The effects of maternal alcohol use disorders on childhood relationships and mental health

Sibling Experiences of Adverse Childhood Experiences: A Scoping Review

Adverse childhood experiences (ACEs) are traumatic events during childhood known to affect health and well-being across the life span. The detrimental impact ACEs have on children and young people is well-established. It is also known that 85 to 90% of children have at least one sibling. Using this as the foundation for our inquiry, the purpose of this scoping review was to understand what we currently know about the experiences of siblings living with ACEs. Sibling relationships are unique, and for some the most enduring of experiences. These relationships can be thought of as bonds held together by love and warmth; however, they can also provide scope for undesirable outcomes, such as escalation of conflicts and animosities. This scoping review was conducted following Arksey and O'Malley's (2005) methodological framework, complemented by the PAGER framework (Bradbury-Jones et al. 2021), offering a structured approach to the review's analysis and reporting through presenting the Patterns, Advances, Gaps, and Evidence for practice and Research. In June 2020, we searched 12 databases, with 11,469 results. Articles were screened for eligibility by the review team leaving a total of 148 articles meeting the inclusion criteria. Included articles highlighted overwhelming evidence of older siblings shielding younger siblings, and the likelihood that when one sibling experiences adversity, other siblings will be experiencing it themselves or vicariously. The implications of this in practice are that support services and statutory bodies need to ensure considerations are given to all siblings when one has presented with experiencing childhood adversity, especially to older siblings who may take far more burden as regards care-giving and protection of younger siblings. Given that more than half of the included articles did not offer any theoretical understanding to sibling experiences of ACEs, this area is of importance for future research. Greater attention is also needed for research exploring different types of sibling relationships (full, step, half), and whether these influence the impact that ACEs have on children and young people.

Alcohol use during pregnancy and motherhood: Attitudes and experiences of pregnant women, mothers, and healthcare professionals

Alcohol is the most used substance by women of childbearing age. Alcohol exposed pregnancies can have serious consequences to the fetus, and the UK has one of the highest rates of drinking during pregnancy. Alcohol use during motherhood is also a public health concern, linked with potential harms to the woman and child. This qualitative study investigated the attitudes and experiences of pregnant/parenting women and healthcare professionals regarding maternal drinking. A semi-structured focus group and interviews were conducted in the North West of England with pregnant women, mothers, and healthcare professionals. Quantitative measures captured demographics, alcohol use, and screened for mental ill-health for pregnant women and mothers. Reflexive thematic analysis was used to analyse narratives. Findings revealed that most participants believed avoiding alcohol during pregnancy is the safest option. However, some pregnant women and mothers stated that there was insufficient evidence to demonstrate the harms of low-level drinking and that abstinence guidelines were patronising. All participants reported that low-level drinking during motherhood was acceptable. Heavy drinking was believed to pose serious harm during pregnancy and motherhood to the baby and mother, in addition to damaging relationships. Strong motives were revealed for choosing and avoiding to drink, such as coping with the difficulties of motherhood and parental responsibilities, respectively. Contradictions were found across quantitative and qualitative self-reports of consumption, reflecting potential underreporting of alcohol use. Additionally, drinking levels were discussed in extremes only (low/heavy) without considering 'grey area' drinking. Clear, consistent advice and guidelines are needed to support women in reducing their alcohol use during pregnancy and motherhood. These should include the unique potential risks regarding maternal drinking, and the harm attributable to non-clinically dependent alcohol use. The maternal participants in this study were middle-class, therefore, research is needed to capture the views and experiences of women of all socioeconomic backgrounds.

Inner child of the past: long-term protective role of childhood relationships with mothers and fathers and maternal support for mental health in middle and late adulthood

PURPOSE

National longitudinal studies that investigate the long-term association between early family life and mental health in middle and older adulthood are limited. This study aims to fill the gap by examining the protective effect of positive childhood relationships with mothers and fathers and parental support against depression among women and men in middle and late adulthood.

METHODS

The sample of 12,606 adults (7319 females; 5287 males) from the US Health and Retirement Study was nationally representative with the inclusion of 7 depression measures from 2008 to 2018. Two depression measures, CESD-8 scale and binary indicators of severe depressive symptoms, were used. Generalized estimation equations (GEE)-negative binomial models were estimated for CESD-8 and GEE-logit models were estimated for the binary indicator of severe depression. This study aimed to assess how positive parent-child relationships and maternal support protect the mental health of women and men in adulthood. Other risk and psychosocial factors, such as childhood depression, traumatic life events, stressful life events, marital status, and social support in adulthood were adjusted for.

RESULTS

Positive childhood relationships with mothers, fathers, or both parents and increased maternal support were associated with a lower risk of depression among both females and males from middle to old age, even if they experienced trauma, stressful life events, divorce, singlehood, widowhood, or little social support. Females benefited more psychologically than males from positive mother-daughter relationships and high-quality relationships with both parents. However, compared to mother-child relationships, positive father-child relationships protected men better psychosocially than females.

CONCLUSION

Findings underscore the importance of fathers' roles in promoting their children's, especially sons', emotional well-being. Interventions in early mother-child and father-child relationships and parental support are crucial for healthy aging in mental development.

Kurzzeiteffekte und Akzeptanz einer Intervention für drogenabhängige Eltern: Das „SHIFT PLUS“ Elterntraining

Hintergrund Eltern mit einer Drogenabhängigkeit sind häufig in ihren elterlichen Kompetenzen eingeschränkt. Die Lebenswelt von Kindern, die in suchtbelasteten Familien aufwachsen, ist oft prekär, insbesondere wenn diese von der Drogensubkultur geprägt ist. Gleichzeitig stehen für Mütter und Väter mit Drogenproblemen in Deutschland keine evidenzbasierten, standardisierten Interventionen zur Verfügung.

Methode Mit SHIFT PLUS wurde ein modularisiertes Gruppenprogramm für drogenabhängige Eltern mit Kindern bis 8 Jahren entwickelt, welches ihre Elternkompetenzen und die Familienresilienz stärken sowie ihre Bereitschaft bzw. Fähigkeit zur Abstinenz fördern soll. Das Training basiert auf dem bestehenden „SHIFT“-Elterntraining für Crystal Meth-konsumierende Eltern und wurde für den gesamten Bereich der Abhängigkeit von illegalen Substanzen erweitert sowie um Module für Angehörige ergänzt. Die Umsetzung des Programms erfolgte an acht Praxisstandorten im Bundesgebiet in Kooperation von Sucht- und Jugendhilfeeinrichtungen mit N=87 teilnehmenden Eltern. Zur Evaluation der kurzzeitigen Wirkeffekte wurde ein quasi-experimentelles Forschungsdesign mit Interventions- und Wartekontrollgruppe zu zwei Messzeitpunkten realisiert. Ergänzend wurden Akzeptanz und Praktikabilität durch Teilnehmende und Trainer/innen bewertet.

Ergebnisse Das SHIFT PLUS-Elterntraining zeigte sich als praktikabel und hoch akzeptiert von teilnehmenden Müttern und Vätern, die berichteten familiäre Herausforderungen subjektiv besser bewältigen zu können. Die Wirksamkeitsevaluation zeigte zudem eine signifikante Reduktion depressiver Symptome in der IG sowie einen signifikant besseren Umgang mit dem Thema Sucht in der Familie. Ergänzend verbesserten sich beide Gruppen hinsichtlich psychischer Belastungen, Substanzkonsum und Elternkompetenz.

Schlussfolgerung Die Intervention bietet eine innovative Ergänzung zur evidenzbasierten Unterstützung suchtbelasteter Familien in Deutschland. Sie ermöglicht eine systematische Förderung elterlicher Fähigkeiten und familiärer Resilienz unter Berücksichtigung einer kooperativen Versorgung durch Jugend- und Suchthilfe. Der direkte Einbezug von Angehörigen in das Training gestattet dieser Zielgruppe zudem einen direkten, niedrigschwelligen Zugang zum Hilfesystem.

Maternal alcohol use disorders and depression in emerging adulthood: Examining the relevance of social ties, childhood adversity, and socioeconomic status

A number of recent studies have found that alcohol use disorders (AUDs) among parents are associated with higher levels of depression in their adult children. However, these studies have not considered whether several important social conditions in childhood help explain this association. Using a large sample of young adults from the National Longitudinal Surveys of Youth 1979 Children and Young Adults (NLSY79-CY), this study examines changes in the relationship between maternal AUDs and depression in emerging adulthood after controlling for three clusters of variables related to childhood social ties, adversity, and socioeconomic status. After models adjust for these factors, the association is reduced, but maternal AUDs remain a robust predictor of depression in emerging adulthood. These findings highlight the intergenerational consequences of AUDs and the need to develop interventions that supplement children's social support and economic circumstances.

Gender differences in the transmission of risk for antisocial behavior problems across generations

Previous studies have shown that children of alcohol use disorder (AUD) parents are more likely to develop alcohol problems as well as antisocial and other behavior problems. The purpose of this study was to examine gender discordance in the effect of early maternal and paternal influences on antisocial behaviors of boys and girls, as well as the environmental factors that moderate the parental effects. Specifically, we examined the effects of childhood and adulthood antisocial behavior of the parents on offspring antisocial behavior as young adults. We also examined whether mothers' and fathers' drinking problems when offspring were young children (6-8 years) affected offspring antisocial behavior as young adults (18-21 years). We evaluated 655 children from 339 families in the Michigan Longitudinal Study (MLS), a prospective study of AUD and non-AUD families. Path models were constructed in order to test for the parental contributions to offspring outcomes. We found that both mothers' and fathers' antisocial behavior contributed to the children's young adult antisocial behavior. Only mothers' drinking problems while their children were little had a significant effect on their sons' later drinking, but not on their daughters'. These different parental effects suggest that maternal and paternal influences may be mediated by different mechanisms.