Child Development, Maternal Stress, Executive Functioning and Reflective Functioning in Mothers with Substance use Disorder

• In Event: 2-039 - New Perspectives on Maternal Drug-use: Risk and Protective Factors for Parenting, Child Development and Interventions

Integrative Statement

Introduction:
There is a consensus that having a substance use disorder (SUD) may adversely affect caregiving capacities (Barrocas, Vieira-Santos, & Paixão, 2016; Siqveland & Moe, 2014; Suchman, McMahon, Slade, & Luthar, 2005), and consequently the development of physical, emotional and cognitive capacities in the child (Salo & Flykt, 2013; Schore, 2015). Parental reflective functioning (PRF) and executive functioning (EF) are both important capacities for sensitive parenting as well as often being impaired in SUD mothers (Gonzalez, 2015; Pajulo, Suchman, Kalland, & Mayes, 2006). SUD mothers with adequate PRF exhibit significantly better EF compared to mothers with negative to low PRF (Håkansson, Söderström, Watten, Skårderud, & Øie, 2017). In addition, mothers with SUD as a group, are shown to exhibit high levels of stress (Kelley, 1998; Nair, Schuler, Black, Kettinger, & Harrington, 2003; Zvolensky & Hogan, 2013). Compromised EF and PRF are both known to be associated with heightened parental stress (Kluwe-Schiavon, Viola, Sanvicente-Vieira, Malloy-Diniz, & Grassi-Oliveira, 2016; Levy & Truman, 2002; Rutherford, Booth, Luyten, Bridgett, & Mayes, 2015; Rutherford, Goldberg, Luyten, Bridgett, & Mayes, 2013; Williams, Suchy, & Rau, 2009). Mothers with SUD may therefore be more vulnerable to parental stress exposure compared to mothers without SUD, which in turn might affect caregiving capacities and accordingly child development.

Aims or Hypotheses:
The aim of this study was to investigate PRF in relation to parental stress and EF components, and whether PRF had a mediating effect between EF and the experience of parental stress. In addition, we aimed to investigate child development in relation to maternal PRF, EF and parental stress.
Study Population: The sample consisted of forty-three Norwegian mother-infant dyads. Mothers (M = 31.0 years, SD 6.4) with a SUD diagnosis and a child under the age of 18 months (M = 8.6 months, SD = 3.8) were recruited during pregnancy or early during the postpartum period.

Methods:
Mothers were tested with the Parenting Stress Index, 3rd ed. to assess for parental stress. A neuropsychological test battery including the Wechsler Adult Intelligence Scale (Wechsler, 2014), and D-KEFS (Delis, Kaplan, & Kramer, 2001) were used to measure EF in the mothers. PRF was measured using the Parent Development Interview (PDI-R2) (Slade, Bernbach, Grienenberger, Levy, & Locker, 2005). In addition, the Ages and Stages questionnaire (Squires, Bricker, & Twombly, 2002) was used to measure child development.

Results and Discussion:
Results revealed that cognitive flexibility contributed uniquely to variance in parental stress. PRF had a full mediating function between EF and parental stress. Preliminary analyses indicate positive associations between emotional, social and cognitive development in the child and maternal PRF and EF and negative associations with parental stress. Our results indicates a possible bi-directional relationship where a well-functioning EF system is a prerequisite for adequate PRF, and that a well-functioning PRF might allow for access of EF resources when a mother is in need for them, particularly during parental stress. Interventions with a dual focus on both EF and PRF could help development of better-customized interventions meeting the unique individual dyadic needs.

Authors

• Ulrika Håkansson, Psychologist
  Presenting Author

• Watten Reidulf, Inland Norway University of Applied Sciences
  Non-Presenting Author

• Kerstin Söderström, Inland Norway University of Applied Sciences
  Non-Presenting Author

• Merete Glenne Øie, University of Oslo
  Non-Presenting Author