Childhood Behavior Problems and Parental Drinking, Part 2

by National Institute of Health

(Page 3 of 4)

Studies Involving Undergraduate

Students. Using undergraduate students as subjects, the first study of the series was designed to evaluate the validity of the concept that interactions with deviant children could induce both stress and stress-related alcohol consumption in adults. In that study, both male and female subjects who interacted with deviant children reported considerably elevated levels of subjective distress and consumed significantly more alcohol compared with subjects who interacted with normal children. No significant differences in subjective distress or alcohol consumption existed between male and female subjects interacting with the deviant children. Thus, the study demonstrated that interactions with a deviant child could produce stressinduced drinking in young adults.

Intriguing as these results were, however, they could not be generalized to parents of children with behavior disorders, because the subjects were single undergraduate students who were not parents. The results did illustrate, however, that child behavior could be used to manipulate adult drinking behavior and that interactions with deviant children were potentially stressful, at least in young adults without parenting experience.

Studies Involving Parents of Normal Children.

Using the same study design, Pelham and colleagues replicated these results with a sample of parents of normal children (children with no prior or current behavior problems or psychopathology). The subjects included married mothers and fathers as well as single mothers. The study found that both mothers and fathers were substantially distressed by interacting with deviant children and showed increases in negative affect and self-ratings of how unpleasant the interaction was overall, how unsuccessful they were in the interaction, and how ineffective they were in dealing with the child. Moreover, parents from all three groups who interacted with a deviant child consumed more alcohol than did parents who interacted with a normal child. Interestingly, for both reported subjective distress and drinking behavior, the differences between subjects interacting with deviant and normal children were considerably larger among parents of normal children than among college students in the investigation by Lang and colleagues. These findings indicate that when parents are presented with a stress-inducing factor (an ecologically valid stressor) relevant to their normal life, such as child misbehavior that induces considerable subjective distress, they may engage in increased alcohol consumption (stress-induced drinking).

It is notable that these effects were obtained in a sample of parents of nondeviant children. Thus, the results are consistent with other studies showing that parenting hassles can cause distress even in normal families. Furthermore, because the effects were obtained in both mothers and fathers, the study demonstrated that problematic child behavior can influence drinking behavior regardless of parent gender. Among the mothers studied, interactions with deviant children had the largest impact on single mothers, who have also been shown to be particularly vulnerable to numerous stressors, including parenting difficulties and drinking problems.

Studies Involving Parents of ADHD Children.

To explore the link between alcohol problems and deviant child behavior in parents of children with ADHD, Pelham and colleagues employed the same study design with a sample of parents who had children with an externalizing disorder. Again, the study included single mothers as well as married mothers and fathers to allow analysis of potential differences in drinking behavior as a function of gender and marital status. In addition, after the initial data analysis, the investigators conducted an unplanned analysis using the Michigan Alcoholism Screening Test to determine problematic drinking behavior of the subjects' parents and associated familial risk for drinking problems. This analysis was prompted by considerable research indicating that familial history of alcohol problems may be associated with the effects of stress and alcohol on a person's behavior.

As in the studies by Lang and colleagues and Pelham and colleagues, parents of ADHD children responded with self-ratings of increased distress and negative affect after interactions with the deviant children. The magnitude of the elevations in parent distress was as great as that seen in parents of normal children. Because parents of children with disruptive behavior disorders are exposed to such deviant child behavior on a daily basis, these observations suggest that those parents experience chronic interpersonal stressors. Other studies have indicated that such chronic interpersonal stressors have a greater impact in causing negative mood states (depression) in adults than do onetime (acute) and/or non-interpersonal stressors. Consequently, these findings illustrate the importance of child behavior on parental stress and mood levels.

Despite the increased distress levels, however, parents of ADHD children as a group did not display the stress-induced drinking shown by college students or parents of normal children. Deviant child behavior resulted in elevated drinking levels only when the investigators conducted the subgroup analyses based on family history of alcohol problems. Thus, parents with a positive family history of alcohol problems exhibited higher drinking levels after interacting with deviant children than after interacting with normal children. Conversely, parents without a family history of alcohol problems showed lower drinking levels after interacting with deviant children than after interacting with normal children.

This finding was somewhat surprising, because the investigators had strongly expected parents of ADHD children as a group to exhibit elevated drinking in response to deviant child behavior. The study results suggest, however, that some parents of ADHD children (parents without a family history of alcohol problems) may have developed coping techniques other than drinking (reducing their alcohol consumption or establishing problem-solving strategies) to cope with the stressors associated with raising a child with deviant behavior. Consequently, it is important to measure additional differences among individuals in order to fully explain responses to various types of child behavior.

Notably, the effect of a family history of alcohol problems on drinking levels was comparable for mothers and fathers. Most previous studies had demonstrated an association between a positive family history and alcohol problems in men, whereas the evidence for such an association in women was less convincing. Furthermore, two distinct subgroups of parents, differentiated by their family history of alcoholism, appeared to exist, and they exhibited different coping techniques. Thus, parents with a family history of alcohol problems more commonly used maladaptive, emotion-focused coping techniques (drinking), whereas parents without such a history more commonly used adaptive, problem-focused coping techniques (not drinking). Accordingly, the researchers continued to explore whether these subgroups also existed among mothers of ADHD children.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.