Parenting contributors to early emerging problem behaviour in children of mothers in methadone maintenance treatment (original) (raw)
Related papers
Journal of Developmental & Behavioral Pediatrics, 2002
This prospective study examined the effects of ongoing maternal drug use, parenting attitudes, and a home-based intervention on mother-child interaction among drug-using women and their children. At 2 weeks postpartum, mothers and infants were randomly assigned to either an Intervention (n = 67) or Control (n = 64) Group. Intervention families received weekly visits until 6 months postpartum and biweekly visits from 6 to 18 months by trained lay visitors. The home intervention was designed to increase maternal empowerment and promote child development. Control families received brief monthly tracking visits. Mother-child interaction was evaluated at 18 months through observation of play. Mothers who continued to use cocaine and/or heroin had lower competence scores (p < .05); poor parenting attitude was also associated with lower competence scores during mother-child interaction (p < .05). Although the intervention had no measured effect, ongoing maternal drug use and poor parenting attitudes were associated with less optimal maternal behavior during mother-child interaction. The focus of much of the research on drug-using mothers and their infants has been on the short-and long-term effects of prenatal drug exposure. However, recent research 1 indicates that developmental and behavioral outcomes once thought to be specific to prenatal cocaine exposure are actually associated with other factors, such as the quality of the child's environment. Drug-exposed children raised in homes with ongoing parental drug use are more likely to display problems in cognitive development than drug-exposed children raised in drug-free environments. 2,3 Women who continue to use drugs after the infants are born are often unable to provide a stable, consistent, nurturing environment for their children. 4-6 Maternal drug use is associated with higher parenting stress 7 and poorer parenting attitudes, 8,9 and poor parenting attitudes such as a belief in harsh discipline were associated with less optimal maternal behavior during a parent-child observation session. 10 Factors such as ongoing maternal drug use and poor parenting attitudes may be associated with less optimal maternal and child behavior during mother-child interaction among substanceabusing mothers and their drug-exposed children. Home-intervention programs have often been used with drug-using women and their children. Using community health nurses, one home-based program provided health education and a child-development curriculum over the first 12 months postpartum. 11 Although the number of home visits varied by family, the intervention led to better motherinfant interaction at 3 months postpartum. Another home-based program using community nurses provided a child-development curriculum and maternal support during biweekly home visits (mean number of visits = 12) over the first 18 months postpartum. 12 Infants in the Intervention Group had higher cognitive scores and a more stimulating and responsive
Differential responsiveness to a parenting intervention for mothers in substance abuse treatment
Child abuse & neglect, 2015
This study examines the relationship between levels of psychological distress in substance-dependent mothers and their differential response to a dyadic parent-child intervention. A sample of 66 mothers who were receiving treatment for substance abuse, as well as a simultaneous parenting intervention, were interviewed pre and post-treatment on measures of psychological distress, adult and child trauma history, parental reflective functioning, and child social-emotional development. Additionally, clinicians provided assessments of the parent-child relationships. As anticipated, trauma histories for mothers and children, children's social emotional development, and parental reflective functioning were associated with aspects of maternal psychological distress. Kruskal-Wallis and subsequent Wilcoxson signed rank tests revealed that women with highest levels of baseline psychological distress showed significant improvements in psychological functioning post-treatment while women wit...
Child: Care, Health and Development, 2007
High rates of child abuse and neglect occur in many families in which either or both parents abuse illicit drugs. This study reports on the results of a randomized controlled trial with families having a parent on methadone maintenance (N = 64), in which an intensive, home-based intervention, the Parents Under Pressure (PUP) program, was compared to standard care. A second brief intervention control group of families received a two-session parenting education intervention. The PUP intervention draws from the ecological model of child development by targeting multiple domains of family functioning including the psychological functioning of individuals in the family, parent-child relationships, and social contextual factors. Mindfulness skills were included to address parental affect regulation, a significant problem for this group of parents. At 3-and 6-month follow-up, PUP families showed significant reductions in problems across multiple domains of family functioning, including a reduction in child abuse potential, rigid parenting attitudes, and child behavior problems. Families in the brief intervention group showed a modest reduction in child abuse potential but no other changes in family function. There were no improvements found in the standard care group and some significant worsening was observed. Results are discussed in terms of their implications for improved treatment. D
Mother-Infant Interaction: Effects of a Home Intervention and Ongoing Maternal Drug Use
Journal of Clinical Child Psychology, 2000
Examined the effects of a home-based intervention on mother-infant interaction among drugusing women and their infants. At 2 weeks postpartum, mothers and infants were randomly assigned to either an intervention (n = 84) or a control (n = 87) group. Control families received brief monthly tracking visits, and intervention families received weekly visits by trained lay visitors. Mother-infant interaction was evaluated at 6 months through observation of feeding. Although there were no direct effects of the intervention, in the control group, mothers who continued to use drugs were less responsive to their babies than mothers who were drug free. In the intervention group, drug use was not associated with maternal responsiveness. Weekly homebased intervention may be a protective strategy for children of drug-using women because it disrupts the relation between ongoing maternal drug use and low maternal responsiveness. Drug abuse among women is often associated with a chaotic caregiving environment (Butz, Lears, O'Neil, & Lukk, 1998), placing infants at significant risk for poor outcome because of prenatal drug exposure and nonresponsive parenting. Maternal substance abuse has been associated with domestic abuse (Amaro, Fried, Cabral, & Zuckerman, 1990), child abuse (Kelley, 1992; Leventhal et al., 1997), and attachment problems (Kelley, 1992), yet the research findings on the parenting of drug-using mothers are contradictory. Some researchers have found that drug-using mothers show less enjoyment and enthusiasm compared with nondrug-using mothers (Burns, Chethik, Burns, & Clark, 1997), and others have found no differences in maternal behavior (Black, Schuler, & Nair, 1993; Schuler, Black, & Starr, 1995). The focus of much of the research on drug-using mothers and their infants has been on the short-and long-term effects of prenatal drug exposure. Few researchers have examined the impact of ongoing maternal drug use on parenting ability or infant outcome. Although maternal drug use beyond the neonatal period has been measured by using urine analysis and hair analysis (Callahan et al., 1992; Graham, Koren, Klein, Schneiderman, & Greenwald, 1989), the majority of studies have used maternal report even though the accuracy of this method has been questioned (Zuckerman et al., 1989). Regardless of how it is assessed, drug addiction is a chronic relapsing disease. Women who continue to use drugs often are unable to provide a consistent, nurturing environment for their children (Hawley, Halle, Drasin, & Thomas, 1995; Zuckerman, 1994). Drug-exposed children raised in homes with ongoing maternal drug use are more likely to display problems in cognitive development at 3 years than drug-exposed children raised in drug-free environments
Substance-Abusing Mothers: Toward an Understanding of Parenting and Risk Behavior
Mental Health and Addiction Care in the Middle East, 2016
I would also like to thank Dr. Alexander Reznik, for his professional help with the research instruments and data analysis, and the Regional Alcohol and Drug Abuse Research Center (RADAR) Team, for their help and support. I thank Sigal Levi, director of the "Sela" methadone maintenance clinic, for allowing us the opportunity to conduct this study, and for the help of her wonderful staff. I also would like to thank Prof. Debra Murphy, an international expert addressing the issue of parenting skills among substance abusing mothers, for recommending the instruments used for the study. Last but not least, I would like to thank my family for their encouragement, support and faith in me.
SpringerPlus, 2016
To investigate whether women raised in a family with substance abuse constitute a particularly vulnerable group of patients in an infant psychiatry setting and to identify the risk factors of suspected parental malfunctioning in women referred to treatment in an infant and toddler intervention program. A history of family substance abuse can severely disrupt the caretaking abilities of parents in ways that can have far-reaching consequences, and children growing up with insufficient parental care may incorporate this deficiency into their own parental behavior. In total, 126 mothers completed self-report questionnaires assessing their substance abuse and health problems as well as problems in their family of origin. The index group was defined as women who reported substance abuse in their family of origin (n = 35). The comparison group was defined as women who denied substance abuse in their family of origin (n = 91). Symptoms of depression and anxiety were overrepresented in the t...
Developmental Psychology, 2013
This study tested the association between parent illicit drug use disorder (DUD) in early adulthood and observed parenting practices at ages 27-28 and examined the following three, theoreticallyderived models explaining this link: a) a disrupted parent adult functioning model, b) a preexisting parent personality factor model, c) a disrupted adolescent family process model. Associations between study variables and child externalizing problems also were examined. Longitudinal data linking two generations were drawn from the Seattle Social Development Project (SSDP) and The SSDP Intergenerational Project (TIP), and included 167 parents and their 2-to 8-year-old child. Path modeling revealed that parent DUD in early adulthood predicted later observed low-skilled parenting, which was related to child externalizing problems. The preexisting parent personality factor model was supported. Parent negative emotionality accounted for the association between parent early adult DUD and later parenting practices. Parent negative emotionality also was related directly to child externalizing behavior. Limited support for the disrupted transition to adulthood model was found. The disrupted adolescent family process model was not supported. Results suggest that problem drug use that occurs early in adulthood may affect later parenting skills, independent of subsequent parent drug use. Findings highlight the importance of parent negative emotionality in influencing their own problem behavior, their interactions with their child, and their child's problem behavior. Prevention and treatment
Development and Psychopathology, 1999
The course of severe depressive symptoms from pregnancy to 6 months postpartum, as well as the occurrence of severe paranoid symptoms prenatally, were examined by the Millon Clinical Multiaxial Inventory I and the Beck Depression Inventory, in 78 women who were heavy, chronic cocaine users and who retained custody of their children after birth. Six months postpartum, the quality of caregiving was observed and assessed in the home, and the children were assessed on the Bayley MDI Index in the laboratory. Mothers who were depressed and paranoid prenatally, regardless of whether the depression continued to 6 months postpartum, were less sensitive in caregiving than women without severe symptoms of paranoia or depression during pregnancy or those who reported only depression that lifted by 6 months postpartum. Mothers who were depressed prenatally and continued to be depressed by 6 months postpartum, regardless of the presence or absence of paranoia, had infants who earned lower Bayley ...
Children of treated substance-abusing mothers: A 10-year prospective study
Clinical Child Psychology and Psychiatry, 2013
The 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 (CBCL). 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. 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 in alcohol, drug, legal and employment. 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.