Abstract
Mothers with a substance use disorder (SUD) have been found to exhibit heightened experience of stress and deficits in executive functioning (EF) and in parental reflective functioning (PRF). Although experiences of stress, EF and PRF are important for caregiving capacities; no studies have explored associations between the phenomena in mothers with SUD. This study aimed to examine the association between EF (working memory, inhibition, and cognitive flexibility) and different forms of stress (parental stress, general life stress, and psychological distress) in 43 mothers with SUD with infants. We further aimed to investigate whether PRF had a mediating function between EF and the experience of stress. The mothers completed self‐report questionnaires regarding experiences of different types of stress, and we also used neuropsychological tests to assess EF and a semistructured interview to assess PRF. Results identified problems in EF were associated with higher parental stress and psychological distress but not with general life stress. Cognitive flexibility contributed uniquely to variance in parental stress, whereas working memory was a unique contributor to variance in psychological distress. PRF had a mediating function between EF and parental stress and between EF and psychological distress. Findings highlight the importance of considering individual differences in PRF when targeting EF in interventions trying to reduce the experience of parental stress and psychological distress in mothers with SUD.
Highlights
Studies on mothers with substance use disorder (SUD) have demonstrated that as a group, these mothers exhibit high levels of stress (Kelley, 1998; Nair, Schuler, Black, Kettinger, & Harrington, 2003; Zvolensky & Hogan, 2013) and difficulties in stress‐regulation capacities (Tronick et al, 2005), compared with normal populations
As research has indicated an association between executive functioning (EF) and mentalizing and that adequate parental reflective functioning (PRF) is associated with increased tolerance of child distress, we aimed to explore whether PRF had a mediating effect between EF and the experience of stress in mothers with SUD
The results indicate that PRF significantly affects how cognitive flexibility and inhibition associate with psychological distress
Summary
Studies on mothers with substance use disorder (SUD) have demonstrated that as a group, these mothers exhibit high levels of stress (Kelley, 1998; Nair, Schuler, Black, Kettinger, & Harrington, 2003; Zvolensky & Hogan, 2013) and difficulties in stress‐regulation capacities (Tronick et al, 2005), compared with normal populations. The experience of stress is related to processes involved in perception, appraisal, and response to challenging or threatening stimuli (Sinha, 2008; Sinha et al, 2005). Mothers with low emotion regulation capacity with young children have been found to exhibit reduced distress tolerance (Deater‐Deckard, Li, & Bell, 2016), and in particular, mothers with SUD have a heightened risk for emotion dysregulation (Suchman, DeCoste, Ordway, & Mayes, 2012). Elevated levels of parenting stress in mothers with SUD may place their children at an increased risk due to dysfunctional parent–child relationship (Hans, Bernstein, & Henson, 1999; Nair et al, 2003). Mothers with higher ratings of psychological distress are more likely to perceive their infant's behaviour as stressful (Sheinkopf et al, 2005)
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