neta peleg-oren, ph.d

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

1

Paternal Alcohol Use, Maternal Warmth and Psychosocial

Outcomes among Adolescents Participating in a School-Based Substance Abuse Intervention

Neta Peleg-Oren, Ph.D . Eric F. Wagner, Ph.D .Staci Leon Morris, Psy.D.

C-BIRG, Florida International University, Miami, FL

This work was supported in part by a grant funded by the NIAAA( R01 AA10245.)

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

2

Monitoring the Future 2006: Use (Lifetime)

http://monitoringthefuture.org 8th 10th 12th

Alcohol (any use) 40.5% 61.5% 72.7%

Alcohol Past Year (any use)

33.6% 55.8% 66.5%

Been Drunk 19.5% 41.4% 56.4%

Any Illicit Drug(s) (include Marijuana)

20.9% 36.1% 48.2%

Cigarettes (any use) 24.6% 36.1% 47.1%

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

3

FL Youth Survey 2006 (FYSAS) (Lifetime) http://www.dcf.state.fl.us/mentalhealth/publications/fysas

8th 10th 12th

Alcohol (any use) 52.3% 68.4% 76%

Been Drink 27.5% 37.2% 47.1%

Any Illict Drug(s) (include Marijuana)

27.8% 39.1% 46.9%

Cigarettes (any use) 27.5% 37.2% 47.1%

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

4

Monitoring the Future 2006: Abuse

(in 30 days)8th 10th 12th

Binge Drinking (5+ drinks in a row in last 2 week)

10.9% 21.9% 26.5%

Daily Alcohol Use 0.5% 1.4% 3.0%

Daily Marijuana Use 1.0% 2.8% 5.0%

/½>=day Pack Cigarettes

1.5% 3.3% 5.9%

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

5

FL Youth Survey (FYSAS) (in 30 days) http://www.dcf.state.fl.us/mentalhealth/publications/fysas

8th 10th 12th

Binge Drinking (5+ drinks in a row in last 2 week)

12.8% 22.3% 32%

Alcohol Use 27.7% 40.7% 52.2%

Any Illict Drug(s) (include Marijuana)

14.5% 19.5% 23.8%

/½>=day Pack Cigarettes

9% 13.1% 20.1%

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

6

Prevalence of COA• 11.6 million children (16%

of children) exposed to alcohol problems

• Additional 2 million children exposed to an alcohol dependent parent (3% of children)(Ramisetty-Mikler & Caetano, 2004 based on 1995 National Alcohol Survey)

• 1 in 4 children exposed to alcohol or drugs in the family

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

7

Characteristics of COAHaving a parent with a history of

alcohol use problems has been associated with increased risk for problems with:•Emotions (e.g., psychiatric disorder)•Cognitions (e.g., stress coping)•Social Skills (e.g., peer interaction)•Behaviors (e.g., self-regulation)

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

8

COA-High Risk for Substance Use

Genetic and non-genetic influences appear to contribute to the risk for substance use problems among COAs.

COAs are 4-9 times more likely to develop SUDs than nonCOAs (Cloninger et al., 1981; Russell, 1990)

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

9

Definition of Maternal Warmth

A mother’s general tendency to be supportive, affectionate, and sensitive to the child’s needs, express approval and direct positive emotions and behaviors toward the child (Zhou, et al., 2002).

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

10

Maternal Warmth (cont’d)

Lack of maternal warmth may heighten the risk for substance use problems in adolescents(Cohen et al., 1994; Foxcroft & Lowe, 1991; Kandel & Davis,

1996; Ruchkin, et al., 2002).

Family positive support and control have been found negatively associated with adolescent drinking (Foxcroft & Lowe, 1991).

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

11

Maternal Warmth (cont’d)

High maternal warmth and expression of positive emotions have been linked to:

•Lower levels of hostility•Fewer internalizing problems•Fewer externalizing problems•Positive social skills•Better self-regulation

(Eiden et al., 2004; Eisenberg et al., 2001; Kandel, 1980; Kochanska & Murray, 2000; Kochanska et al., 2000; Zhou, 2002).

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

12

Aim of the StudyTo examine

• paternal history of alcohol use problems(no use, moderate use, and heavy problematic use by the father)

•maternal warmth(low or high)

as both independent and interactive predictors of psychosocial outcomes of high-risk, alcohol and drug using

school youth

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

13

Alcohol Use, Maternal Warmth and Psychosocial

Outcomes Independent Variables:

1 .COA Status

2 .Maternal Warmth

3 .COA by Maternal Warmth

Dependent Variables )Adolescent Functioning(:

1 .Psychiatric Disorders

2 .Social Skills

3 .Coping Skills

4 .Alcohol and Other Drug Use

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

14

Hypotheses•Adolescents reporting lower maternal

warmth will demonstrate significantly (a) more psychiatric disorders, (b) less adaptive coping skills, and (c) poorer social skills than adolescents reporting higher maternal warmth.

•COAs will demonstrate significantly (a) more frequent and heavier alcohol and drug use and (b) less adaptive coping skills than adolescents with no paternal history of substance use problems.

•The interaction of maternal warmth and COA status were explored (e.g., is maternal warmth even more predictive of outcomes for COAs vs. non-COAs?)

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

15

Present Study•Cross sectional secondary analysis of data derives from an NIAAA-funded randomized clinical trial of school-based group intervention for adolescents with alcohol use problems (Westchester Model SAP).

•Data derived from self-reports collected at baseline from the adolescent.

•The primary analytic strategy was hierarchical multiple regression (HMR).

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

16

Sample Middle and high school students who:

• reported 6 or more occasions of substance use in the 6-month period prior to enrollment.

• reported 6 or more contacts per month with their fathers.

From N = 214 students in the original study 171 (80%) met our above inclusion criteria.

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

17

Sample Demographics•Mean age - 15.4 years •52% - middle schoolers•48% - high schoolers•42% - female•66% - non-Hispanic White, 21% Hispanic, 10% Black, and 3% “other”

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

18

Measures•Adolescent substance use -Timeline Followback (TLFB) ( Sobell et al., 1980; Sobell & Sobell, 1992, 1996).

•COA Status - The Social Support Questionnaire (Richter et al.,1991)

•Study classified the participants into 3 groups. children of:

(1) non-drinking fathers (32%) (2) light drinking fathers (37%) (3) heavy drinking fathers (31%)

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

19

Measures (cont’d) • Maternal Warmth - The Parent-Adolescent

Communication Scale (PACS) ( Barnes & Olson, 1982): Open Family Communication and Problems in Family Communication.

• Psychiatric Disorders - The brief Michigan version of the CIDI (Kessler, et al., 1998)

• Coping Skills - The Revised Ways of Coping Checklist (RWCCL) (Vitaliano et al., 1985)

• Social Skills -The Teenage Inventory of Social Skills (TISS) (Inderbitzen & Foster, 1992)

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

20

Descriptive data of psychosocial functioning variables by COA status Descriptive data of psychosocial functioning variables by COA status and maternal warmth groups.and maternal warmth groups.

Parental Current Drinking Maternal Warmth*

Non-Drinking Light Drinking Heavy Drinking

Low High

( n=55) ( n=63) ( n=53) ( n= 85) ( n= 81)

M SD M SD M SD M SD M SD

Age (years) 15.41 1.63 15.27 1.04 15.54 1.51 15.37 1.55 15.40 1.46

Socioeconomic Status

3.22 1.05 2.93 1.07 2.80 .97 2.91 1.0 3.03 1.1

Psychiatric Disorders

1.96 1.9 1.76 2.11 2.0 1.80 2.24 2.0 1.57 1.84

Adaptive Coping

.62 .48 .50 .05 .51 .05 .49 .05 .51 .06

Poor Social Skills

52.65 16.44 51.95 15.01 56.92 15.61 57.08 15.68 50.40 15.26

30 days alcohol frequency

1.20 1.89 2.17 2.73 2.55 3.04 2.05 2.68 1.88 2.56

Table2A: Summary of hierarchical multiple regression analyses (Maternal Warmth)

1a. Dependent variable: Psychiatric disorders.

Independent variables β 2 total R2 change

Demographic controls .09* .09*

Maternal warmth -.21 .13* .04*

1b. Dependent variable: Coping skills

Independent variables β R2total R2change

Demographic controls .009 .009

Maternal warmth .17 .037* .028*

1c. Dependent variable: Social skills

Independent variables β R2total R2change

Demographic controls .05* .05*

Maternal warmth -.21 .10** .04*

*p < .05; **p < .01.

Table 2B: Summary of hierarchical multiple regression analyses (COA Status)

2a. Dependent variable: 30-day frequency of alcohol use 3 months prior to assessment

Independent variables β R2total R2change

Demographic controls .06* .06*

COA status -.20 .10** .04*

2b. Dependent variable: Proportion of “adaptive” coping skills )from total coping(

Independent variables β R2total R2change

Demographic controls .01 .01

COA status -.18 .04* .03*

*p < .05; **p < .01.

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

23

Results—COA

In comparison to non-COAs, COAs reported significantly (p < .05):

•More frequent alcohol use•Greater quantity per use occasion•Less “adaptive” coping skills

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

24

Results –Maternal Warmth

In comparison to teens reporting high maternal warmth, teens reporting low maternal warmth demonstrated significantly (p < .05):

• more psychiatric disorders• less adaptive coping skills• poorer social skills

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

25

Results—Interactions

No significant interactions were found between paternal alcohol use problems and maternal warmthin predicting adolescent psychosocial adjustment.

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

26

Conclusion•COAs have an increased risk for alcohol-

related problems. •Paternal alcohol use and low maternal

warmth each contribute independently to adolescent adjustment.

•There was no evidence of interactive effects of these variables on adolescent adjustment.

Therefore:•Assessment of family history of alcoholism

and maternal warmth is very important•COA or low maternal warmth adolescents

should be considered high-risk teen in need of specialized services.

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

27

Future Research

•Longitudinal study - the influence of maternal warmth and paternal history of alcohol use on adolescent adjustment over time.

•Identify additional personal and family characteristics which may contribute to psychosocial risk.

•Develop specialized interventions based on documented patterns of risk.

Neta Peleg-Oren, Eric F. Wagner, Staci Leon Morris

28

Thank youYou were such a great

audience !