Parental Substance Use Disorder Research Articles

A Cross-Sectional Study On Psychiatric Disorders among Poor Academic Performance Primary School (6-12 Years) Children with Substance Use Disorders in Their Parents

Abstract Background: Psychiatric disorders are more prevalent among children with poor academic performance. There is limited literature on the impact of substance use disorders (SUD) in parents on psychiatric symptoms of these children. Objectives: (1) To assess the psychiatric disorders in primary school (6–12 years) children with poor academic performance. (2) To assess the prevalence and type of SUD in parents of these children. Materials and Methods: A cross-sectional study was conducted on children with poor academic performance. Simple randomization was adopted and 115 children and their parents were included in the study. Mini International Neuropsychiatry Interview-Kid (M.I.N.I. Kid) was used to screen psychiatric symptoms and various scales were used to assess the severity of symptoms. Parents of these children were interviewed for the presence of SUD. The diagnosis was made as per the International Classification of Diseases tenth revision (ICD-10). The association between psychiatric disorders and parental SUD was assessed using Chi-square test. Results: The prevalence of psychiatric disorders was 54.78% and most prevalent disorder was emotional disorders with onset specific to childhood with prevalence of 21.74%. Prevalence of SUD among parents of these children was found to be 18.26% and alcohol dependence syndrome (ADS) was more common type (12.17%). There was no significant association between psychiatric disorders in these children and SUD in their parents (χ2-2.93, df-10, P = 2013-.98). Conclusion: Emotional disorders with onset specific to childhood are more commonly prevalent psychiatric disorders among children with poor academic performance. A study found no significant association between SUD among parents of these children and psychiatric symptoms.

(Mal)adaptive sibling self and other communicative resilience in the context of parental substance use

Abstract Managing parental substance use disorder (SUD) within the family context is a collaborative effort. For families with multiple children, the sibling relationship might be one source of support for dealing with this stressor. Findings from a sample of adult siblings with parents with SUD highlighted that they (a) experience five resilience triggers, (b) utilize self and other communicative resilience (CR) processes, and (c) experience a tensional process in which CR can be both adaptive, maladaptive, and simultaneously both. Overall, we advance the communication theory of resilience by (a) being the first to apply the other-resilience heuristic, (b) exploring relationships between self-resilience and other-resilience, (c) introducing a new CR tension, and (d) discussing the potential benefit of engaging in what we call strategic resilience. By analyzing the resilience processes of adult siblings experiencing parental SUD, we also recommend practical applications for social workers, providers, and counselors.

Longitudinal associations between parenting practices and children’s later decision-making competence

Developmental research has suggested that certain parenting practices impact the development of children’s later risk behaviors. However, little evidence exists regarding how parenting may impact a child’s actual decision-making skills later in life. This study examined the degree to which earlier child-reports of parenting practices (assessed at age 10–12 and 12–14), specifically monitoring/involvement, firm/lax control, and psychological control, predicted decision-making competence (DMC), a measure of decision-making skills, at age 19. We conducted these analyses on a large, diverse sample of children (N = 775; 227 Female, 21.8% African-American); approximately half had at least one parent with a positive Substance Use Disorder (SUD) diagnosis. Analyses revealed that children reporting greater levels of psychological control demonstrated lower DMC performance at age 19, holding other parenting variables, level of neighborhood disadvantage, and parental SUD status constant. We relate these results to the broader effects of psychological control on decision-making and self-regulatory capabilities.

Swimming Against the Current: Addressing Community Needs and Establishing Partnerships for the Prevention of Opioid and Methamphetamine use Among Parents

The opioid and methamphetamine crises in Oregon have a consequential impact on young families, as an increasing number of parents experience substance use disorder (SUD). As parental substance use escalates, the child welfare system (CWS) becomes overwrought with families who have complex needs. The burden placed on families and on the CWS indicates a need for prevention and treatment interventions for parental SUDs. In response to the worst statewide opioid and methamphetamine epidemics in the USA, a Hybrid Type 2 trial of PRE-FAIR—a prevention intervention for parents—is being implemented in five Oregon counties. Establishing strong partnerships within the communities helped identify the need to implement the evidence-based FAIR treatment model alongside PRE-FAIR. A strong focus on implementation includes meeting the needs of communities and establishing the infrastructure necessary for sustainment of the FAIR programs at the provider agencies. Despite implementation efforts to direct toward PRE-FAIR referrals, parents in need of treatment are being referred at a disproportionate rate, as are older parents who fall outside of study-eligibility. Both challenges have delayed the ability to enroll a sufficient number of participants for the prevention trial. This commentary describes the impact of the opioid and methamphetamine epidemics in Oregon as the crises relate to implementing prevention versus treatment interventions—highlighting the importance of addressing community needs and establishing strong partnerships, which has allowed creative strategies to increase PRE-FAIR recruitment.

Parental substance use disorder and risk of intellectual disability in offspring in Sweden: a national register study

Intellectual disability (ID) is a disorder with unknown aetiology in many cases. Maternal alcohol use is a known risk factor for ID, but less is known about the importance of maternal and paternal substance use disorder (SUD) and risk of ID in offspring. Data from multiple nationwide registers were used to create a cohort of children born from January 01, 1978 to December 31, 2002. All participants were born in Sweden, had available parental identification information and did not emigrate or die before age 12 (n=1,940,820). Logistic regression modelling was performed with exposure defined as having a parent who received any SUD diagnosis, including alcohol use disorder (AUD) and drug use disorder (DUD). The outcome was registration of diagnosis of any form of ID. First, we analysed the risk of ID if parental SUD was registered prior to childbirth with stepwise adjustment of multiple covariates. Second, the effect of timing of SUD diagnosis in relation to childbirth was analysed. Of 37,410 offspring with parental SUD registered prior to birth, 3.0% (n=1110) had any form of ID compared to 1.2% (n=23,168) of those 1,903,410 individuals without parental SUD prior birth. Parental SUD prior birth was associated with an increased risk of any form of ID (Odds Ratio [OR]: 2.3 [2.2-2.5]), with ORs similar for maternal (OR: 2.3 [2.1-2.5]) and paternal SUD (OR: 2.3 [2.1-2.5]). These ORs were reduced but remained statistically significant after adjusting for parental education, migration, psychiatric comorbidity, and co-parent SUD (OR parental SUD: 1.6 [1.5-1.8]; OR maternal SUD: 1.4 [1.2-1.5]; OR paternal SUD: 1.6 [1.5-1.7]). Parental SUD was associated with increased risk of ID in offspring irrespective of timing of diagnosis, but if mothers or fathers were diagnosed with AUD during pregnancy (OR maternal AUD: 5.0 [3.1-8.2]; OR paternal AUD: 2.8 [2.2-3.6]), the risk was significantly greater than if the AUD diagnosis was first registered after childbirth (OR maternal AUD: 1.9 [1.8-2.0]; OR paternal AUD: 1.6 [1.6-1.7]). Both paternal and maternal SUD were associated with an increased risk of ID in offspring, with greatest risk observed when AUD was diagnosed during pregnancy. Possible mechanisms may involve shared genetic and environmental factors, including toxic effects from alcohol intake. These findings have clinical implications in suggesting that parental SUD in either parent represents a possibly modifiable risk factor to consider when developing prevention, diagnostics and treatment programs for children with ID. Stockholm County Council, the Research Council of the Swedish Alcohol Retailing Monopoly, Fredrik and Ingrid Thurings stiftelse, Academy of Finland, the Swedish Research Council and the Swedish Research Council for Health, Working Life and Welfare, Nordforsk by the Nordic Council of Ministers and the Polish Medical Research Agency.

Sex differences in stress responses among underrepresented minority adolescents at risk for substance use disorder

Adolescence is a period of dramatic physiological changes preparing individuals to face future challenges. Prolonged exposure to stressors during childhood can result in dysregulated stress systems which alter normative physiological progression, leading to exacerbated risk for developing psychiatric disorders. Parental substance use disorder (SUD) is considered a significant childhood stressor which increases risk for the offspring to develop SUD. Thus, it is important to understand stress reactivity among adolescents with parental SUD. We used the Trier Social Stress Task (TSST), which includes a public speech presentation, as an acute stressor. Changes in heart-rate (HR) were measured while disadvantaged minority adolescents with and without a family history (FH+/FH-) of SUD performed the TSST. We investigated sex-specific stress response patterns during the TSST. HR peaked during the speech presentation and was overall higher in females than males. Changes in HR measures between baseline and speech showed an interaction between biological sex and FH group. Specifically, FH- females and FH+ males had significantly larger positive HR changes than FH- males. These results suggest that male and female adolescents with parental SUD have atypical, but divergent changes in stress reactivity that could explain their increased risk for developing SUD via different sexually dimorphic mechanisms.

Physical inactivity during adolescence heightens risk for cannabis use disorder in adulthood.

The association between physical inactivity and substance use throughout adolescence was prospectively investigated in relation to developing cannabis use disorder (CUD). Physical inactivity and substance use in males (N = 462) and females (N = 178) were measured at 12-14, 16, 19, and 22 years of age in a repeated measures design. A structured diagnostic interview was administered to formulate current CUD diagnosis at 22 years of age. Mixture modeling path analysis evaluated the association between physical inactivity, substance use, and CUD. Males: Slope of physical inactivity increase spanning 12-22 years of age mediates the association between number of parents with substance use disorder (SUD) and rate of increase in substance use frequency (prodrome) which mediates the association between physical inactivity (hypothesized vulnerability) and CUD. Females: Number of SUD parents predicts slope of physical inactivity increase in daughters throughout adolescence which covaries with slope of increasing substance use frequency culminating in CUD. The association between parental SUD load (number of SUD affected parents) and CUD was found to not be mediated by physical inactivity. Rate of increase in physical inactivity during adolescence in males and females is a facet of the vulnerability for CUD. These results have ramifications for prevention considering that numerous cognitive, behavior, and emotion features of CUD vulnerability are attenuated by exercise. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Latent classes among substance-involved families in child welfare: Associations with treatment completion and reunification

BackgroundWhile often treated as a single group in previous studies, families involved with the child welfare system (CWS) because of parental substance use disorder (SUD) present with various combinations of risk factors and needs (e.g., housing instability, criminal justice involvement, single parenthood, etc.) that affect treatment and child welfare outcomes. Understanding these differential risk and need factors is important for effective case planning and service provision. The generalizability of existing research on this topic is limited by geographic and/or demographic homogeneity, small sample sizes, or short observation windows. The current study sought to examine latent risk/need profiles among families with parental SUD in child welfare using a large, longitudinal multi-state sample and compare treatment and reunification outcomes across classes. Participants & SettingThis study included N = 13,291 parent–child dyads served by the Regional Partnership Grant (RPG) program, which funded implementation of 53 demonstration projects from 29 states between 2007 and 2012. RPG projects aimed to increase well-being and permanency for children in CWS due to parental SUD. MethodsLatent class analysis was used to identify groupings among the study sample on the basis of six key parent-level risk and need factors. A latent class regression model (LCR, Bandeen-Roche et al., 1997) was used to examine differences in the likelihood of treatment completion and reunification across classes controlling for covariates. ResultsModel fit statistics supported a four-class solution: Moderate Risk/Need, Criminal Justice Risk, Complex Risk & Need, and Opioid Use Disorder. The LCR suggested that the Criminal Justice Risk class had the highest odds for treatment completion but lowest odds of reunification. The Complex Risk & Need class had the lowest odds for treatment completion. A significant interaction indicated that the individuals in the Opioid Use Disorder class were more likely to reunify if they completed treatment. ConclusionsHeterogeneity exists among families involved with the child welfare system due to parental substance use. The findings suggest, however, that they present with distinct patterns of risk/need characteristics. Moreover, these combined characteristics are associated with the likelihood that a parent completes SUD treatment and is reunified with their child. Comprehensive and collaborative service delivery must respond to the varied risks and needs of these families.

Sex-related differences in the prevalence of substance use disorders, treatment, and overdose among parents with young children

IntroductionRisk factors and treatment rates for substance use disorders (SUDs) differ by sex. Females often have greater childcare and household responsibilities than males, which may inhibit SUD treatment. We examined how SUD, medication for opioid use disorder (MOUD) receipt, and overdose rates differ by sex among parents with young children (<5 years). MethodsUsing deidentified national administrative healthcare data from Optum’s Clinformatics® Data Mart Database version 8.1 (2007–2021), we identified parents aged 26–64 continuously enrolled in commercial insurance for ≥ 30 days and linked to ≥ 1 dependent child < 5 years from January 1, 2016-February 29, 2020. We used generalized estimating equations to estimate the average predicted prevalence of SUD diagnosis, MOUD receipt after opioid use disorder (OUD) diagnosis, and overdose by parent sex in any month, adjusting for age, race/ethnicity, state of residence, enrollment month, and mental health conditions. ResultsFrom 2016 to 2020, there were 2,241,795 parents with a dependent child < 5 years, including 1,155,252 (51.5%) females and 1,086,543 (48.5%) males. Male parents had a higher average predicted prevalence of an SUD diagnosis (11.1% [11, 11.16]) than female parents (5.5% [5.48, 5.58]). Among parents with OUD, the average predicted prevalence of receiving MOUD was 27.4% [26.1, 28.63] among male and 19.7% [18.34, 21.04] among female parents, with no difference in overdose rates by sex. ConclusionFemale parents are less likely to be diagnosed with an SUD or receive MOUD than male parents. Removing policies that criminalize parental SUD and addressing childcare-related barriers may improve SUD identification and treatment.

Familial associations in adolescent substance use disorder: a population-based cohort study.

Family history of substance use disorder (SUD) affects a child's risk of the disorder through both genetic and shared environmental factors. We aimed to estimate the association between parental or older sibling SUD history with the risk of adolescent SUD diagnosis. We conducted a population-based cohort study using administrative health-care databases in the Province of Manitoba, Canada, which has a universal and publicly funded health-care system. We included all children born from 1984 to 2000 who have linkages to both parents and were followed until age 18 years. We used generalized estimating equation models to produce unadjusted and adjusted relative risk (RR) estimates of adolescent SUD risk. The study cohort included 134 389 children and 31 307 full sibling pairs; 51.3% were male and 35.4% first-born. The exposure was SUD diagnosis in a mother or father in either hospitalization or outpatient physician visit records before the children's age of 13 years. The secondary exposure was an adolescent SUD diagnosis in an older full sibling. The outcome was SUD diagnosis during adolescence (13 and 18 years of age) identified in either hospitalization or physician visit records. Children demographics and characteristics associated with SUD diagnosis were included in the models. Of the 134 389 children, 9.5% had a mother with a history of SUD, 11.3% had a father and 1.3% had an older sibling with a history of SUD diagnosis; 2566 (1.9%) had an adolescent SUD diagnosis. An increased risk of adolescent SUD was observed with SUD history in mothers [adjusted RR (aRR) = 2.50; 95% confidence interval (CI) = 2.26, 2.79], fathers (aRR = 2.15; 95% CI = 1.95, 2.37), both parents (aRR = 3.74; 95% CI = 3.24, 4.31) and older sibling (aRR = 3.85; 95% CI = 2.53, 5.87). A family history of substance use disorder in parents or older siblings appears to be associated with increased SUD risk in adolescents.

P41. Family History of Substance Use Disorder and Parental Impulsivity Are Differentially Associated With Neural Responses During Risky Decision-Making

Risky decision-making is associated with the development of substance use behaviors during adolescence. Although previous work has investigated risky decision-making in adolescents at familial high risk for developing substance use disorders (SUDs), little work has controlled for the presence of other SUD risk factors, such as co-morbid externalizing disorders (EDs). Moreover, although there has been considerable work investigating parental SUDs and offspring risky decision-making, little work has investigated the role of parental impulsivity in offspring neurobiology associated with risky decision-making.

Risk of pain disorders in offspring of parents with substance use disorders.

Individuals with substance use disorders (SUD) have higher risk of developing pain disorders. This study aimed to investigate the risk of major psychiatric disorders (MPD), SUD, and pain disorders among their offspring. This study used data from the Taiwan National Health Research Database. The case cohort included participants who had a parent diagnosed with SUD. The matched control cohort was offspring of parents without any SUD or major psychiatric disorder (MPD). Poisson regression was applied to estimate the risk of MPD, SUD, and pain disorder between case and control cohorts. We recruited 13,840 cases and 138,400 matched controls. After adjusting for demographic characteristics and family history of psychiatric disorder, the offspring of parents with SUD had higher risk for bipolar disorder (reported as risk ratio with 95% confidence interval: 2.48, 1.79-3.43), depressive disorder (2.22, 1.94-2.52), SUD (2.53, 2.18-2.92), and alcohol use disorder (1.43, 1.16-1.76) than controls. With adjustments of demographic characteristics, individual MPD, and family history of psychiatric disorder, they also presented higher risk than controls for several pain disorders, including migraine (1.43, 1.15-1.78), fibromyalgia (1.21, 1.03-1.42), dorsopathies (1.20, 1.06-1.37), dysmenorrhea (1.16, 1.04-1.29), irritable bowel syndrome (1.26, 1.11-1.43), and dyspepsia (1.14, 1.02-1.27). Clinicians should be aware of the influence of parental SUD on the elevated risk for MPD, SUD, and pain disorders in their offspring.

The impact of parental substance use disorder and other family-related problems on school related outcomes

AimsTo identify young people with different levels of family-related problems, including parental substance use disorder (PSUD), and investigate differences in grades at graduation from compulsory school and further enrollment in education. MethodsParticipants included 6784 emerging adults (aged 15–25 years) from samples drawn for two national surveys in Denmark 2014-2015. Latent classes were constructed using the following parental variables: PSUD, offspring not living with both parents, and parental criminality, mental disorders, chronic diseases and long-term unemployment. The characteristics were analyzed using an independent one-way ANOVA. Differences in grade point average and further enrollment were analyzed using linear regression and logistic regression, respectively. ResultsFour classes of families were identified: 1. “Low adverse childhood experiences (ACE) families”, 2. “Families with PSUD”, 3. “Families with unemployment” and 4. “High ACE families”. There were significant differences in grades, with the highest average among youth from “Low ACE families” (males = 6.83; females = 7.40) and significant lower averages among both males and females from the other types of families, but lowest among young people from “High ACE families” (Males = 5.58; females = 5.79). Youth from “Families with PSUD” (Males: OR = 1.51; 95% CI: 1.01-2.26; females: OR = 2.16; 95% CI: 1.22-3.85) and “High ACE families” (Males: OR = 1.78; 95% CI: 1.11-2.26) were significantly more likely not to be enrolled in further education compared with “Low ACE families”. ConclusionsYoung people who experience PSUD, both as the primary family-related problem as well as among multiple family-related problems, are at increased risk for negative school-related outcomes.

Parental and own substance use disorder: The intersection of gender and early adversity

BackgroundChildren who are exposed to parental substance use disorder (SUD) have a higher risk of SUD themselves. This study examines the extent to which the association between parental and own SUD is conditional upon childhood trauma, socioeconomic status, and gender. MethodsThis study uses data from the Nashville Stress and Health Study with 1234 respondents ages 25–65 collected from 2011 to 2014, weighted be representative of the general population. The association between parental SUD and own SUD was estimated using Cox Proportional Hazard Models, controlling for covariates, and testing for interactions. ResultsOther things being equal, the risk of own SUD is more strongly associated with parental SUD in households with childhood traumas among men, but not women. Childhood trauma is not associated with own SUD in the absence of parental SUD among men. For men with parental SUD exposure, just one traumatic event is associated with a 38% increased risk of own SUD (HR=1.382, SE=.201, p < 0.05). For men, living with grandparents is associated with added SUD risk (HR=1.476, SE=.228, p < 0.05). For women, childhood trauma is not associated with own SUD, but parental SUD (HR=1.556, SE=.238, p < 0.01), and early onset mood or anxiety disorder (HR=1.682, SE=.316, p < 0.01) are. For both genders, those who are African American have lower risk of SUD than those who are White (HR=0.774, SE=.109, p < 0.05 for women; HR=0.672, SE=.079, p < 0.01 for men). ConclusionsParental SUD is associated with a substantial increase in risk for own SUD, and this association differs by gender and early trauma.

Higher socioeconomic status and less parental psychopathology improve prognosis in youths with bipolar disorder

BackgroundTo identify prospectively ascertained individual and family factors that are associated with improvement in Bipolar Disorder (BD) among youths who initially presented with poor course. Methods82 youths with BD with persistent poor mood symptomatology (“predominantly ill course”) were compared to 70 youths with BD who at intake had poor course, but showed improvement during the follow-up (“ill with improving course”), (ages 12.3 ± 3.3, vs. 11.7 ± 3.3 years old, at intake). Improvement was measured by the percentage of time euthymic during a mean follow-up of 12.8 years. Youths and parents were interviewed to assess psychopathology, functioning, treatment, and familial functioning and psychopathology. ResultsCompared to the ill group, since intake, the improving group showed significantly lower subthreshold depression and hypo/mania, Attention Deficit Hyperactivity Disorder, and Disruptive Behavior Disorders. Parental Socioeconomic Status (SES) remained unchanged over time in the ill group, but progressively increased in the improving group. Importantly, the change in SES predated the improvement in the mood trajectory. The most influential variables that predicted improvement were higher SES, and absence of parental BD and Substance Use Disorder (SUD). Parental SUD also negatively affected the parental SES, which was directly associated with worse mood course. LimitationsPredominantly self-reported White samples may limit generalizability; other factors potentially associated with outcome (e.g., treatment adherence), were not ascertained. ConclusionsIn addition to treating mood/comorbid psychopathology in symptomatic BD youths, to improve their prognosis, it is crucial to address their parent's BD and SUD and promote parental education/employment.

A population-wide perspective on the reach of substance use disorders: Parental exposure, diagnostic remission, and current disorders.

Parental substance use disorder (SUD) increases the risk for childhood adversities. Lifetime and current SUDs are associated with functional impairment and psychiatric comorbidity. Research shows that these abate with diagnostic remission. However, a hierarchically ordered heuristic profile of adult subpopulations affected by SUDs has not been explored. We used data from the National Epidemiologic Survey on Alcohol and Related Conditions Wave III (NESARC-III; N = 36,309) to compare four subpopulations defined by the following hierarchy: (1) neither parental nor lifetime SUD (un-affected group); (2) parental SUD but no personal SUD; (3) past but not current SUD (diagnostic remission); and (4) current SUD. We conducted bivariate comparisons and multivariable-adjusted logistic regression to identify characteristics independently differentiating each group. Almost half of the US adult population (108.9 million) were at risk from SUDs. Relative to the unaffected group (56.1%), the parental-exposure-only group (13.9%) experienced diverse parental and childhood adversities and increased risk for psychiatric disorders. Compared to the parental-exposure-only group those in the remitted group (14.1%) were more likely to report behavioral problems and lifetime psychiatric multimorbidities. Those with current SUD (15.9%) had a poorer mental health-related quality of life. This heuristic SUD hierarchy is associated with increasing adversities affecting almost half the US population, although only 15.9% meet the criteria for a current disorder. Our findings provide a rigorous population-based estimate of the staggering public health impact of SUDs in the United States and suggest that almost half of the US population is either directly or indirectly affected by SUDs.

Effects of substance misuse and current family history of substance use disorder on brain structure in adolescents and young adults with attention-deficit/hyperactivity disorder

BackgroundAlterations in brain structure in attention-deficit/hyperactivity disorder (ADHD) show considerable overlap with those observed in substance use disorder (SUD). These overlapping structural alterations in ADHD and SUD might be explained by family history (FH-trait) effects of SUD, and/or substance misuse (state) effects. Our aim was to investigate effects of 1) current parental SUD (SUD-FH) and 2) recent substance misuse (SM) on brain structure in a cohort of ADHD patients and controls. DesignCortical thickness and subcortical volumes were measured using structural MRI. We compared ADHD subjects and controls with or without SUD-FH (aim 1) and additionally explored differences between SUD-FH- and SUD-FH + subjects with one versus two parents with SUD. We also compared ADHD groups with and without SM (ADHD + SM and ADHD-only, respectively) and controls (aim 2). FindingsThere was no association between SUD-FH and brain structure. Exploratory analysis on SUD-FH showed decreased IFG thickness (p = 0.032) and nucleus accumbens (NAcc) volume (p = 0.017) in subjects with two versus one SUD parent, regardless of ADHD. ADHD + SM showed decreased inferior frontal gyrus (IFG) thickness compared to controls (pars opercularis p = 0.025, pars orbitalis p = 0.010, pars triangularis p = 0.049), while no difference was found between ADHD-only and either ADHD + SM or controls. ConclusionsDespite negative findings in the primary trait-analysis, exploratory trait-analysis on SUD-FH loading suggested potential SUD trait-effects on IFG thickness and NAcc volume. Substance misuse state effects in ADHD were linked to lower IFG thickness. Future studies should confirm these findings and investigate their clinical relevance, including the functional consequences of decreased IFG thickness.

Effects of substance misuse on inhibitory control in patients with attention-deficit/hyperactivity disorder.

Patients with attention‐deficit/hyperactivity disorder (ADHD) are often diagnosed with comorbid substance misuse (SM), which is associated with poor treatment efficacy. Although literature indicates similar inhibitory control deficits in both conditions, it is unclear whether SM in ADHD exaggerates pre‐existing deficits, with additive or distinct impairments in patients. Our aim was to examine SM effects on inhibitory control in ADHD. Behavioural and functional magnetic resonance imaging (fMRI) data from a stop‐signal task were compared across ADHD patients with and without SM (ADHD + SM and ADHD‐only, respectively) and controls (n = 33/group; 79 males, mean age 18.02 ± 2.45). To limit substance use disorder (SUD) trait effects, groups were matched for parental SUD. Overall, we found worse performance for ADHD‐only and/or ADHD + SM compared with controls but no difference between the ADHD groups. Moreover, the ADHD groups showed decreased frontostriatal and frontoparietal activity during successful and failed stop trials. There were no differences between the ADHD groups in superior frontal nodes, but there was more decreased activation in temporal/parietal nodes in ADHD‐only compared with ADHD + SM. During go‐trials, ADHD + SM showed decreased activation in inferior frontal nodes compared with ADHD‐only and controls. Findings during response inhibition showed deficits in inhibition and attentional processes for ADHD patients with and without SM. Despite no evidence for SM effects during response inhibition, results during go‐trials suggest distinct effects on nodes that are associated with several executive functions. Future studies should investigate whether distinct deficits in ADHD + SM relate to poor treatment results and can direct development of distinct ADHD treatment strategies for these patients.

Examining unique substance-related risk profiles for neglectful behaviors among parents with and without clinical depression

BackgroundParental substance use disorder (SUD) is one of the predominant parental risk factors observed for child neglect. Yet, individual risks do not exist in a vacuum. ObjectiveThis study explored the relative importance of parental substance use behaviors based on the presence of key risk (clinical depression) and protective (social support type) factors. Participants and settingThe final analytic sample was composed of 3,545 parents of children aged 2–17 years from Wave 4 data collection of the National Survey of Child and Adolescent Well-Being (NSCAW I). MethodsWeighted negative binomial regression models examined the interactive relationship between parent self-report of past year substance use patterns, clinical depression, and social support type for annual neglect frequencies. ResultsAmong parents meeting criteria for clinical depression, only parental SUD was associated with higher annual neglect frequency (compared to harmful/risky use); the presence of tangible supports was associated with lower annual neglect frequency while the presence of social companionship was associated with higher annual neglect frequency. For parents not meeting criteria for clinical depression, the study observed an interactive effect where both harmful/risky use behaviors and meeting criteria for SUD significantly contribute to higher average neglect frequencies compared to no past year use, depending on social companionship level. ConclusionsIn order to mitigate neglect risk among substance-using parents, practitioners should look beyond abstinence to address parents’ underlying cognitive/affective functioning and social context.

Estimating perceived parental substance use disorder: Using register data to adjust for non-participation in survey research

AimsTo estimate the prevalence of parental substance use disorder (PSUD) in the general population based on young adults’ reports adjusted for non-participation using register-based indicators of PSUD. DesignA national sample survey study combined with a retrospective register-based study. Setting Denmark. Participants 10,414 young people (aged 15–25 years) invited to two national sample surveys in 2014 and 2015 (5,755 participants and 4,659 non-participants). MeasurementsA crude prevalence of PSUD was calculated based on participants’ reports. Parental data from medical, mortality, prescription, and treatment registers (from the young adults’ birth until the time of the surveys) were used to estimate a register-based prevalence of PSUD for both participants and non-participants. Differences between participants and non-participants were analysed using bivariate comparisons. Inverse probability weighting was used to adjust for bias due to non-participation. The crude prevalence of PSUD based on survey data was adjusted using the ratio of incidence proportion of the register-based PSUD compared with the survey-based PSUD. FindingsA total of 731 (12.7%) of the 5,755 survey participants reported PSUD. Register-based PSUD was more common among non-participants (856/4,659; 18.4%) compared with participants (738/5,755; 12.8%, OR = 1.53, 95% CI 1.38–1.70). The adjusted estimate of the survey-based PSUD increased by 2.5 percentage points, from 12.7% to 15.2%. ConclusionsIn the absence of register data, youth-reported PSUD is likely to underestimate the number of young people experiencing PSUD.