably by parental status, with 14.84% of parents with kids under age 5, 12.72% of parents with kids 5 to 17, and 23.15% of non-parents reporting HID. The strength of the associations of parenthood and HID were strongest for females and for older parents.

CONCLUSIONS

While parents engage in HID less than those who are not parents, a portion of parents of young and adolescent children do report heavy drinking. Younger parents and male parents, in particular, are at high risk for HID. Given the risks to children and parents, interventions focused on preventing HID among parents, especially fathers, could have significant public health impacts.

Husband's Alcohol Use, Intimate Partner Violence, and Family Maltreatment of Low-Income Postpartum Women in Mumbai, India

Husbands' alcohol use has been associated with family-level stress and intimate partner violence (IPV) against women in India. Joint family systems are common in India and IPV often co-occurs with non-violent family maltreatment of wives (e.g., nutritional deprivation, deprivation of sleep, blocking access to health care). Alcohol use increases for some parents following the birth of a child. This study examined 1,038 postpartum women's reports of their husbands' alcohol use and their own experiences of IPV (by husband) and non-violent maltreatment from husbands and/or in-laws. We analyzed cross-sectional, quantitative data collected in 2008, from women (ages 15-35) seeking immunizations for their infants <6 months at three large urban health centers in Mumbai, India. Crude and adjusted logistic regression models estimated associations between the independent variable (husbands' past month use of alcohol) and two dependent variables (postpartum IPV and maltreatment). Overall, 15% of husbands used alcohol, ranging from daily drinkers (10%) to those who drank one to two times per week (54%). Prevalence of postpartum IPV and family maltreatment was 18% and 42%, respectively. Prevalence of IPV among women married to alcohol users was 27%. Most abused women's husbands always (27%) or sometimes (37%) drank during violent episodes. Risk for IPV increased with a man's increasing frequency of consumption. Women who lived with a husband who drank alcohol, relative to non-drinkers, were more likely to report postpartum IPV, aOR = 2.0, 95% confidence interval (CI) = [1.3, 3.1]. Husbands' drinking was marginally associated with increased risk for family maltreatment, aOR = 1.4, 95% CI = [1.0, 2.1]. Our findings suggest that men's alcohol use is an important risk factor for postpartum IPV and maltreatment. Targeted services for Indian women contending with these issues are implicated. Postpartum care offers an ideal opportunity to screen for IPV, household maltreatment, and other health risks, such as husband's use of alcohol. There is need to scale up proven successful interventions for reducing men's alcohol use and design strategies that provide at-risk women protection from alcohol-related IPV.

From cannabis to problem drinking? Use and abuse from youth to adulthood

Aims

The transition from youth to adulthood is associated with changes in the consumption of drugs and alcohol. The aim is to explore the process of “maturing out” of high levels of alcohol consumption, substance use and alcohol related problems from youth to adulthood. We are particularly interested in the relationship between the use of cannabis and alcohol consumption in relation to indicators of adult roles and responsibilities and alcohol-related problems over the life-course.

Methods

We used data from the norwegian longitudinal panel survey Arbeid, Livsstil og Helse (ALH). The data contains information on alcohol and drug consumption, alcohol related problems and a range of indicators of adulthood like marriage and parenthood from surveys repeated in 1985, 1987, 1989, 1993, 2003 and 2010. The sample was nationally representative for the cohorts born 1965–1968 and thus contains individual histories from youth (17–20 years) to adulthood (42–45 years) with response rates ranging from 80% in 1985 to 53% in 2010 (total n=1997).

Results

Alcohol consumption is found to be substantially higher among users of cannabis than among nonusers throughout the period from youth to adulthood. The use of cannabis, the level of alcohol consumption and probability of experiencing alcohol related problems decrease as the cohorts grow older. Alcohol related problems are still associated with the level of involvement with cannabis: those with a current or previous involvement with cannabis report more alcohol related problems. Taking into account the decreasing trend of alcohol related problems with age we find that becoming a parent and/ or getting married reduces the risk of experiencing such problems.

Alcohol consumption among partners of pregnant women in Sweden: a cross sectional study

Background

Antenatal care in Sweden involves a visit in pregnancy week 6–7 for counseling about lifestyle issues, including alcohol. The aim of this study was to investigate alcohol consumption among partners of pregnant women, their motives for changing drinking patterns when becoming a parent and their perceptions of the midwife’s counseling about alcohol.

Method

The study was conducted at 30 antenatal care centers across Sweden in 2009–2010. All partners who accompanied a pregnant women in pregnancy week >17 were asked to participate. The questionnaire included questions on alcohol consumption.

Results

Questionnaires from 444 partners were analyzed. Most, 95 %, of the partners reported alcohol consumption before pregnancy; 18 % were binge drinking (6 standard drinks or more per occasion, each drink containing 12 grams of pure alcohol) at least once every month during the last year. More than half, 58 %, of all partners had decreased their alcohol consumption following pregnancy recognition and a higher proportion of binge drinkers decreased their consumption compared to non-frequent binge drinkers (p = 0.025). Their motives varied; the pregnancy itself, fewer social gatherings (potentially involving alcohol consumption) and a sense of responsibility for the pregnant partner were reported. Of the partners, 37 % reported support for decreased drinking from others (pregnant partner, parents, friend or workmates). Further, most partners appreciated the midwife’s counseling on alcohol.

Conclusion

A majority of partners decreased their alcohol consumption in transition to parenthood, which also appears to be a crucial time for changing alcohol-drinking patterns. The partners with higher AUDIT-C scores reported more support for decreased drinking. Most partners appreciated the midwife’s talk about alcohol and pregnancy and those who filled out AUDIT in early pregnancy reported that the counseling was more engaging. During pregnancy it is possible to detect partners with high alcohol consumption, and promote interventions for decreased drinking, also for the partners. Written information addressing alcohol use and directed to partners is needed.

Positional Role Changes and Drinking Patterns: Results of a Longitudinal Study

This study of heavily drinking males in the general population assesses the effect of positional role changes on drinking behaviors. The data are derived from a longitudinal study over a three-year period (1992–1995) of a representative sample of 617 male heavy drinkers from the Quebec (Canada) adult population. Three types of positional roles have been examined: employment, marital, and parental status. This study examined two dimensions of the drinking pattern: the annual frequency of drinking and the annual frequency of five drinks or more on a single occasion. Standard multiple regression analyses were conducted independently for each dimension of the drinking patterns. Results indicated that baseline annual frequency and baseline annual frequency of five drinks or more per occasion were the main predictors of both drinking patterns under study. Furthermore, positional role changes contributed to explain the Δ1992–1995 annual frequency of drinking, but marginally. Men who reported a child's birth between 1992 and 1995 reduced their annual frequency of drinking, while men who reported being unemployed in 1992 and in 1995 increased their annual frequency of drinking. Further research should take into account the qualitative aspects of positional roles.

Effect of Prepregnancy Alcohol Consumption on Postpartum Relationship Satisfaction and Divorce among Norwegian Mothers

This study assessed the effect of prepregnancy level of alcohol use among mothers on relationship breakups with young children at 36 months after birth and the extent to which relationship satisfaction (RS) throughout the postpartum period could mediate any association between alcohol use and divorce. The data were part of the Norwegian Mother and Child Cohort Study, and analyses of the present article were based on a total of 69,117 mothers divided into low-, medium-, and high-risk consumption groups. All the three groups experienced a decrease in RS, but the largest effect was observed for the high-risk group. Mothers in this group had 55% higher odds for divorce as compared to the low-risk group. The findings supported a conceptual model whereby the effects of alcohol use on divorce were mediated through lowered RS.

Harmful alcohol use as a predictor of intimate partner violence during the transition to parenthood: interdependent and interactive effects

Harmful alcohol use is known to increase the risk of intimate partner violence (IPV), however very little is known about the role of alcohol use during the transition to parenthood. The current study was designed to examine harmful alcohol use as a dyadic and interactive time-varying risk factor for psychological and physical IPV across the transition to parenthood using a sample of 98 couples assessed prenatally and again at one and two years postpartum. Longitudinal actor-partner interdependence models demonstrated that changes in harmful alcohol use during the transition to parenthood were significantly related to changes in psychological IPV for both men and women and with physical IPV for men only, whereas harmful alcohol use was actually negatively related to variations in women's physical IPV. Partners' harmful use of alcohol during the transition to parenthood also explained additional variance in psychological IPV for men and physical IPV for women over time. Time-varying interactions between actors' and partners' harmful alcohol use were additionally predictive of greater psychological IPV for women and greater physical IPV for both men and women. Contrary to some past research, time-varying discrepancies in levels of harmful alcohol use between men and women were related to a lower risk of psychological IPV for women and physical IPV for both genders. Findings from this study indicate that harmful alcohol use by both men and women combines in a dyadic and interactive manner to place couples at risk for IPV during the transition to parenthood. Prenatal interventions may benefit from strategies to reduce the harmful use of alcohol by both men and women during the prenatal and postpartum periods.

Women’s longitudinal smoking patterns from preconception through child’s kindergarten entry: profiles of biological mothers of a 2001 US birth cohort

To identify longitudinal patterns of women’s smoking during the pre-conception, perinatal, and early parenting period and describe risk factors distinguishing the different profiles. We conducted longitudinal latent class analysis of maternal smoking status over a 6–7 year period in a sample of 8,650 biological mothers of the Early Childhood Longitudinal Study-Birth Cohort, nationally representative of US births in 2001. Five latent classes were identified: pregnancy-inspired quitters (4.3 %), delayed initiators (5.1 %), persistent smokers (8.5 %), temporary quitters (10.4 %), and nonsmokers (71.7 %). These classes were distinguished by age, race/ethnicity, education, poverty status, marital status, parity, drinking behavior, and depression. For example, when compared to those with college degrees, those with less than a high school degree were at least five times as likely to be in the delayed initiator, temporary quitter, or persistent smoker classes (vs. the nonsmoker class). Heterogeneous longitudinal smoking patterns indicate the need for both prevention messages and cessation treatment continuing past parturition, tailored to fit individual profiles in order to achieve better health outcomes for both mothers and children.

Posttraumatic stress, partner violence victimization, and harmful drinking: risk factors for relationship discord in new parents

The first year of parenthood can be a stressful time, especially for high-risk couples. Symptoms of posttraumatic stress (PTS) have been associated with decreased intimacy, communication, and relationship adjustment, yet there is a lack of research on how PTS symptoms might affect couples in early parenthood. Furthermore, there is little evidence regarding the way in which PTS symptoms may affect couples above and beyond known risk factors such as intimate partner violence (IPV) and harmful alcohol use. The current study investigated how PTS symptoms were related to new parents' relationship satisfaction in the context of IPV and harmful drinking. Ninety-eight heterosexual couples filled out questionnaires 1 year after the birth of their first child. Hierarchical multiple regression analyses indicated that, for men, PTS symptoms predicted lower relationship satisfaction over and above IPV victimization and harmful drinking. However, for women, psychological IPV victimization was the only significant multivariate predictor. In addition, for men, PTS symptoms interacted with harmful drinking to predict poorer relationship satisfaction. The results suggest that women's relationship satisfaction is particularly linked to psychological IPV victimization during early parenthood, whereas men's relationship satisfaction is particularly associated with their own harmful drinking and PTS symptoms. Implications are discussed.

Developing a genetically informative measure of alcohol consumption using past-12-month indices

OBJECTIVE

The goal of this study was to develop a factor score derived from measures of past-12-month alcohol consumption.

METHOD

Data were drawn from two studies-the Adult and Family Development Project (N = 734) and the Missouri Adolescent Female Twin Study (N = 3,787). Data on four indices of alcohol consumption (quantity, frequency, frequency of drinking to intoxication, and frequency of five or more drinks/day) were factor analyzed, and differences in factor loadings across gender, race/ethnicity, and study were tested. Correlations between these factors were computed across three assessments and between parent and offspring self-reports. Finally, using the classical twin design, variance in the past-12-month alcohol consumption factor was decomposed into additive genetic (A), shared environmental (C), and nonshared environmental (E) influences, and the extent to which these factors overlap with those influencing lifetime heaviest drinking were examined.

RESULTS

Factor loadings across all groups were high (.69-.95), with some evidence for differing factor loadings across gender, race/ethnicity, and study. The across-wave correlations for the factor ranged from .22 to .62. The within-wave correlation between parental and offspring drinking was .25, suggesting the importance of familial influences, which genetic analyses attributed to both additive genetic (31%) and shared environmental (17%) factors. The overlap between genetic influences on past-12-month and lifetime heaviest drinking was 0.97.

CONCLUSIONS

A factor score derived from past-12-month drinking measures is heritable and is largely influenced by those genetic factors that influence heaviest drinking, at least in young adults. It also shows moderate across-wave stability. This will allow for large- and small-scale genomic studies to use past-12-month drinking measures in data analysis of similar cohorts.

Caregiver burden and alcohol use in a community sample

Little attention has been paid to the relationship between caregiver burden and alcohol use. It is important to examine the particular aspects of caregiver burden that most influence alcohol use. A mail survey was conducted using a representative sample of 998 employed Chicago residents who provided informal care for at least one person. Ordinary least squares regression models were computed to examine the relationship between caregiver burden and drinking outcomes. Findings suggest that caregivers who experience social and emotional burdens related to caregiving are at risk for problematic alcohol use and warrant attention from health care and mental health service professionals.

Workplace harassment, active coping, and alcohol-related outcomes

PURPOSE

While sexual harassment and generalized workplace abuse (GWA) have been linked with alcohol use and abuse, active problem-focused coping has been shown to lessen vulnerability to deleterious mental health consequences of varied social stressors. At the same time, active coping is relatively more efficacious in response to stressors, which are amenable to change by personal actions. However, the moderating role that coping plays in relation to harassment and drinking is unknown.

METHOD

Using data from a two-wave survey of university employees (N=2038), we addressed the extent to which (1) active coping was utilized by harassed and abused employees, (2) whether coping impacted on the continuation or cessation of harassment and abuse, and (3) the extent to which nonsuccessful coping was predictive of alcohol use and abuse.

RESULTS

Active coping had no significant impact on the ability to end harassing or abusive experiences. Moreover, the use of problem-focused coping that was unsuccessful predicted some drinking outcomes for both men and women, controlling for Wave I drinking and sociodemographic characteristics.

IMPLICATIONS

The data suggest that increased institutional attention to the prevention of workplace harassment and abuse might impact on decreasing alcohol use and abuse.

Changes in Alcohol Use and Drinking Problems in Relation to Role Transitions in Different Stages of the Life Course

Older and younger generations are compared with respect to changes in alcohol use and alcohol-related problems associated with role transitions in the life course, using data from a 9-year follow-up study in the Netherlands. Transitions in several role domains are summarized in an index for structure of everyday life. It was hypothesized that role transitions involving an increase in structure of everyday life would lead to a decrease in drinking and in problems. As expected, the association of the index with alcohol use and alcohol related problems was negative among the younger generation. However, contrary to expectation, the association was positive among the older generation. It is concluded that the role-theoretic framework from which our expectations were derived should be amended when used for research among older people. More specific attention to the content of social roles and associated resources and coping mechanisms available at older age is recommended.

A bibliographic essay: the relationship between stress and substance use

The purpose of this review is to outline and critique studies that have examined the link between stress and substance use. Studies are categorized according to the age of the sample and the type of substance use measure considered. The research is mostly limited to studies that operationalize stress as stressful life events, daily hassles, or subjective stress. This paper concludes that there is a robust relationship between stress and substance use. However, there is a clear need for general population studies to address age, gender, and cultural differences to better assess the specificity and complexity of the stress/substance use relationship.

Postpartum depressive symptomatology in new mothers and fathers: parenting, work, and support

Control and social gratification at work and in other social roles have been shown to be predictive of depression in general adult populations, yet the potential importance of these factors in the postpartum period has not been explored. This study examines the influence of self-reported social gratification, support, and control at work and in the parenting role on depressive symptomatology for both men and women in the postpartum period. A model including perceptions of control, social gratification, and support in these two life domains is tested at 6 months postpartum in a sample of 108 first-time parents. When this model is compared to a parallel model using information obtained 6 months before the birth, strong support for the increased significance of these variables in the postpartum period is found. The need to include work and role-related variables in a comprehensive stress-diathesis model of postpartum depression for both men and women is discussed.