Parsing Alcohol-dependent Mothers’ Insensitivity to Child Distress: Longitudinal Links with Children’s Affective and Anxiety Problems

• In Event: Maternal Adversity and Child Psychopathology in the First Years of Life: Parenting Difficulties as Mechanisms

Abstract

Substance-dependent mothers often struggle to sensitively respond to their child’s needs and interests which can increase children’s risk for psychopathology. While this association between maternal addiction and child psychopathology is known, the mechanisms and processes underlying this association remain under-identified. Prior work has examined maternal insensitivity as a broad construct comprised of caregiving behaviors that are ill-attuned to the child’s interests and needs. However, insensitivity can manifest in different ways and each may uniquely impact children’s mental health trajectories. For example, maternal intrusiveness is frequently associated with child anxiety; whereas, maternal disengagement is often linked with child depression. Moreover, maternal insensitivity to children’s distress (e.g. sadness or fearfulness) uniquely impairs children’s emotional development, which can children at risk for future internalizing problems; however, no prior study has examined these links among substance-abusing mothers and their children. In sum, it remains unknown whether specific types of maternal insensitivity to child distress mediate associations between maternal alcohol dependence and child internalizing problems. Thus, our study sought to answer a) if alcohol-dependent mothers display different types of insensitivity to child distress, are they more likely to be emotionally disengaged or intrusive? And b) do distinct types of insensitivity differentially influence children’s development of affective and anxiety problems.

201 mother-child dyads (Mage = 26 months; SD = 1.69) participated in our three-wave longitudinal study with each wave spaced one year apart. Most dyads (56%) identified as Black, followed by those identifying as white (23%), Latinx (11%), multi-racial (7%) and “other” (3%). The average family income was $18,300 per year and most families received public assistance (95%). Mothers reported their depression, PTSD, and alcohol dependence symptoms on the Diagnostic Interview Schedule (Robins et al., 1995). The Strange Situation (Ainsworth & Wittig, 1969) was used to capture children’s distress and maternal insensitivity. Lastly, children’s affective and anxiety problems were obtained using the Caregiver-Teacher Report Form Ages 1 ½-5 (Achenbach, 2000).

Separate structural equation models examined mediational pathways between maternal alcohol dependence, maternal insensitivity, and children’s affective (Figure 1) and anxiety problems (Figure 2). Covariates included children’s baseline distress and gender, mothers’ non-substance-related psychopathology, income, and age. Latent difference score analyses revealed that maternal disengagement, but not intrusiveness, mediated associations between maternal alcohol dependence and child affective problems, 95% CI [.0004, .07] (see Figure 1.). Although maternal alcohol dependence was unassociated with maternal intrusiveness, only intrusiveness to child distress predicted increases in child anxiety problems (see Figure 2).

Findings help elucidate how and why maternal alcohol dependence confers risk for child internalizing problems, specifically that alcohol-dependent mothers may be more emotionally disengaged when responding to children’s distress which may subsequently predict children’s affective problems. Since alcohol dependence often decreases brain reactivity in regions that process emotions, alcohol-dependent mothers may misidentify, misinterpret, and ultimately fail to respond to children’s emotional cues. Consequently, children may become emotionally dysregulated which could elevate their risk for future affective problems. Results highlight the utility of and need for differentiated and contextualized approaches to studying caregiving and child developmental psychopathology in substance-abusing families.

Authors

• Debrielle Teresa Jacques, University of Washington
  Presenting Author

• Melissa L Sturge-Apple, University of Rochester
  Non-Presenting Author

• Patrick Davies, University of Rochester
  Non-Presenting Author

• Dante Cicchetti, University of Minnesota - Twin Cities
  Non-Presenting Author