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CORK Bibliography: Parenting

68 citations. January 2007 to present

Prepared: September 2008

Abrahams RR; Kelly SA; Payne S; Thiessen PN; Mackintosh J; Janssen PA. Rooming-in compared with standard care for newborns of mothers using methadone or heroin. Canadian Family Physician 53: 1723-1730, 2007. (18 refs.)

OBJECTIVE To evaluate the effect of rooming-in (rather than standard nursery care) on the incidence and severity of neonatal abstinence syndrome among opioid-exposed newborns and on the proportion of mothers who retain custody of their babies at hospital discharge. DESIGN Retrospective cohort study. SETTING Lower mainland in southwestern British Columbia. PARTICIPANTS We selected 32 women in the city of Vancouver known to have used heroin or methadone during pregnancy between October 2001 and December 2002. Comparison groups were a historical cohort of 38 women in Vancouver and a concurrent cohort of 36 women cared for in a neighbouring community hospital. MAIN OUTCOME MEASURES Need for treatment with morphine, number of days of treatment with morphine, and whether babies were discharged in the custody of their mothers. RESULTS Rooming-in was associated with a significant decrease in need for treatment of neonatal abstinence syndrome compared with the historical cohort (adjusted relative risk [RR] 0.40, 95% confidence interval [CI] 0.20 to 0.78) and the concurrent cohort (adjusted RR 0.39, 95% CI 0.20 to 0.75). Rooming-in was also associated with shorter newborn length of stay in hospital compared with both comparison groups. Newborns who roomed in at BC Women's Hospital were significantly more likely to be discharged in the custody of their mothers than babies in the historical cohort (RR 2.23, 95% CI 1.43 to 3.98) or the concurrent cohort (RR 1.15 to 2.53) were. CONCLUSION Rooming-in might ease opioid-exposed newborns' transition to extrauterine life and promote more effective mothering.

Ames SC; Rock E; Hurt RD; Patten CA; Croghan IT; Stoner SM et al. Development and feasibility of a parental support intervention for adolescent smokers. Substance Use & Misuse 43(3/4): 497-511, 2008. (31 refs.)

The aim of this investigation was to develop and evaluate the feasibility and acceptability of a parental support intervention. A new measure of perceived parental support for stopping smoking was also developed. The sample included 59 adolescent-parent pairs recruited from a mid-sized Midwestern town during 2000-2003. The mean SD age of the participants (32 males, 27 females) was 16.3 0.9 (range 14-18) years and 86% were Caucasian, 7% American Indian, 5% African American, and 2% Hispanic. Participants were randomized to parental support or minimum behavioral intervention. Severity of nicotine dependence was evaluated using the Fagerstrm Tolerance Questionnaire, and perceived social support was evaluated using the Family Environment Scale and the new measure of perceived parent support for stopping smoking that was developed as part of this investigation. Treatment attendance, adherence, and acceptability were also evaluated. The parental support intervention was feasible but not superior to the minimum behavioral intervention with respect to attendance, retention, or change in support. This study expands on the knowledge of treating adolescent smokers and presents a new assessment measure. The study's limitations are noted. This investigation was funded by NICHHD.

Bernard M. Drug Addiction and Families. London: Jessica Kingsley Publishers, 2007

Drug problems on individuals have an impact on family members. This book, draws upon interviews conducted by the author in Great Britain, with drug users and extended family members. It begins with an examination of the responses of families -- the process of discovery, adaptation, and expulsion -- exploring the feelings of anger, sadness, anxiety, shame and loss that are commonly experienced by the extended family. The book also examines the effects of drug use on family dynamics and relationships, including possible social and emotional costs, as well as the costs on physical and mental health. The role of parenting is examined, along with the often overlooked role of grandparents in protecting the children of drug users. The lives of children are examined and the problems which proliferate. It is emphasized that the current service system, in treating the problem drug user in isolation, fails to address the needs of drug-affected families, and misses the opportunity to develop family-oriented support and treatment.

Blokland EAWDE; Hale WW; Meeus W; Engels RCME. Parental support and control and early adolescent smoking: A longitudinal study. Substance Use & Misuse 42(14): 2223-2232, 2007. (15 refs.)

The aim of this study is to examine the role of parental support and control on young adolescent smoking initiation, increase, continuation, and cessation. Longitudinal data gathered every 6 months over a one-year period were collected in Utrecht, The Netherlands,for 1,012 adolescents in 2000. Logistic regressions demonstrated that low parental control predicted adolescent smoking initiation but neither support nor control predicted adolescent smoking increase or continuation. Parental smoking status was important in adolescent smoking continuation and cessation. Suggestions based on these findings are made for prevention programs. A limitation is that the study only utilized adolescent reports.

Bono KE; Sheinberg N; Scott KG; Claussen AH. Early intervention for children prenatally exposed to cocaine. Infants and Young Children 20(1): 26-37, 2007. (59 refs.)

This article brings together information from our experience of providing research-based intervention to more than 600 children who were prenatally exposed to cocaine and from the research literature on the effects of prenatal cocaine exposure. Based on our experience and this literature, it is now clear that there are no large negative independent effects of cocaine exposure and that there is no "crack baby" syndrome. However, many of these children who have been exposed to cocaine are at risk for poor developmental outcomes, particularly in the area of language development, primarily because of the environmental factors that are associated with parental substance abuse. As our intervention research shows, early intervention can be effective in ameliorating some of this risk. Suggestions are made regarding programmatic steps that should be taken next to further improve program effectiveness and enhance the knowledge base.

Brook JS; Duan T; Brook DW. Fathers who abuse drugs and their adolescent children: Longitudinal predictors of adolescent aggression. American Journal on Addictions 16(5): 410-417, 2007. (57 refs.)

This longitudinal study examines the relationship between earlier paternal drug abuse, environmental factors, paternal child-rearing practices, and adolescent vulnerable personality attributes and later adolescent aggressive behavior. Data were collected at two points in time, one year apart, via individual, structured interviews. Structural Equation Modeling (SEM) was used to assess the interrelationship of the earlier factors with respect to later adolescent aggression. Interviews took place in an inner- city community, within the schools and the participants' homes. Participants included low- income, predominantly African American and Hispanic adolescents (N = 296) whose fathers abused drugs. The fathers were recruited from drug- abuse treatment programs in several U. S. cities. The outcome measure was adolescent aggressive behavior at Time 2 (T2). The findings showed that paternal drug abuse, environmental factors, and paternal child- rearing practices were mediated by the adolescent's vulnerable personality attributes. The adolescent's vulnerable personality attributes were the most proximal constructs to later adolescent aggressive behavior. Both paternal drug abuse and environmental factors were mediated by paternal child- rearing practices. The findings suggest that earlier environmental stresses, paternal drug abuse, paternal child-rearing practices, and adolescent vulnerable personality attributes are associated with later adolescent aggression.

Choi Y; He M; Harachi TW. Intergenerational cultural dissonance, parent-child conflict and bonding, and youth problem behaviors among Vietnamese and Cambodian immigrant families. Journal of Youth and Adolescence 37(1): 85-96, 2008. (62 refs.)

Intergenerational cultural dissonance (ICD)-a clash between parents and children over cultural values-is a frequent issue for Asian American youth. Using longitudinal data from the Cross Cultural Families Project, this study examines the mechanisms by which ICD contributes to problem behaviors, including whether ICD predicts parent-child conflict, whether parent-child conflict then has a direct effect on youth problem behavior, and whether positive bonding with parents mediates the effects of such conflict on youth problem behaviors among Vietnamese (n = 164) and Cambodian (n = 163) families with adolescents [average age = 15.2 years (SD = 1.05)]. The results from the path analyses show that, in both groups, ICD indirectly predicts problem behaviors by increasing parent-child conflict, which in turn weakens positive parent-child bonding. Interventions that target youths' perception of intergenerational cultural gaps, help them manage conflict, and help strengthen bonds with parents may prevent problem behaviors among Cambodian and Vietnamese families. This study contributes to inform how to effectively prevent problems and difficulties among these families.

Cousins JC; Bootzin RR; Stevens SJ; Ruiz BS; Haynes PL. Parental involvement, psychological distress, and sleep: A preliminary examination in sleep-disturbed adolescents with a history of substance abuse. Journal of Family Psychology 21(1): 104-113, 2007. (37 refs.)

The relationships between family environment and psychological distress and between psychological distress and sleep disturbance in adolescents are well established. However, less is known about the influence of family environment on sleep disturbance. The authors' goal is to examine the effects of parental involvement on psychological distress and sleep disturbance in 34 adolescents with a history of substance abuse. Linear regression techniques and confidence intervals were used to test the significance of mediation analyses. Lower levels of parental involvement were associated with higher levels of psychological distress, and higher levels of psychological distress were associated with lower sleep efficiency and more time spent in bed. Follow-up analyses found that higher levels of parental involvement were associated with earlier morning arising times, when controlling for psychological distress. These data indicate that psychological distress is important to consider when examining the relationship between parental involvement and sleep in adolescents.

Crawford LA; Novak KB. Parent-child relations and peer associations as mediators of the family structure-substance use relationship. Journal of Family Issues 29(2): 155-184, 2008. (62 refs.)

Using data from the National Education Longitudinal Survey of 1988, the authors assess the extent to which adolescents' levels of parental attachment and opportunities for participating in delinquent activities mediate the family structure-substance use relationship. A series of hierarchical regressions supported the hypotheses that high levels of substance use among adolescents residing with stepfamilies would be explained by low parental attachment, whereas heightened opportunities for participating in deviant activities would account for the substance use behaviors of individuals living in single-parent households. More generally, the findings suggest that family structure has a moderate effect on youth substance use; that parental and peer relations are better predictors than family structure of levels of alcohol and marijuana consumption; and that variations in parental attachment, parenting style, and peer relations across family types explain some, but not all, of the effects of family structure on adolescents' substance use behaviors.

Dillon FR; Pantin H; Robbins MS; Szapocznik J. Exploring the role of parental monitoring of peers on the relationship between family functioning and delinquency in the lives of African American and Hispanic adolescents. Crime & Delinquency 54(1): 65-94, 2008. (65 refs.)

This cross-sectional study explores potential mediating effects of parental monitoring of peers on three adolescent problem behaviors (externalizing behavior, drug use, sexual risk behavior) among juvenile delinquents and their families. Participants are 190 African American and Hispanic adolescents and parent guardians enrolled in a family therapy treatment efficacy study targeting delinquency. Parental monitoring of peers mediates the association between family functioning and externalizing behavior in the full sample. Comparable results are not found in post hoc analyses of each racial and ethnic sample or among drug use and sexual risk behaviors. Research and health service implications are discussed.

Ditre JW; Coraggio JT; Herzog TA. Associations between parental smoking restrictions and adolescent smoking. Nicotine & Tobacco Research 10(6): 975-983, 2008. (46 refs.)

The purpose of this study was to examine the cross-sectional relation between reported levels of parental smoking restriction and several behavioral and cognitive variables in a sample of 757 (363 males, 394 females) adolescent smokers. Experimenters administered surveys to students in the homerooms of three Florida high schools. After controlling for student age, gender, and parental smoking status, results revealed that more restrictive parental smoking policies were significantly associated with less smoking on weekdays and weekend days, greater latency to smoking the first cigarette of the day, greater motivation to quit smoking, greater confidence in ability to quit smoking, and higher estimated risk perception regarding the health consequences of smoking. Results also revealed that 44% of adolescent smokers reported that their parents or legal guardians did not know that they smoked tobacco. These findings suggest that parental smoking restrictions may have the potential to impede adolescent progression to adult smoking behavior by reducing smoking rates and nicotine dependence, and increasing motivation to quit, self-confidence to quit, and health risk perception. Parental restrictions on smoking may present obstacles and inconveniences to adolescent smoking behavior that make smoking cessation a more attractive option.

Drapela LA; Mosher C. The conditional effect of parental drug use on parental attachment and adolescent drug use: Social control and social development model perspectives. Journal of Child & Adolescent Substance Abuse 16(3): 63-87, 2007. (27 refs.)

The effect of parental deviance on adolescent deviance has been a source of considerable debate in the criminological literature. Classic theoretical explanations of the relationships between parental and adolescent deviance posit additive effects of parental deviance on youth behavior. Proponents of the Social Development Model have hypothesized that parental deviance interacts with parent-child attachment to increase adolescent antisocial behavior. Using data from a household survey of drug use in Washington State, we find that youth who are strongly attached to fathers in households where parents frequently use drugs are more likely to use both licit and illicit drugs than adolescents strongly bonded to nondrug-using parents. Adolescents' perceptions of drug availability and associations with drug-using peers are also significantly higher among youth strongly attached to fathers in households where parent drug use is present.

Eiden RD; Foote A; Schuetze P. Maternal cocaine use and caregiving status: Group differences in caregiver and infant risk variables. Addictive Behaviors 32(3): 465-476, 2007. (42 refs.)

This study examined differences between cocaine and non-cocame-using mothers, and between parental and non-parental caregivers of cocaine-exposed infants on caregiver childhood trauma, psychiatric symptoms, demographic, and perinatal risks. Participants included 115 cocaine and 105 non-cocaine mother-infant dyads recruited at delivery. Approximately 19% of cocaine mothers lost custody of their infants by I month of infant age compared to 0.02% of non-cocaine mothers. Mothers who used cocaine during pregnancy had higher demographic and obstetric risks. Their infants had higher perinatal risks. Birth mothers who retained custody of their infants had higher demographic risks and perinatal risks, higher childhood trauma, and higher psychiatric symptoms compared to birth mothers who did not use cocaine and non-parental caregivers of cocaine-exposed infants. Results highlight the importance of addressing childhood trauma issues and current psychiatric symptoms in substance abuse treatment with women who engaged in substance use during pregnancy.

Eisenberg ME; Neumark-Sztainer D; Fulkerson JA; Story M. Family meals and substance use: Is there a long-term protective association? Journal of Adolescent Health 43(2): 151-156, 2008. (34 refs.)

Purpose: To examine 5-year longitudinal associations between family meal patterns and subsequent substance use in adolescents. Methods: A total of 806 Minnesota adolescents were surveyed in public schools in 1998-1999 (mean age, 12.8 years) and again by mail in 2003-2004 (mean age, 17.2 years) as part of a longitudinal population-based study. Logistic regression was used to estimate the odds of tobacco, alcohol, and marijuana use at follow-up for adolescents reporting regular farnily meals at baseline compared with those without regular family meals, adjusting for family connectedness and prior substance use. Results: Family meal frequency at baseline was associated with significantly lower odds of cigarette smoking, alcohol use, and rnarijuana use at follow-up among female adolescents, even after adjusting for baseline substance use and additional covariates. Family meals were not associated with use of any substance at follow-up for male adolescents after adjusting for baseline use. Conclusions: Results from this study suggest that regular family meals in adolescence may have a long-term protective association with the development of substance use over 5 years among females. Parents should be encouraged to establish a pattern of regular family meals, as this activity may have long lasting benefits.

Fidler JA; West R; van Jaarsveld CHM; Jarvis MJ; Wardle J. Smoking status of step-parents as a risk factor for smoking in adolescence. Addiction 103(3): 496-501, 2008. (18 refs.)

Aim: To examine the extent to which smoking by step-parents and biological parents predicts adolescent smoking. Dsign: Five-year cohort study. Setting: Thirty-six schools in South London, England. Participants A subset of 650 students participating in the Health and Behaviour In Teenagers Study (HABITS), who reported living in step-families, were assessed annually from age 11-12 to age 15-16 years. Measurements: Students reported their smoking status, which was cotinine-verified, as well as whether their parents smoked and, if they lived with a step-parent, whether that step-parent smoked. Analyses also controlled for gender, ethnicity and deprivation. Findings Students who reported that just their step-parent smoked at age 11-12 were significantly more likely to report current smoking at any time-point from age 11-16 than those who reported having neither biological parents nor a step-parent who smoked [odds ratio (OR) 2.72, 95% confidence interval (CI) = 1.36-5.47], as were those with both a parent and a step-parent who smoked (OR 2.23, 95% CI = 1.46-3.41). While the association between smoking in students and smoking in biological parents in this subsample did not reach statistical significance (OR 1.39, 95% CI = 0.88-2.19), these students were no more or less likely to smoke than those with just a step-parent who smoked. Conclusion: Smoking by a non-biological parent appears at least as influential as smoking by biological parents. This confirms the importance of social influence on smoking initiation and suggests that attempts to work with parents in smoking prevention should involve, and perhaps pay particular attention to, step-parents who smoke.

Field T; Yando R; Bendell D; Hernandez-Reif M; Diego M; Vera Y et al. Prenatal depression effects on pregnancy feelings and substance use. Journal of Child & Adolescent Substance Abuse 17(1): 111-125, 2007. (45 refs.)

Depressed (n = 110) and nondepressed (n = 104) mothers were given a set of self-report measures, including the CES-D (depression), the STAI (anxiety), the STAXI (anger), the Perinatal Anxieties and Attitudes Scale, a questionnaire on substance use and the Feelings About Pregnancy and Delivery Scale that was designed for this study and that includes scales on coping, support, intimacy, common knowledge of depression, and cultural effects on pregnancy. During the neonatal period, the depressed mothers scored higher on the depression, anger, and anxiety scales as well as the Perinatal Anxieties and Attitudes Scale. They also reported using more substances including cigarettes, caffeine, and medications (primarily antibiotics). Their scores on the Feelings About Pregnancy and Delivery Scale were lower including the coping, support, intimacy, and cultural effects scores. In addition, they reported having more stressful situations during pregnancy, being less happy when finding out them were pregnant and their significant other being less happy when finding out about the pregnancy. A regression analysis on maternal depression suggested that 28% of the variance was explained by low support scale scores, not co-sleeping with their infant and high caffeine intake.

Fitzsimons GJ; Moore SG. Should we ask our children about sex, drugs and rock & roll? Potentially harmful effects of asking questions about risky behaviors. Journal of Consumer Psychology 18(2): 82-95, 2008. (93 refs.)

Research shows that asking questions can fundamentally change behavior. We review literature on this question-behavior effect, which demonstrates that asking questions changes both normal and risky behaviors. We discuss potential explanations for the effect and review recent findings that reveal interesting moderators of the influence of questions on behavior. We then highlight the potential impact of the question-behavior effect in an important public health context: screening adolescents for risky behavior. While medical guidelines emphasize the importance of asking adolescents questions about substance (drug, alcohol) use and sexual behaviors, research on the question-behavior effect suggests that asking adolescents about risky behaviors has the potential to increase the frequency with which they engage in these behaviors. We argue that the act of screening or measuring risky behavior is potentially counterproductive. We emphasize the importance of interventions beyond screening, and suggest ways in which screening can be carried out to minimize its impact. in short, asking questions about behaviors can change behavior, and asking questions about risky behaviors may itself be a risky undertaking.

Foster SE; Jones DJ; Olson AL; Forehand R; Gaffney CA; Zens MS et al. Family socialization of adolescent's self-reported cigarette use: The role of parents' history of regular smoking and parenting style. Journal of Pediatric Psychology 32(4): 481-493, 2007. (48 refs.)

Objective: To examine the main and interactive effects of parental history of regular cigarette smoking and parenting style on adolescent self-reported cigarette use. Methods Predictors of adolescent self-reported cigarette use, including parents' history of regular cigarette smoking and two dimensions of parenting behavior, were analyzed in a sample of 934 predominately Caucasian (96.3%) parent-adolescent dyads. Families were drawn from the control group of a randomized control trial aimed at preventing adolescent substance use. Results In addition to the main effects of parents' history of regular smoking and parental warmth, logistic regression analysis revealed that the interaction of these two variables was associated with adolescent self-reported cigarette use. Parental warmth was associated with a decreased likelihood of the adolescent ever having smoked a cigarette; however, this was true only if neither parent had a history of regular cigarette smoking. Conclusions: Findings suggest that adolescent smoking prevention programs may be more efficacious if they address both parental history of regular smoking and parenting behavior.

Freisthler B; Weiss RE. Using Bayesian space-time models to understand the substance use environment and risk for being referred to child protective services. Substance Use & Misuse 43(2): 239-251, 2008. (30 refs.)

Parental substance misuse has often been cited as a cause of children being referred for investigation of child abuse and neglect. Research on how the substance use environment might affect this relationship is still in its infancy with primarily only cross-sectional studies finding a positive relationship of alcohol outlet density at the level of neighborhoods and alcohol prices at level of states and maltreatment. A longitudinal study shows that increasing female drug-related arrests are related to increasing rates of maltreatment in rural and urban counties. The current study incorporates three aspects of the substance use environment in a panel study of 58 California counties over 4 years (n = 232) to study this relationship for referrals to child protective services (CPS) for child abuse and neglect. We use conditionally autoregressive (CAR) Bayesian models to model the spatial and temporal structure in the data. We find that use of welfare benefits, the number of outliers per population, and the number of drug-related arrests per population are positively related to referrals while unemployment and admissions to publicly funded alcohol and drug user treatment programs are negatively correlated to referrals. Significant spatial structure and space-time relationships are also found. The findings indicate that supply of alcohol and drugs (as measured by number of alcohol outlets and arrests for drug use and sales) may increase risk for being referred to CPS, but treatment for substance use does not increase the risk for referral.

Gainey RR; Haggerty KP; Fleming CB; Catalano RF. Teaching parenting skills in a methadone treatment setting. Social Work Research 31(3): 185-190, 2007. (30 refs.)

This article discusses the effects of substance abuse, delinquency, and other problem behaviors on parenting and family. Children of substance abusers represent a high risk population. Prenatal exposure to addictive substances and the medical complications that may arise are important factors in placing this population at high risk of drug abuse and other behavior problems. As children of drug abusers grow older, their lives are often characterized by exposure to continued drug use by family members, chronic illnesses, financial troubles, legal conflicts and family disorganization.

Gerra G; Leonardi C; Cortese E; Zaimovic A; Dell'Agnello G; Manfredini M et al. Adrenocorticotropic hormone and cortisol plasma levels directly correlate with childhood neglect and depression measures in addicted patients. Addiction Biology 13(1): 95-104, 2008. (53 refs.)

Hypothalamic-pituitary-adrenal (HPA) axis dysfunction has been reported to be involved in vulnerability to alcohol and drug dependence in humans, possibly underlying both addictive behaviour and depression susceptibility. The aim of the present study was to investigate the possible interactions between childhood adverse experiences, depressive symptoms and HPA axis function in addicted patients, in comparison with healthy control. Eighty-two abstinent heroin or cocaine dependent patients and 44 normal controls, matched for age and sex, completed the symptoms Check List-90 (SCL-90), measuring depressive symptoms, and the Childhood Experience of Care and Abuse Questionnaire. Blood samples were collected to determine adrenocorticotropic hormone (ACTH) and cortisol basal plasma levels at 8:00 and 8:30 a.m. Addicted individuals showed significantly higher neglect and depression scores and ACTH-cortisol plasma levels respect to control subjects. Depression scores at SCL-90 in addicted patients positively correlated with plasma ACTH and cortisol values. In turn, plasma ACTH levels were directly associated with childhood neglect measures, reaching statistical significance with 'mother-neglect' scores. Plasma cortisol levels were related to 'father antipathy' among cocaine addicts. These findings suggest the possibility that childhood experience of neglect and poor parent-child attachment may have a persistent effect on HPA axis function as an adult, partially contributing, together with genetic factors and other environmental conditions, to both depressive traits and substance abuse neurobiological vulnerability.

Huver RME; Engels RCME; Vermulst AA; de Vries H. Is parenting style a context for smoking-specific parenting practices? Drug and Alcohol Dependence 89(2/3): 116-125, 2007. (74 refs.)

This study examined whether global parenting style can be regarded as a context in which smoking-specific parenting practices relate to adolescent smoking cognitions and behaviors. Data were gathered through self-administered questionnaires from 482 adolescents aged 12-19 years, who participated in the Study of Medical Information and Lifestyles in Eindhoven (SMILE). We assessed parenting style dimensions (support, strict control, psychological control), smoking-specific parenting practices (parent-child communication about smoking, anti-smoking house rules, availability of tobacco products, non-smoking agreement), smoking-related cognitions according to the I-Change Model (attitude, social norm, self-efficacy, intention), and smoking behavior. Structural equation models were computed and compared for adolescents in different parenting climates. Results showed that communication and availability were related to adolescents' attitude towards smoking. Availability was additionally associated with reduced self-efficacy to refrain from smoking. Attitude and self-efficacy were subsequently related to intention to smoke, which in turn was related to smoking behavior. No direct relations were found between anti-smoking parenting practices and adolescent smoking behavior. These results were not dependent on the parenting climate. Parenting style thus did not serve as a context for smoking-specific parenting practices, indicating that these facets of parenting operate independently, and that anti-smoking parenting practices may be effective regardless of parenting climate.

Jacobs-van der Bruggen MAM; Wijga AH; Brunekreef B; de Jongste JC; Baan CA; Kerkhof M et al. Do parents who smoke underutilize health care services for their children? A cross sectional study within the longitudinal PIAMA study. BMC Health Services Research 7: article 83, 2007. (26 refs.)

Background: A higher prevalence of respiratory symptoms and an associated increase in health care utilization among children with parents who smoke is to be expected. From previous studies however, it appears that parents who smoke may underutilize health services for their children, especially with respect to respiratory care. This study explores the validity and generalizability of the previous assumption. Methods: Data were obtained from a Dutch birth-cohort study; the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) project. Information regarding parental smoking, the child's respiratory symptoms and health care use and potential confounders were obtained by postal questionnaires. Multivariate logistic models were used to relate parental smoking to the child's respiratory symptoms and health care use. Results: The study comprised 3,564, 4-year old children. In the crude analysis, respiratory symptoms were more frequent among children with a parent who smoked, while health care utilization for respiratory symptoms was not significantly different between children with or without a parent who smoked. In the multivariate analyses, maternal smoking had a larger impact on the child's respiratory symptoms and health care use as compared to paternal smoking. Maternal smoking was positively associated with mild respiratory symptoms of the child, adjusted odds ratio [AOR] 1.50 (1.19-1.91), but not with severe respiratory symptoms AOR 1.03 (0.75-1.40). Among children with mild respiratory symptoms, children with a mother who smoked were less likely to be taken to the general practitioner ( GP) for respiratory symptoms, than children with mothers who did not smoke, AOR 0.58 (0.33-1.01). This finding was less pronounced among children with severe respiratory symptoms AOR 0.86 (0.49-1.52). Neither GP visits for non-respiratory symptoms nor specialized care for respiratory disease were significantly associated with parental smoking. Conclusion: Mothers who smoke appear to underutilize health care for their children with mild respiratory symptoms. Health care workers should be informed about this phenomenon. Inquiring after the respiratory health of the children during regular visits to healthy baby clinics may help to track potential underutilization of care.

Jones AS. Maternal alcohol abuse/dependence, children's behavior problems, and home environment: Estimates from the National Longitudinal Survey of Youth using propensity score matching. Journal of Studies on Alcohol and Drugs 68(2): 266-275, 2007. (65 refs.)

Objective: Propensity score (PS) matching was used to investigate the relationship between maternal alcohol abuse (AA) and alcohol dependence (AD), based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria and three child outcomes: child behavior problems and two characteristics of the child's home environment as measured by the Home Observation and Measurement of the Environment-Short Form, cognitive stimulation and emotional support. Method: A cohort of children (N = 2,193; 49% female) whose mothers were drawn from the 1994 National Longitudinal Survey of Youth were stratified by gender and matched on maternal propensity to exhibit AA or AD. Results: After matching, sons of mothers with AA/ AD had higher behavior problem scores (p <= .05), and daughters of mothers with AA/AD lived in homes with significantly less emotional support (p <= 05) and cognitive stimulation (p :<= .005). Results were robust to alternative specifications of PS regressions. Conclusions: The findings suggest that policies aimed at reducing AA and AD among young adult women with children are justified. PS matched results also suggest that school counselors and mental health providers who encounter young boys with elevated behavior problems should consider maternal AA/AD as one possible causal factor. Future research should be directed toward understanding the trajectory of these outcomes and their sequelae over the child's life cycle and toward developing improved methods of identifying and intervening with at-risk children of both genders and their mothers.

Kandel DB; Hu MC; Griesler PC; Schaffran C. On the development of nicotine dependence in adolescence. (review). Drug and Alcohol Dependence 91(1): 26-39, 2007. (116 refs.)

Little is known about the natural history of drug dependence. This article describes the development and predictors of DSM-IV nicotine dependence in adolescence when tobacco use is initiated. In a two-stage design, a survey was administered to 6th-10th graders in the Chicago Public Schools to select a cohort of adolescents. Household interviews were conducted with adolescents five times and with one parent (predominantly mothers, three times over 1 years, The analytical sample includes 353 youths, who started using tobacco within 11 months preceding Wave I or between Waves 1-5. Survival analysis estimated latency to individual DSM-IV nicotine dependence criteria and the full dependence syndrome. Twenty-five percent of youths experienced the syndrome within 23 months of tobacco use onset. Tolerance, impaired control and withdrawal were experienced most frequently. Youths who developed full dependence experienced their first symptom faster after tobacco use onset than those who experienced only one criterion through the end of the observation period. Cox proportional hazards models estimated the importance of time-constant and time-varying sociodemographic, tobacco and other drug use, parental and peer smoking, social psychological and biological risk factors for experiencing the first criterion and the full syndrome. Pleasant initial sensitivity to tobacco and number of cigarettes smoked the prior month predicted both outcomes. Parental dependence predicted the full syndrome. Significant covariates were generally the same across gender and racial/ethnic subgroups. The predictive significance of the initial smoking experience and parental dependence highlight the potential importance of genetic factors in the etiology of nicotine dependence.

Kelley ML; French A; Bountress K; Keefe HA; Schroeder V; Steer K et al. Parentification and family responsibility in the family of origin of adult children of alcoholics. Addictive Behaviors 32(4): 675-685, 2007. (33 refs.)

The present study examined parentification and family responsibility in the families of origin of 103 female college students who met criteria for being Adult Children of Alcoholics (ACOAs) as compared to 233 women who did not. The gender of the parent with an alcohol problem (mother only, father only, both parents, neither) was also examined in relation to family roles. Participants completed the Parentification Questionnaire-Adult (PQ-A; Sessions, M. W, and Jurkovic, G. J. (1986). Parentification Questionnaire-Adult (PQ-A). Unpublished document. Department of Psychology, Georgia State University, Atlanta, GA), the Filial Responsibility Scale-Adult (FRS-A; Jurkovic, G. J., and Thirkield, A. (1999). Filial Responsibility Scale-Adult (FRS-A). Unpublished document. Department of Psychology, Georgia State University, Atlanta, GA), the Children of Alcoholics Screening Test (CAST; Jones, J. W. (1983). The Children of Alcoholics Screening Test: Test manual. Chicago: Camelot), and indicated whether they suspected their mother/father of a drinking problem. ACOAs reported more parentification, instrumental caregiving, emotional caregiving, and past unfairness in their families of origin as compared to non-ACOAs. However, as compared to ACOAs who indicated that their father was the alcohol-abusing parent or non-ACOAs, respondents who thought their mothers had an alcohol problem reported greater past unfairness. In addition, ACOAs who thought their mothers had a problem with alcohol abuse reported more parentification and emotional caretaking than did non-ACOAs.

Kinner SA; Alati R; Najman JM; Williams GM. Do paternal arrest and imprisonment lead to child behaviour problems and substance use? A longitudinal analysis. Journal of Child Psychology and Psychiatry 48(11): 1148-1156, 2007. (39 refs.)

Background: Children of prisoners are at increased risk of impaired health, behavioural problems and substance misuse; however, the causal pathways to these problems are unclear. Under some circumstances, parental imprisonment may result in improved outcomes for the child. This study investigates the impact of paternal arrest and imprisonment on child behaviour and substance use, as a function of child gender, and in the context of known social and familial risk factors. Methods: Longitudinal analysis of an Australian birth cohort (N = 2,399) recruited 1981-83, with child outcomes measured at age 14. Participants were recruited prenatally from a large, public hospital in Brisbane, Australia and followed up in the community. History of paternal arrest and imprisonment were based on maternal self-report, at age 14. Outcome measures included mother- and child-reported internalising and externalising behaviour (CBCL and YSR), and child self-reported alcohol and tobacco use. Results: In univariate analyses, paternal imprisonment was associated with maternal reports of increased child internalising (OR = 1.82, 95%CI 1.08-3.06) and externalising (OR = 2.24, 95%CI 1.41-3.57), and alcohol use (OR = 1.68, 95%CI 1.11-2.53) at age 14. However, controlling for socio-economic status, maternal mental health and substance use, parenting style and family adjustment, these associations became non-significant. For boys only, in the multivariate model paternal arrest but not imprisonment predicted alcohol (OR = 1.79, 95%CI 1.09-2.95) and tobacco (OR = 1.83, 95%CI 1.03-3.25) use at age 14. Conclusions: The association between paternal arrest and imprisonment and adverse outcomes in adolescence is accounted for by well-established social and familial risk factors. Paternal imprisonment may not, in itself, increase the risk for child behaviour and substance use problems.

Komro KA; Maldonado-Molina MM; Tobler AL; Bonds JR; Muller KE. Effects of home access and availability of alcohol on young adolescents' alcohol use. Addiction 102(10): 1597-1608, 2007. (52 refs.)

Aims The purpose of the present study was to examine the effects of parental provision of alcohol and home alcohol accessibility on the trajectories of young adolescent alcohol use and intentions. Design Data were part of a longitudinal study of alcohol use among multi-ethnic urban young adolescents who were assigned randomly to the control group of a prevention trial. Setting Data were collected from a cohort of youth, and their parents, who attended public schools in Chicago, Illinois (2002-2005). Participants: The sample comprised the 1388 students, and their parents, who had been assigned randomly to the control group and were present and completed surveys at baseline, in the beginning of 6th grade (age 12). The sample was primarily low-income, and African American and Hispanic. Measurements: Students completed self-report questionnaires when in the 6th, 7th and 8th grades (age 12-14 years; response rates 91-96%). Parents of the 6th grade students also completed questionnaires (70% response rate). Findings: Student report, at age 12, of parental provision of alcohol and home alcohol availability, and parental report of providing alcohol to their child and the accessibility of alcohol in the home, were associated with significant increases in the trajectories of young adolescent alcohol use and intentions from ages 12-14 years. Student report of receiving alcohol from their parent or taking it from home during their last drinking occasion were the most robust predictors of increases in alcohol use and intentions over time. Conclusion: Results indicate that it is risky for parents to allow children to drink during early adolescence. When these findings are considered together with the risks associated with early onset of alcohol use, it is clear that parents can play an important role in prevention.

Kroll B. A family affair? Kinship care and parental substance misuse: Some dilemmas explored. Child & Family Social Work 12(1): 84-93, 2007. (67 refs.)

Both the Children Act 1989 and the Human Rights Act 1998 support the principle that children should remain within their birth families wherever possible and that this option must be considered when children are unable to live with their parents. Where parental substance misuse is an issue, family placements, whether formally or informally arranged, are increasingly being used and the support of grandparents, in particular, has been identified as a significant protective factor for children. This paper examines some of the issues that can arise with such placements, particularly in view of the part that substance misuse may play within the wider family system, the impact of parental drug and alcohol use on attachment and child development, and the complex dynamics that can ensue. Drawing on themes emerging from parental substance misuse literature and kinship care research, some practice dilemmas will be explored. While acknowledging the complex aetiology of substance misuse and the dangers of pathologizing family systems in which it is found, some hypotheses about potential risks and challenges will be debated. It will be argued that, although such placements can often provide children with a safe haven, they may demand a specic type of support and monitoring, if children's welfare is to be safeguarded.

Kumpfer KL. Why are there no effective child abuse prevention parenting interventions? (editorial). Substance Use & Misuse 43(8-9): 1262-1265, 2008. (9 refs.)

Kumpfer KL; Fowler MA. Parenting skills and family support programs for drug-abusing mothers. Seminars in Fetal & Neonatal Medicine 12(2): 134-142, 2007. (58 refs.)

Children born to drug-using mothers can suffer from fetal alcohol or drug syndrome (FAS/FDS) or fetal alcohol or drug effect (FAE/FDE). Such children have a greater likelihood of developing acute or chronic physical, cognitive and behavioral problems. In-utero exposure to tobacco, alcohol or drugs impact on the developing fetus and, after birth, the family environment and family system exert effects on the infants and children of substance-abusing parents. Evidence-based prevention and maternal drug treatment programs focus on enhancing parental childcaring abilities, supporting parent-child attachment and encouraging family support systems to improve children's health and cognitive outcomes. FAS/FDS prevention programs, as well as selective and indicated prenatal and postnatal interventions, can improve the support given both to mother and to child, and evidence-based, in-home parenting and family-skills-training approaches are particularly useful.

Lam WK; Fals-Stewart W; Kelley ML. Effects of parent skills training with behavioral couples therapy for alcoholism on children: A randomized clinical pilot trial. Addictive Behaviors 33(8): 1076-1080, 2008. (18 refs.)

This pilot study examined preliminary effects of Parent Skills Training with Behavioral Couples Therapy on children's behavioral functioning. Participants were men (N = 30) entering outpatient alcohol treatment, their female partners, and a custodial child between 8 and 12 years of age. Couples were randomly assigned to one of three equally intensive conditions: (a) Parent Skills with Behavioral Couples Therapy (PSBCT), (b) BCT (without parent training), and (c) Individual-Based Treatment (IBT; without couples-based or parent skills interventions). Parents completed measures of child externalizing and internalizing behaviors at pretreatment, posttreatment, 6- and 12-month follow up; children completed self-reports of internalizing symptoms at each assessment. Only PSBCT participants reported significant effects on all child measures throughout the 12-month follow up. PSBCT showed medium to large effects in child functioning relative to IBT, and small to medium effects relative to BCT from baseline through follow up. Effect sizes suggest clinically meaningful differences between PSBCT and both BCT and IBT that warrant further empirical evaluation of BCT with parent training for alcohol-abusing men and their partners.

Lam WKK; Cance JD; Eke AN; Fishbein DH; Hawkins SR; Williams JC. Children of African-American mothers who use crack cocaine: Parenting influences on youth substance use. Journal of Pediatric Psychology 32(8): 877-887, 2007. (52 refs.)

Objective: To examine relationships between parenting behaviors, parent-child relationship, and moderating effects of age on youth substance use among a community sample of African-American mothers who use crack cocaine and their children (12-17 years). Methods: Maternal-child dyads (n=208) were recruited through street outreach and snowball sampling and completed interviews about substance use and parenting. Results: Regression analyses found significant main effects of youth age, family conflict, warmth, and disapproval of youth substance use on children's substance use. Age x Parenting interactions were significant for conflict and disapproval. Higher family conflict increased older youths' risk, while higher perceived maternal disapproval protected against substance use for older youth. Conclusions: Family influences may offer risk and protective effects for adolescent children of maternal drug users. Outreach and family-focused interventions that address family conflict and communication of disapproval of substance use may help reduce intergenerational risk transmission. However, longitudinal research with comprehensive parenting assessments is needed.

Larrieu JA; Heller SS; Smyke AT; Zeanah CH. Predictors of permanent loss of custody for mothers of infants and toddlers in foster care. Infant Mental Health Journal 29(1): 48-60, 2008. (21 refs.)

The maltreating mothers of abused and neglected infants and toddlers were evaluated as part of an intensive intervention program. The purpose of this study was to examine cumulative risk versus specific risk factors that led to permanent loss of custody by mothers, predicated upon decisions by the Juvenile Court with regard to permanency planning. The following risk factors were analyzed as potential predictors of placement outcomes: maternal education, maternal history of abuse as a child, history of psychiatric difficulties, substance-abuse history, conviction history (excluding child-abuse charges), depressive symptomatology, degree of partner violence experienced, and cumulative number of risks the mother experienced. Results indicated that mothers who lost custody had significantly more risk factors than those who were reunified with their children. Cumulative risk was a stronger predictor than specific risk factors. Implications for intervention are discussed.

Latendresse SJ; Rose RJ; Viken RJ; Pulkkinen L; Kaprio J; Dick DM. Parenting mechanisms in links between parents' and adolescents' alcohol use behaviors. Alcoholism: Clinical and Experimental Research 32(2): 322-330, 2008. (59 refs.)

Background: Adolescence has been identified as a critical period with regard to the initiation and early escalation of alcohol use. Moreover, research on familial risk and protective processes provides independent support for multiple domains of parental influence on adolescent drinking; including parents' own drinking behaviors, as well as the practices they employ to socialize their children. Despite this prevalence of findings, whether and how these distinct associations are related to one another is still not entirely clear. Methods: The present study used data from 4,731 adolescents and their parents to test the nature of associations between (a) parents' frequencies of alcohol use and intoxication, and lifetime alcohol-related problems, (b) adolescents' perceptions of the parenting that they receive, and (c) adolescents' prevalence of alcohol use and intoxication at 14 and 171/2 years of age. As such, multiple mediation modeling was used to assess whether parental alcohol use behaviors influence adolescent alcohol use directly, or if they operate through indirect associations with various aspects of parenting that subsequently influence adolescent use. Results: Examination of simple associations demonstrated that maternal and paternal alcohol use behaviors were positively linked with adolescent use behaviors at 14 and 17 1/2 years of age. Likewise, several parenting behaviors were independently associated with both parental and adolescent drinking. Examined collectively, multivariate path analyses indicated that associations between parents' and adolescents' alcohol-related behaviors were mediated, in part, by adolescents' perceptions of the parenting that they received, especially at 14 years of age. Furthermore, perceived parental monitoring and discipline had unique mediating capabilities, net the effects of all other parenting behaviors. Conclusions: This study demonstrates that parenting is an important mediator of the association between parental and adolescent drinking practices. An important area for future research will be to study how adolescents can avoid alcohol-related problems despite being reared within a risk laden parenting environment and/or having parents who drink frequently.

Leder S; Grinstead LN; Torres E. Grandparents raising grandchildren - Stressors, social support, and health outcomes. Journal of Family Nursing 13(3): 333-352, 2007. (59 refs.)

The major purpose of this study was to identify predictors of grandparent care-giver health status. Additional purposes were to describe the physical and emotional health of grandparent caregivers and the perceived benefits of support group attendance. A convenience sample of 42 grandparents was recruited from support groups. Data were collected through telephone interviews. Grandparents who had higher parenting stress reported lower levels of physical, social, and mental health. Inverse correlations were present between life stress and mental health. Positive correlations were found between social support and physical health. No pattern emerged in a comparison of the health of caregiving grandparents and a normative sample. Emotional support was the primary benefit derived from support group attendance. There were modest inverse associations between the length of time the child had lived with the grandparent and six of the eight indicators of grandparent health.

Libby AM; Orton HD; Beals J; Buchwald D; Manson SM. Childhood abuse and later parenting outcomes in two American Indian tribes. Child Abuse & Neglect 32(2): 195-211, 2008. (53 refs.)

Objectives: To examine the relationship of childhood physical and sexual abuse with reported parenting satisfaction and parenting role impairment later in life among American Indians (AIs). Methods: AIs from Southwest and Northern Plains tribes who participated in a large-scale community-based study (n = 3,084) were asked about traumatic events and family history; those with children were asked questions about their parenting experiences. Regression models estimated the relationships between childhood abuse and parenting satisfaction or parenting role impairment, and tested for mediation by depression or substance use disorders. Results: Lifetime substance use disorder fully mediated the relationship between childhood physical abuse and both parenting satisfaction and parenting role impairment in the Northern Plains tribe. There was only partial mediation between childhood sexual abuse and parenting role impairment in the Southwest. In both tribes, lifetime depression did not meet the criteria for mediation of the relationship between childhood abuse and the two parenting outcomes. Instrumental and perceived social support significantly enhanced parenting satisfaction; negative social support reduced satisfaction and increased the likelihood of parenting role impairment. Exposure to parental violence while growing up had deleterious effects on parenting outcomes. Mothers and fathers did not differ significantly in the relation of childhood abuse experience and later parenting outcomes. Conclusions: Strong effects of social support and mediation of substance abuse disorders in the Northern Plains offer direct ways in which childhood victims of abuse could be helped to avoid negative attributes of parenting that could put their own children at risk. Practice implications: Mothers were not significantly different from fathers in the relation of abusive childhood experiences and later parenting outcomes, indicating both are candidates for interventions. Strong effects of social support offer avenues for interventions to parents. The prevalence of substance use disorders and their role as a mediator of two parenting outcomes in the Northern Plains should focus special attention on substance use treatment, especially among those who experienced childhood victimization. These factors offer direct ways in which childhood victims of abuse can be helped to avoid negative attributes of parenting that could put their own children at risk of violence.

Luthar SS; Sexton CC. Maternal drug abuse versus maternal depression: Vulnerability and resilience among school-age and adolescent offspring. Development and Psychopathology 19(1): 205-225, 2007. (66 refs.)

In this study of 360 low-income mother-child dyads, our primary goal was to disentangle risks linked with commonly co-occurring maternal diagnoses: substance abuse and affective/anxiety disorders. Variable- and person-based analyses suggest that, at least through children's early adolescence, maternal drug use is no more inimical for them than is maternal depression. A second goal was to illuminate vulnerability and protective processes linked with mothers' everyday functioning, and results showed that negative parenting behaviors were linked with multiple adverse child outcomes. Conversely, the other parenting dimensions showed more domain specificity; parenting stress was linked with children's lifetime diagnoses, and limit setting and closeness with children's externalizing problems and everyday competence, respectively. Results are discussed in terms of implications for resilience theory, interventions, and social policy.

Luthar SS; Suchman NE; Altomare M. Relational Psychotherapy Mothers' Group: A randomized clinical trial for substance abusing mothers. Development and Psychopathology 19(1): 243-261, 2007. (69 refs.)

The purpose of this study was to ascertain the effectiveness of the Relational Psychotherapy Mothers' Group (RPMG), a supportive parenting group intervention for substance abusing women. Sixty mothers receiving RPMG were compared to 67 women receiving recovery training (RT); both treatments supplemented treatment in the methadone clinics. At the end of the 6-month treatment period, RPMG mothers showed marginally significant improvement on child maltreatment (self-reported) and cocaine abuse based on urinalyses when compared with RT mothers; notably, children of RPMG mothers reported significantly greater improvement in emotional adjustment and depression than children of RT mothers. At 6 months follow-up, however, treatment gains were no longer apparent. Overall, the findings suggest that whereas supportive parenting interventions for substance abusing women do have some preventive potential, abrupt cessation of the therapeutic program could have deleterious consequences.

Luther EJ; Parzynski CS; Jaszyna-Gasior M; Bagot KS; Royo MB; Leff MK et al. Does allowing adolescents to smoke at home affect their consumption and dependence? Addictive Behaviors 33(6): 836-840, 2008. (13 refs.)

Negative parental attitudes towards smoking decrease adolescent smoking initiation but limited research explores the relationship between parental attitudes and degree of adolescent smoking among established smokers. The aim of this study was to examine the relationship between parental allowance of smoking in the home and adolescent smoking behavior and level of dependence. Interviews from 408 youths seeking assistance to quit smoking showed that adolescents who were allowed to smoke at home smoked more cigarettes per day and had higher scores on the Fagerstrom Test of Nicotine Dependence than those not allowed to smoke at home. Studies that additionally evaluate parental smoking status and the temporal relationship of parental allowance of smoking with changes in adolescent smoking behavior are warranted to clarify public health implications of parental smoking interdictions.

Marques PR; Pokorni JL; Long T; Teti LO. Maternal depression and cognitive features of 9-year-old children prenatally-exposed to cocaine. American Journal of Drug and Alcohol Abuse 33(1): 45-61, 2007. (22 refs.)

This study evaluated cocaine exposure and maternal characteristics as competing predictors of school-age cognitive, achievement, and language performance. One group of 47 exposed 9-year-old children were first studied in an earlier prenatal study. A non-exposed contrast group (n = 46) served as a reference. Maternal measures included: IQ, psychopathology, drugs, demographics, and environment. Child intelligence, language, and achievement scores were inversely related to maternal IQ and depression scores, with cocaine exposure significant secondary or tertiary predictors for many children. Verbal IQ scores of exposed children strongly reflected maternal depression (r = .54) but no such relationship was found among the non-exposed cohort (r = .00).

Martins SS; Storr CL; Alexandre PK; Chilcoat HD. Adolescent ecstasy and other drug use in the National Survey of Parents and Youth: The role of sensation-seeking, parental monitoring and peer's drug use. Addictive Behaviors 33(7): 919-933, 2008. (60 refs.)

The association between high sensation-seeking, close friends' drug use and low parental monitoring with ecstasy (MDMA) use in adolescence was examined in a sample of US household-dwelling adolescents aged 12 - 18 years (N=5049). We also tested whether associations were of stronger magnitude than associations between these correlates and marijuana or alcohol/tobacco use in adolescence. Data from Round 2 of the National Survey of Parents and Youth (NSPY) Restricted Use Files (RUF) was analyzed via Jackknife weighted multinomial logistic regression models. High sensation-seekers were more likely to be ecstasy, marijuana, and alcohol/tobacco users, respectively, as compared to low sensation-seekers. High sensation-seeking and close friends' drug use were more strongly associated with ecstasy as compared to marijuana and alcohol/tobacco use. Low parental monitoring was associated with marijuana use and alcohol/tobacco use and there was a trend for it to be associated with ecstasy use. Ecstasy use is strongly associated with peer drug use and more modestly associated with high sensation-seeking. School prevention programs should target high-sensation-seeking adolescents and also encourage them to affiliate with non-drug using peers.

McMahon TJ; Winkel JD; Rounsaville BJ. Drug abuse and responsible fathering: A comparative study of men enrolled in methadone maintenance treatment. Addiction 103(2): 269-283, 2008. (62 refs.)

Aim Because very little is known about the parenting of drug-abusing men, this study was designed to document ways that drug abuse contributes to compromise of responsible fathering. Design, setting, participants Generalized linear models and data representing different dimensions of responsible fathering were used to clarify ways that the fathering of 106 men receiving methadone maintenance treatment differed from that of 118 men living in the same community with no history of alcohol or drug abuse. Measurement Men who enrolled in the study completed two structured interviews and a battery of five self-report measures selected to document current and historical dimensions of responsible fathering. Findings When the opioid-dependent fathers were compared to the other fathers, there were significant differences in: (i) economic resources to support family formation; (ii) patterns of pair-bonding; (iii) patterns of procreation; and (iv) parenting behavior. When fathering of the youngest biological child was examined, the opioid-dependent fathers confirmed few differences in historical dimensions of fathering, but they reported significant differences in current dimensions reflecting: (i) constricted personal definitions of the fathering role; (ii) poorer relationships with biological mothers; (iii) less frequent residence with the child; (iv) less frequent provision of financial support; (v) less involvement in positive parenting; (vi) poorer appraisal of self as a father; and (vii) less satisfaction as a father. Conclusions: The findings highlight ways that drug abuse contributes to compromise of responsible fathering, and they raise questions about ways that the drug abuse treatment system might better address parenting as a treatment issue for men.

Mena MP; Mitrani VB; Muir JA; Santisteban DA. Extended parent-child separations: Impact on substance-abusing Hispanic adolescents. Journal for Specialists in Pediatric Nursing 13(1): 50-52, 2008. (8 refs.)

Extended parent-child separations, which can take many different forms and occur for different reasons, have the potential to be disruptive to healthy family processes such as attachment and to healthy adolescent functioning. Two types of separations are most prominent in substance-abusing Hispanic adolescents and their families. The first commonly seen type in immigrant Hispanic families is family separations that occur when family members, specifically mothers and children, immigrate separately to the United States. The second type-namely, non-immigration-related separations-can occur because parents are unable to care for the children due to their own financial, mental health, or substance abuse issues; the child's behavioral problems are beyond the parents' control, requiring a new context such as extended family or a residential setting for drug use; or other family circumstances such as divorce and death. Because Hispanic family systems tend to have close extended networks, it is not unusual for extended family members to be available to serve as parental surrogates. This is a strength, insofar as it allows for support and accommodation in times of family crisis. At times, however, there may be negative repercussions resulting from parent-child separations. This column explores some of the clinical characteristics that appear to be associated with these separations and to discuss some of the important clinical implications for nurses as well as other healthcare disciplines.

Mezzich AC; Tarter RE; Kirisci L; Feske U; Day BS; Gao Z. Reciprocal influence of parent discipline and child's behavior on risk for substance use disorder: A nine-year prospective study. American Journal of Drug and Alcohol Abuse 33(6): 851-867, 2007. (78 refs.)

Aim: This study aimed at determining the association of father's and mother's (parental) substance use disorder (SUD) and discipline styles and son's neurobehavior disinhibition (ND) with son's SUD from childhood (age 10-12) to young adulthood ( age 19). It was hypothesized that (1) parental discipline styles and son's ND mediate the association between parental SUD and son's SUD, ( 2) son's ND mediates the association between parental discipline styles and son's SUD, and ( 3) parental discipline styles mediate the association between ND and SUD in the son. Methods: Two-hundred-sixty-three families including a 10-12 year-old son and both parents participated in the study. Results: ( 1) mother's discipline styles predicted father's discipline styles, ( 2) son's ND predicted mother's instilling guilt positively and father's punishment negatively, ( 3) son's ND mediated the association between father's SUD and punishment and son's SUD, and ( 4) mother's SUD predicted son's ND and SUD. Conclusions: The reciprocal prediction between son's ND and father's punishment and prediction of father's punishment by mother's punishment point to the need for family-based interventions that take into account the quality of specific dyadic interactions pertaining to discipline behaviors that amplify the risk for SUD in male children.

Mogro-Wilson C. The influence of parental warmth and control on Latino adolescent alcohol use. Hospanic Journal of Behavioral Sciences 30(1): 89-105, 2008. (36 refs.)

Latino adolescent alcohol use is related to substance use, later life addiction, and other negative outcomes. The lack of knowledge on parenting and the parent-youth relationship in Latino families in the context of acculturation and its affects on alcohol use prompted this study. Secondary data analysis using the Add Health data set indicates that high amounts of parental control function positively for Latino families, contrary to some findings for non-Latinos. In addition, parental warmth significantly reduced alcohol use and also positively affected the parent-youth relationship which decreased alcohol use. When families spoke English at home, parental control decreased which lead to an increase in alcohol use. A critical examination of the implications for the cultural understanding of parental influences on adolescent alcohol use is discussed. Findings indicate that there are unique family mechanisms for Latino families that should be considered when developing intervention options.

Nuno-Gutierrez BL; Alvarez-Nemegyei J; Rodriguez-Cerda O. Social representations used by the parents of Mexican adolescent drug users under treatment to explain their children's drug use: Gender differences in parental narratives. Adolescence 43(170): 351-371, 2008. (41 refs.)

The aim of this study was to explore the social representations used by the parents of adolescent drug users to explain the onset of drug use. Differences in explanations between the parents of male and female adolescents were also explored. Sixty parents who accompanied their children to four rehabilitation centers in 2004 completed two semi-structured questionnaires. In addition, indepth interviews were applied to a subsample. The explanation of the drug use was carried out through two social representations: the neglectful family and the son or daughter as an inexperienced teen. The parents-son model was well structured; however, the parents-daughter was unstructured, which suggests a higher resonance in the familial group.

Ohannessian CM; Hesselbrock VM. Do personality characteristics and risk taking mediate the relationship between paternal substance dependence and adolescent substance use? Addictive Behaviors 32(9): 1852-1862, 2007. (40 refs.)

This longitudinal study examined whether adolescent personality characteristics and risk taking mediate the relationship between paternal substance dependence and adolescent substance use. At Time 1, the sample included 249 15-19 year-old adolescents and their fathers. These individuals also were assessed 5 years later (Time 2). Results indicated that paternal substance dependence directly and indirectly (via personality and risk taking) predicted adolescent substance use. Paternal substance dependence had significant direct effects on age when the adolescent first used marijuana and significant indirect effects on age when regular drinking began, age when first used marijuana, and frequency of drinking to get "high" or "drunk." All of the indirect personality effects were via adolescent disinhibition. In addition, adolescent risk taking further mediated personality and adolescent substance use. Results from this study are discussed in relation to an epigenetic perspective of human development.

Patock-Peckham JA; Morgan-Lopez AA. College drinking behaviors: Mediational links between parenting styles, parental bonds, depression, and alcohol problems. Psychology of Addictive Behaviors 21(3): 297-306, 2007. (83 refs.)

Mediational links between parenting styles (authoritative, authoritarian, permissive), parental bond (positive, negative), depression, alcohol use and abuse were tested. A 2-group, multiple-indicator, multiple-cause structural equation model with 441 (216 female, 225 male) college students was examined. In general, a poor parental bond with one's father was highly predictive of depression, a well-known predictor of alcohol abuse and related problems for both genders. In contrast, a positive parental bond with one's father significantly mediated the positive effects of authoritative fathering on depression, which then decreased alcohol use problems for both genders. For women, a negative parental bond with one's father significantly mediated the effect of having an authoritarian father on depression, which increased alcohol use problems. These findings suggest that parental influences on pathways to alcohol abuse through depression (primarily through fathers for both genders) are distinct from pathways stemming from poor impulse control (with influences primarily from the same-sex parents for both genders).

Pears K; Capaldi DM; Owen LD. Substance use risk across three generations: The roles of parent discipline practices and inhibitory control. Psychology of Addictive Behaviors 21(3): 373-386, 2007. (71 refs.)

This study used 3 generations and 21 years of prospective data to test models of intergenerational transmission of substance use and substance use risk. Thus, the study extends prior studies in the field that have focused predominantly on substance abuse. The association between the grandparental generation's (G1 mother and father) and the parental generation's (G2 father) alcohol use and illicit drug use was hypothesized to be mediated by G2's poor inhibitory control. Additionally, G1's poor discipline of G2 was hypothesized to be directly associated with G2's substance use as well as to partially mediate the association between G1's substance use and G2's inhibitory control. In turn, G2's substance use in late adolescence was expected to be associated with its offspring's (G3) poor inhibitory control at age 3 years. Findings partially supported the predictions and varied by substance. For alcohol use, only cross-generational associations in use were found. For illicit drugs, both poor inhibitory control and poor discipline played some mediational role in cross-generational use.

Petrie J; Bunn F; Byrne G. Parenting programmes for preventing tobacco, alcohol or drugs misuse in children under 18: A systematic review. Health Education Research 22(2): 177-191, 2007. (37 refs.)

We conducted a systematic review of controlled studies of parenting programmes to prevent tobacco, alcohol or drug abuse in children < 18. We searched Cochrane Central Register of Controlled Trials, specialized Register of Cochrane Drugs and Alcohol Group, Pub Medicine, psych INFO, CINALH and SIGLE. Two reviewers independently screened studies, extracted data and assessed study quality. Data were collected on actual or intended use of tobacco, alcohol or drugs by child, and associated risk or antecedent behaviours. Due to heterogeneity we did not pool studies in a meta-analysis and instead present a narrative summary of the findings. Twenty studies met our inclusion criteria. Statistically significant self-reported reductions of alcohol use were found in six of 14 studies, of drugs in five of nine studies and tobacco in nine out of 13 studies. Three interventions reported increases of tobacco, drug and alcohol use. We concluded that parenting programmes can be effective in reducing or preventing substance use. The most effective appeared to be those that shared an emphasis on active parental involvement and on developing skills in social competence, self-regulation and parenting. However, more work is needed to investigate further the change processes involved in such interventions and their long-term effectiveness.

Pirsaraee HY. When parents use drugs: Key findings from qualitative research on parenting and children in Iran. Child & Family Social Work 12(2): 113-122, 2007. (34 refs.)

This paper reports on the finding of a grounded theory study on drug dependency and parenting in Iran. This study is qualitative in nature; data were obtained through semi-structured interviews. The grounded theory method was used to guide the analysis. Interviews with 41 opium- and heroin-dependent parents selected from a treatment centre in Rasht, Iran provided detailed information on the impact of drug dependency on parenting. The study focused on drug dependency and parenting and explored the links between them in order to understand the impact of drug dependency on parental duties and responsibilities. The findings showed that parental drug dependency affects various aspects of parenting, including children's material needs and basic requirements; parent-child relationships; parent-child communication; and the disciplinary strategies of parents. The results showed that children's material needs and basic requirements may be overshadowed by parents' drug dependency. It was also discovered that abuse of children by drug-dependent parents was manifested in three major forms. This study also found that the bonds within families of drug-dependent parents tended to weaken and that control over children almost disappeared in many cases. Intervention and prevention programmes should be offered to the children of drug-dependent parents.

Rangarajan S. Mediators and moderators of parental alcoholism effects on offspring self-esteem. Alcohol and Alcoholism 43(4): 481-491, 2008. (62 refs.)

Aims: The goal of the proposed study was fourfold: (i) to examine the effects of parental alcoholism on adult offspring's self-esteem; (ii) to identify and test possible mediators and moderators of parental alcoholism effects on the self-esteem of adult offspring; (iii) to examine the utility and relevance of attachment theory (Bowlby J. (1969) Attachment and Loss: Vol. 1. Attachment. New York: Basic Books) in explaining parental alcoholism effects on self-esteem and (iv) to address some of the methodological limitations identified in past research on adult children of alcoholics (ACOA). Methods: Participants (N = 515) completed retrospective reports of parental alcoholism, family stressors, family communication patterns, parental attachment and a current measure of self-esteem. Results: The results showed support for the detrimental effects of parental alcoholism on offspring self-esteem and offered partial support for family stressors as a mediator of parental alcoholism effects on parental attachment and parental attachment as a mediator of parental alcoholism effects on offspring self-esteem, respectively. Finally, support was found for family communication patterns as a moderator of the effects of family stressors on attachment. Conclusions: The study findings offer preliminary support for the utility of attachment theory in explicating parental alcoholism effects on the self-esteem of adult offspring. Findings from the present study make salient the need to consider factors beyond the identification of parental alcohol abuse when explicating individual differences in offspring self-esteem in adulthood. The identification of protective and risk factors can contribute to the development of optimal intervention strategies to help ACOAs better than simply the knowledge of family drinking patterns.

Reboussin BA; Hubbard S; Ialongo NS. Marijuana use patterns among African-American middle-school students: A longitudinal latent class regression analysis. Drug and Alcohol Dependence 90(1): 12-24, 2007. (76 refs.)

The aim of this paper was to describe patterns of marijuana involvement during the middle-school years from the first chance to try marijuana down through the early stages of experiencing health and social problems from marijuana use in a sample of African-American adolescents. A total of 488 urban-dwelling African-American middle-school students were interviewed in sixth, seventh and eighth grades as part of a longitudinal field study. Longitudinal latent class models were used to identify subgroups (classes) of adolescents with similar patterns of marijuana involvement. Three classes were identified; little or no involvement (prevalence 85%, 71%, 55% in sixth, seventh and eighth grade, respectively), marijuana exposure opportunity (12%, 19% and 26%), and marijuana use and problems (2%, 9% and 19%). High levels of aggressive/disruptive behavior exhibited as early as first grade and moderate to high levels of deviant peer affiliation were associated with an increased risk of marijuana exposure opportunities in middle-school. Moderate to high levels of aggressive/disruptive behavior and deviant peer affiliation, moderate to low levels of parent monitoring and high levels of perceived neighborhood disadvantage were associated with an increased risk of marijuana use and problems. Significant interactions with grade provided evidence that the influences of parent monitoring and neighborhood disadvantage decrease through the middle-school years. Although not statistically significant, the magnitude of the effects of deviant peer affiliation on marijuana use and problems increased two-fold from sixth to eighth grade. These findings highlight the importance of marijuana exposure opportunities in the pathway to marijuana use and problems and the potential to intervene on behaviors exhibited as early as first grade. It also underscores the importance of developing interventions that are sensitive to the strong influence of parents at entry into middle-school and the shift to peer influences by the end of middle-school.

Rojas NL; Sherrit L; Harris S; Knight JR. The role of parental consent in adolescent substance use research. Journal of Adolescent Health 42(2): 192-197, 2008. (33 refs.)

Purpose: The objective of our study was to assess the effects of requiring parental consent upon study participation and self-reported substance-related problems among 14-18-year-olds. Methods: This was a secondary analysis of combined data from two similar studies of adolescent substance use that recruited participants from the same adolescent clinic at Children's Hospital Boston. Study I waived parental consent, whereas Study 2 required parental consent. The combined dataset included demographic characteristics and Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) study screening test responses. The CRAFFT is an orally administered screen that yields a score from 0-6 and that has been shown to be a valid and reliable measure of risk for substance-related problems. Results: The participation refusal rate in Study 1, where consent was waived, was 19.7% (132 of 670 eligible individuals) and in Study 2 (243 of 411 eligible individuals), where consent was required, it was 59.1% (p <.0001). Participants did not differ significantly with respect to gender and age but did differ by self-identified race/ethnicity between the two studies. Because the CRAFFT score distributions were highly skewed, we used the nonparametric Mann-Whitney U test for differences in mean rank. The mean rank in Study I was significantly higher than in Study 2 (mean rank 362 vs. 325, p =.02). After controlling for age, gender, and race/ethnicity, the adjusted proportional odds ratio for a one-point increase in CRAFFT score was 1.47 (CI 1.03, 2.10) for Study 1 compared with Study 2. Conclusions: The research requirement of parental consent may result in substantial self-selection bias towards a lower risk sample.

Ryan LG; Miller-Loessi K; Nieri T. Relationships with adults as predictors of substance use, gang involvement, and threats to safety among disadvantaged urban high-school adolescents. Journal of Community Psychology 35(8): 1053-1071, 2007. (65 refs.)

Using a resilience framework, the authors examined the protective effects of parental support, self-disclosure to parents, parent-initiated monitoring of adolescent behavior, and relationships with school personnel on three critical problems of adolescents: substance use, gang involvement, and perceived threats to safety at school. The sample consisted of 342 ethnically diverse high-school students in an economically disadvantaged urban area in the southwestern United States. The regression analyses controlled for academic performance, poor anger management, 'risk-seeking propensities, co-occurring substance use, and co-occurring gang involvement. Interactions as well as main effects were examined. The specific protective roles of all four adult relationships were identified with respect to problematic outcomes. Adolescent self-disclosure to parents, a variable rarely examined in resilience research, was associated with less chance of substance use for two high-risk groups: those already involved with gangs, and those with high risk-seeking tendencies.

Schuetze P; Eiden RD. The association between prenatal exposure to cigarettes and infant and maternal negative affect. Infant Behavior & Development 30(3): 387-398, 2007. (70 refs.)

This study examined the association between prenatal exposure to cigarettes and infant and maternal negative affect. Participants were 115 mother-infant dyads (69 prenatally exposed to cigarettes and 46 nonexposed). Infant and maternal negative affect were both assessed during the neonatal period (2-4 weeks of age) and again at 7 months of infant age. Results indicated that only prenatal exposure to cigarettes predicted infant negative affect. Infants who were prenatally exposed to more cigarettes had higher levels of negative affect at both time points. Furthermore, regression analyses indicated that both infant and maternal negative affect during the neonatal period predicted maternal negative affect at 7 months of age. These results highlight the importance of considering the reciprocal relationship between infant and maternal behavior when examining developmental outcomes among infants prenatally exposed to cigarettes.

Simons-Morton B. Social influences on adolescent substance use. American Journal of Health Behavior 31(6): 672-684, 2007. (45 refs.)

Objectives: To assess the over-time relationships between adolescent and peer substance use and parenting practices. Methods: Five times from sixth to ninth grade, students (n=2453) in 7 middle schools reported smoking, drinking, and marijuana use; the number of substance-using friends; and parent practices. Relationships were assessed using latent growth curve modeling. Results: Adolescent substance use predicted the growth in substance-using friends, and substance-using friends predicted adolescent use, except for smoking. The negative over-time relationship between parenting practices and adolescent substance use was mediated by tine growth in the number of substance-using friends. Conclusions: The results are consistent with both selection and socialization effects and provide evidence of the protective effects of positive parenting practices.

Spijkerman R; van den Eijnden RJJM; Huiberts A. Socioeconomic differences in alcohol-specific parenting practices and adolescents' drinking patterns. European Addiction Research 14(1): 26-37, 2008. (46 refs.)

The aim of this study was to investigate to what extent alcohol-specific parenting practices relate to adolescents' alcohol use, binge drinking, and alcohol-related problems, and whether these associations are moderated by socioeconomic status (SES), i.e. parents' education level and family income. The present data were collected within the framework of a representative study on alcohol use among Dutch students. The present findings are based on data from respondents who had been drinking in the past year (81.5%), and of whom one of the parents had filled out a short questionnaire including SES characteristics (52%). The sample consisted of 1,344 adolescents. Adolescents were approached in a school setting; parents received a short questionnaire at the home address. The results show that applying strict rules about alcohol use and having qualitative good conversations about drinking alcohol seem to prevent adolescents from heavy drinking patterns, whereas parental alcohol use seems to promote adolescents' drinking. A positive association was found between frequency of alcohol communication and availability of alcohol at home on the one hand and adolescents' drinking on the other. Some moderating effects of SES were found.

Stewart D; Gossop M; Trakada K. Drug dependent parents: Childcare responsibilities, involvement with treatment services, and treatment outcomes. Addictive Behaviors 32(8): 1657-1668, 2007. (44 refs.)

Relatively little is known about the treatment of drug dependent parents. This study of drug misusers (n= 1075) investigates the involvement of parents with treatment services, childcare arrangements before and during treatment, and outcomes at 1-year follow up. Almost half the sample (46%) were parents. Women were more likely to be responsible for the care of children. Parents, and especially women, who looked after children, were less likely to receive residential treatment. Illicit drug use and psychiatric symptoms were reduced at I year. Outcomes did not differ by gender or parenting status, but there was an interaction effect for psychiatric symptoms: for women, looking after children during treatment was associated with less improvement in psychiatric symptoms at follow up. Such women face special difficulties in access to services and would benefit if treatment services were able to offer improved access and childcare support.

Suchman N; DeCoste C; Castiglioni N; Legow N; Mayes L. The mothers and toddlers program. Psychoanalytic Psychology 25(3): 499-517, 2008. (37 refs.)

The authors examined pilot data from an attachment-based parenting intervention for substance-abusing mothers of toddlers (ages 12-36 months). The Mothers and Toddlers Program (MTP) is a 20-week individual therapy intervention that aims to help mothers develop more balanced representations of their children and improve their capacity for reflective functioning (i.e., recognition of the intentional nature of children's behavior). The authors hypothesized that improvement in maternal representational balance and maternal capacity for reflective functioning would correspond with improvements in maternal behavior with toddlers (e.g., sensitivity to cues, responsiveness to distress, and social-emotional growth fostering) and reduction in maternal psychiatric distress and substance abuse. Eight mothers who completed MTP showed moderate improvements in representational balance and reflective functioning, and these changes corresponded with significant improvements in maternal behaviors with toddlers. The authors also compared MTP completers and noncompleters on sociodemographic and psychosocial indexes and examined the validity of the intervention's proposed mechanisms of change. Preliminary findings support the importance of attachment mechanisms and indicate that attachment-based interventions may strengthen substance-abusing mothers' capacities to foster their toddlers' socioemotional development.

Suchman NE; Rounsaville B; DeCoste C; Luthar S. Parental control, parental warmth, and psychosocial adjustment in a sample of substance-abusing mothers and their school-aged and adolescent children. Journal of Substance Abuse Treatment 32(1): 1-10, 2007. (37 refs.)

Parenting interventions for substance-abusing adults have been broadly based on two approaches, one emphasizing parental control as a means to managing children's behavior and the second emphasizing parental warmth and sensitivity as means to fostering children's psychological development. In this investigation, we examined associations of parental control and parental warmth, respectively, with children's behavioral and psychological adjustment in a sample of 98 women enrolled in methadone maintenance and their school-aged and adolescent children. Using collateral data collected during the baseline phase of a randomized clinical trial (Luthar, S. S., Suchman, N. E., & Altomare, M. [in press). Relational Psychotherapy Mothers Group: A randomized clinical trial for substance abusing mothers [in preparation]), we tested predictions that (a) parental control would be more strongly associated with children's behavioral adjustment and (b) parental warmth would be more strongly associated with children's psychological adjustment. Both predictions were generally confirmed, although some crossover among parenting and child dimensions was also evident. Results support the theoretical stance that parental limit setting and autonomy support, as well as nurturance and involvement, are important factors, respectively, in children's behavioral and psychological adjustment.

Sun AP; Freese MP; Fitzgerald M. An exploratory study of drug-exposed infants: Case substantiation and subsequent child maltreatment. Child Welfare 86(3): 33-50, 2007. (23 refs.)

This study explores factors related to drug-exposed infants' case substantiation and subsequent child maltreatment. Child protective services computerized administrative data (from January 1998 to October 2001) were obtained from an urban Nevada county. The data included 457 drug-exposed infant cases. Chi-square, t-test, oneway ANOVA, and logistic regression were used to analyze the data. Results indicate that: (1) drug-exposed infant case substantiation was related to the type of drug exposure and the unit to which the case was assigned, but not to the mother's ethnicity; and (2) subsequent maltreatment among drug-exposed infants was related to the mother's age and prior parental alcohol abuse, but not to the type of drug exposure, nor to the initial drug-exposed infant status of case substantiation. Implications for child welfare practice and research are discussed.

Tragesser SL; Beauvais F; Swaim RC; Edwards RW; Oetting ER. Parental monitoring, peer drug involvement, and marijuana use across three ethnicities. Journal of Cross-Cultural Psychology 38(6): 670-694, 2007. (54 refs.)

The purposes of the present study were to test differences in parental monitoring and marijuana use rates and relationships among constructs across three ethnicities, and to use Structural Equation Modeling (SEM) and Van de Vijver and Leung's Analysis of Variance (ANOVA) technique to test for cultural equivalence and item bias in the measurement of these constructs. Participants included 7,500 Mexican American, African American, and non-Hispanic White 10th-12th graders. African American participants showed higher levels of parental monitoring, lower levels of marijuana use, and a stronger relationship between parental monitoring and peer influence. SEM results indicated lack of cultural equivalence for each latent factor. ANOVA results indicated item bias for specific items. Putative cultural differences in the relations between parental monitoring and peer influence, as well as potential sources of bias in measuring family, peer, and drug involvement factors among participants from different cultural groups are discussed.

Twomey JE. Partners of perinatal substance users: Forgotten, failing, or fit to father? American Journal of Orthopsychiatry 77(4): 563-572, 2007. (66 refs.)

The role fathers play in families affected by perinatal substance use largely has been unexamined. It is difficult to reconcile this peripheral role assigned to the fathers of substance-exposed infants as the importance of fathers in the lives of children and of partners in the lives of substance-using women has become better appreciated. In this article, case presentations of families in which both parents were substance users illustrate the complexities and diverse trajectories of relationships between perinatal substance users and their children's fathers. An examination of families' lives can be used to better understand the challenges they face, stimulate further discussion about how partners of perinatal substance users can be conceptualized as fathers, and consider the impact they have in the lives of their children and their children's mothers. Discussion of case studies can yield increased knowledge about the role of fathers in the lives of families affected by perinatal substance abuse. This will lead to better-informed treatment interventions, research, and public policy.

Wall AE; Kohl PL. Substance use in maltreated youth: Findings from the National Survey of Child and Adolescent Well-Being. Child Maltreatment 12(1): 20-30, 2007. (47 refs.)

The purpose of this study was to describe the characteristics associated with different levels of substance use in a national probability sample of maltreated 11- to 15-year-olds (n = 1, 179). Bivariate (chi-square tests) and multivariate (logistic regression) analyses were used to examine the association of adolescent substance use with demographics, placement type, and youth and family characteristics. Seventy-one percent of youth reported no use, 20% reported low levels of substance use, and approximately 9% reported moderate to high levels of use. Youth substance use was similar across placement types. Conduct problems and low caregiver relatedness were more prevalent for youth reporting higher levels of substance use. High levels of conduct problems increased the odds of substance use, whereas high caregiver monitoring decreased the odds of substance use. Caregiver monitoring may be a key tactic in attempts to reduce the likelihood of substance use in maltreated youth, regardless of placement type.

Walls ML; Whitbeck LB; Hoyt DR; Johnson KD. Early-onset alcohol use among Native American youth: Examining female caretaker influence. Journal of Marriage and the Family 69(2): 451-464, 2007. (58 refs.)

This article investigates the influence of female caretaker substance use on early-onset youth drinking among Native American families in the Northern Midwest. Data include 603 Native American families, with reports from female caretakers and youths aged 10 - 13 years. Two potential caretaker influences are taken into account: adolescent modeling of caretaker behaviors and the effects of caretaker substance abuse on parenting. Results of bivariate and path analysis provide support for the influence of caretaker substance use on adolescent drinking from both perspectives; these effects vary, however, depending on the type or degree of adult substance use, or both.

Wilens TE; Biederman J; Adamson J; Monuteaux M; Henin A; Sgambati S et al. Association of bipolar and substance use disorders in parents of adolescents with bipolar disorder. Biological Psychiatry 62(2): 129-134, 2007. (45 refs.)

Background: We have previously shown that juvenile bipolar disorder (BPD) is a risk for substance use disorders (SUD). Here we examine the expression of both disorders in families of youth with BPD to evaluate the familial risk mechanism. Methods: We studied 108 adolescent BPD probands with 187 parents (34 with SUD and 58 parents) and 96 control probands with 177 parents with structured interviews. We compared the prevalence of BPD and SUD with Cox proportional hazards models with time to onset of BPD or SUD as the dependent variable and proband diagnosis (Control, BPD, or BPD+SUD) as the independent variable. Results: The parents of the proband youth with BPD (without SUD) and BPD+SUD were more likely to develop BPD than the parents of control subjects [omnibus test chi(2) = 10.18, p = .006]; we found no differences between the two bipolar groups. Parents of proband youth with BPD and with BPD+SUD were more likely than relatives of control subjects to develop SUD [omnibus test chi(2) = 14.69, p < .001]; however, we found no differences between the parents of the two proband bipolar groups. Within the parents of proband youth with BPD+SUD, we found higher risk of SUD in parents with BPD than in those without BPD [chi(2) = 8.39, p = .004], although the frequency of BPD was low in this group of parents. Conclusions: Bipolar disorder and SUD are prevalent in the first-degree relatives of adolescents with BPD. Adults with BPD were more likely to manifest SUD with preliminary evidence of BPD and SUD cosegregation.