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Mother’s Prenatal Substance Use Disorder, Early Parenting and Child Socioemotional Development at School-age

Fri, March 22, 8:00 to 9:30am, Hilton Baltimore, Floor: Level 1, Johnson B

Integrative Statement

Introduction
Maternal substance use disorder (SUD) during pregnancy indicates severe, cumulative biological and psychosocial risks for healthy child development (Conners et al., 2004). Parenting quality may be an important protective factor for children with substance-exposure (Eiden, 2016). However, there are no previous longitudinal studies in this high-risk population from prenatal period into school-age. Earlier studies on the socioemotional outcomes of these children have concentrated on mental health and substance use problems (e.g., Lester et al., 2012; Ranta & Raitasalo, 2015). Deficits in social cognition as well as traumatic attachment histories may underlie these two risks (Bora & Zorlu, 2016, Mason et al., 2016; Venta et al. 2017); however, no previous studies have examined them or their developmental antecedents in school-age children of SUD mothers.

Hypotheses
We hypothesize that children of mothers with prenatal SUD more often display insecure and disorganized attachments and problems in social cognition (mentalization and facial emotion recognition) at school-age than children of non-using mothers. We further hypothesize that this association is moderated by parenting quality, i.e., that children of mothers with good early emotional availability do not differ from control children in their socioemotional development.

Study population
The original sample comprised 51 pregnant, polydrug-using (with substance-addiction diagnosis) participating in outpatient interventions, and 50 non-using controls with medical pregnancy risks. Most SUD mothers were able to abstain from drugs after pregnancy recognition. There were no group differences in infant health or development, but SUD mothers had more socioeconomic problems. At the child age of 8-12 years, families were re-contacted and 39% (n=20) of the SUD group (6 children with a foster mother) and 61% (n=31) of the control group participated. Drop-out was associated only with lower educational level. 55% of the mothers still had active substance misuse.

Methods
Maternal emotional availability was measured at 4 and 12 months with EA scales 4th edition (Biringen, 2008). At school-age, child mentalization was measured with LEAS-C (Bajgar & Lane, 2004), facial emotion recognition with DANVA (Nowicki & Carton, 1993) and attachment with Attachment Story Stem for school-age (Granot & Mayseless, 2001; Kerns et al., 2011).

Results
As hypothesized, SUD group had a higher incidence of child insecure (90% vs. 51.5%, χ2(1)=8.06, p = .005) and disorganized (45% vs.13%, χ2(1)= 6.59, p =.01) attachments; however, there were no differences in child emotion recognition or mentalization. There was partial support for the moderating effect of parenting quality: higher maternal emotional availability at both 4 and 12 months predicted better emotion recognition and mentalization in both groups (See Tables 1 and 2), but not attachment. The results suggest that early parent-child relationship may be a more prominent predictor of child social cognition than maternal SUD. As maternal emotional availability already at four months had long-term protective effects, it would be highly important to offer early and long-term parenting support for these families from the very beginning. In addition, the high rate of disorganized attachment implies a continuing need of support for these children also in their later development, in addition to early interventions.

Authors