Assessing Young Children and Their Relationships

1
Paternal Alcohol Use, Maternal Warmth and
Psychosocial Outcomes among Adolescents
Participating in a School-Based Substance Abuse
Intervention
Neta
Peleg-Oren, Ph.D.
Eric F. Wagner, Ph.D. Staci Leon Morris,
Psy.D. C-BIRG, Florida International University,
Miami, FL This work was supported in part by a
grant funded by the NIAAA (R01 AA10245).
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Monitoring the Future 2006 Use (Lifetime)
http//monitoringthefuture.org
8th 10th 12th
Alcohol (any use) 40.5 61.5 72.7
Alcohol Past Year (any use) 33.6 55.8 66.5
Been Drunk 19.5 41.4 56.4
Any Illicit Drug(s) (include Marijuana) 20.9 36.1 48.2
Cigarettes (any use) 24.6 36.1 47.1
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FL Youth Survey 2006 (FYSAS) (Lifetime)
http//www.dcf.state.fl.us/mentalhealth/publicatio
ns/fysas
8th 10th 12th
Alcohol (any use) 52.3 68.4 76
Been Drink 27.5 37.2 47.1
Any Illict Drug(s) (include Marijuana) 27.8 39.1 46.9
Cigarettes (any use) 27.5 37.2 47.1
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Monitoring the Future 2006 Abuse (in 30 days)
8th 10th 12th
Binge Drinking (5 drinks in a row in last 2 week) 10.9 21.9 26.5
Daily Alcohol Use 0.5 1.4 3.0
Daily Marijuana Use 1.0 2.8 5.0
gt½/day Pack Cigarettes 1.5 3.3 5.9
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FL Youth Survey (FYSAS) (in 30 days)
http//www.dcf.state.fl.us/mentalhealth/publicatio
ns/fysas
8th 10th 12th
Binge Drinking (5 drinks in a row in last 2 week) 12.8 22.3 32
Alcohol Use 27.7 40.7 52.2
Any Illict Drug(s) (include Marijuana) 14.5 19.5 23.8
gt½/day Pack Cigarettes 9 13.1 20.1
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Prevalence of COA

• 11.6 million children (16 of children) exposed
  to alcohol problems
• Additional 2 million children exposed to an
  alcohol dependent parent (3 of children)
• (Ramisetty-Mikler Caetano, 2004 based on 1995
  National Alcohol Survey)
• 1 in 4 children exposed to alcohol or drugs in
  the family

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Characteristics of COA

• Having a parent with a history of alcohol use
  problems has been associated with increased risk
  for problems with
• Emotions (e.g., psychiatric disorder)
• Cognitions (e.g., stress coping)
• Social Skills (e.g., peer interaction)
• Behaviors (e.g., self-regulation)

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COA-High Risk for Substance Use

• Genetic and non-genetic influences appear to
  contribute to the risk for substance use problems
  among COAs.
• COAs are 4-9 times more likely to develop SUDs
  than nonCOAs (Cloninger et al., 1981 Russell,
  1990)

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Definition of Maternal Warmth

• A mothers general tendency to be supportive,
  affectionate, and sensitive to the childs needs,
  express approval and direct positive emotions and
  behaviors toward the child (Zhou, et al., 2002).

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Maternal Warmth (contd)

• Lack of maternal warmth may heighten the risk for
  substance use problems in adolescents
• (Cohen et al., 1994 Foxcroft Lowe, 1991
  Kandel Davis, 1996 Ruchkin, et al., 2002).
• Family positive support and control have been
  found negatively associated with adolescent
  drinking (Foxcroft Lowe, 1991).

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Maternal Warmth (contd)

• High maternal warmth and expression of positive
  emotions have been linked to
• Lower levels of hostility
• Fewer internalizing problems
• Fewer externalizing problems
• Positive social skills
• Better self-regulation
• (Eiden et al., 2004 Eisenberg et al., 2001
  Kandel, 1980 Kochanska Murray, 2000 Kochanska
  et al., 2000 Zhou, 2002).

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Aim of the Study

• To examine
• paternal history of alcohol use problems
• (no use, moderate use, and heavy problematic use
  by the father)
• maternal warmth
• (low or high)
• as both independent and interactive predictors of
  psychosocial outcomes of high-risk, alcohol and
  drug using school youth

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Alcohol Use, Maternal Warmth and Psychosocial
Outcomes
Independent Variables 1. COA Status 2. Maternal
Warmth 3. COA by Maternal Warmth
Dependent Variables (Adolescent Functioning) 1.
Psychiatric Disorders 2. Social Skills 3. Coping
Skills 4. Alcohol and Other Drug Use
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Hypotheses

• Adolescents reporting lower maternal warmth will
  demonstrate significantly (a) more psychiatric
  disorders, (b) less adaptive coping skills, and
  (c) poorer social skills than adolescents
  reporting higher maternal warmth.
• COAs will demonstrate significantly (a) more
  frequent and heavier alcohol and drug use and (b)
  less adaptive coping skills than adolescents with
  no paternal history of substance use problems.
• The interaction of maternal warmth and COA status
  were explored (e.g., is maternal warmth even more
  predictive of outcomes for COAs vs. non-COAs?)

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Present Study

• Cross sectional secondary analysis of data
  derives from an NIAAA-funded randomized clinical
  trial of school-based group intervention for
  adolescents with alcohol use problems
  (Westchester Model SAP).
• Data derived from self-reports collected at
  baseline from the adolescent.
• The primary analytic strategy was hierarchical
  multiple regression (HMR).

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Sample

• Middle and high school students who
• reported 6 or more occasions of substance use in
  the 6-month period prior to enrollment.
• reported 6 or more contacts per month with their
  fathers.
• From N 214 students in the original study 171
  (80) met our above inclusion criteria.

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Sample Demographics

• Mean age - 15.4 years
• 52 - middle schoolers
• 48 - high schoolers
• 42 - female
• 66 - non-Hispanic White, 21 Hispanic, 10
  Black, and 3 other

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Measures

• Adolescent substance use -Timeline Followback
  (TLFB) ( Sobell et al., 1980 Sobell Sobell,
  1992, 1996).
• COA Status - The Social Support Questionnaire
  (Richter et al.,1991)
• Study classified the participants into 3 groups.
  children of
• (1) non-drinking fathers (32)
• (2) light drinking fathers (37)
• (3) heavy drinking fathers (31)

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Measures (contd)

• Maternal Warmth - The Parent-Adolescent
  Communication Scale (PACS) ( Barnes Olson,
  1982) Open Family Communication and Problems in
  Family Communication.
• Psychiatric Disorders - The brief Michigan
  version of the CIDI (Kessler, et al., 1998)
• Coping Skills - The Revised Ways of Coping
  Checklist (RWCCL) (Vitaliano et al., 1985)
• Social Skills -The Teenage Inventory of Social
  Skills (TISS) (Inderbitzen Foster, 1992)

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Descriptive data of psychosocial functioning
variables by COA status and maternal warmth
groups.
Parental Current Drinking Parental Current Drinking Parental Current Drinking Parental Current Drinking Parental Current Drinking Parental Current Drinking Parental Current Drinking Maternal Warmth Maternal Warmth Maternal Warmth Maternal Warmth
Non-Drinking Non-Drinking Non-Drinking Light Drinking Light Drinking Heavy Drinking Heavy Drinking Low Low High High
(n55) (n55) (n55) (n63) (n63) (n53) (n53) (n 85 ) (n 85 ) (n 81 ) (n 81 )
M SD M SD M SD M SD M SD
Age (years) 15.41 1.63 15.27 1.04 15.54 1.51 15.37 1.55 15.40 1.46
Socioeconomic Status 3.22 1.05 2.93 1.07 2.80 .97 2.91 1.0 3.03 1.1
Psychiatric Disorders 1.96 1.9 1.76 2.11 2.0 1.80 2.24 2.0 1.57 1.84
Adaptive Coping .62 .48 .50 .05 .51 .05 .49 .05 .51 .06
Poor Social Skills 52.65 16.44 51.95 15.01 56.92 15.61 57.08 15.68 50.40 15.26
30 days alcohol frequency 1.20 1.89 2.17 2.73 2.55 3.04 2.05 2.68 1.88 2.56
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Table2A Summary of hierarchical multiple
regression analyses (Maternal Warmth)
1a. Dependent variable Psychiatric disorders.
Independent variables ß 2 total R2 change
Demographic controls .09 .09
Maternal warmth -.21 .13 .04
1b. Dependent variable Coping skills
Independent variables ß R2total R2change
Demographic controls .009 .009
Maternal warmth .17 .037 .028
1c. Dependent variable Social skills
Independent variables ß R2total R2change
Demographic controls .05 .05
Maternal warmth -.21 .10 .04
p lt .05 p lt .01.
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Table 2B Summary of hierarchical multiple
regression analyses (COA Status)
2a. Dependent variable 30-day frequency of alcohol use 3 months prior to assessment
Independent variables ß R2total R2change
Demographic controls .06 .06
COA status -.20 .10 .04
2b. Dependent variable Proportion of adaptive coping skills (from total coping)
Independent variables ß R2total R2change
Demographic controls .01 .01
COA status -.18 .04 .03
p lt .05 p lt .01.
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ResultsCOA

• In comparison to non-COAs, COAs reported
  significantly (p lt .05)
• More frequent alcohol use
• Greater quantity per use occasion
• Less adaptive coping skills

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Results Maternal Warmth

• In comparison to teens reporting high maternal
  warmth, teens reporting low maternal warmth
  demonstrated significantly (p lt .05)
• more psychiatric disorders
• less adaptive coping skills
• poorer social skills

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ResultsInteractions

• No significant interactions were found between
  paternal alcohol use problems and maternal warmth
• in predicting adolescent psychosocial adjustment.

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Conclusion

• COAs have an increased risk for alcohol-related
  problems.
• Paternal alcohol use and low maternal warmth each
  contribute independently to adolescent
  adjustment.
• There was no evidence of interactive effects of
  these variables on adolescent adjustment.
• Therefore
• Assessment of family history of alcoholism and
  maternal warmth is very important
• COA or low maternal warmth adolescents should be
  considered high-risk teen in need of specialized
  services.

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Future Research

• Longitudinal study - the influence of maternal
  warmth and paternal history of alcohol use on
  adolescent adjustment over time.
• Identify additional personal and family
  characteristics which may contribute to
  psychosocial risk.
• Develop specialized interventions based on
  documented patterns of risk.

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Thank you

• You were such a great audience !