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Child Externalising Behaviours May Be Clue to Severity of Parent's Drug Addiction: Presented at AACAP

By Paula Moyer
Special to DG News

SAN FRANCISCO, CA -- October 29, 2002 -- When parents struggling with addiction report externalising behaviours on the part of their child, those behaviours may be an indication of the severity of the parent's addiction and addictive behaviours.

"This is the first step in research that will encompass a longer period of time in which we look at child behaviour problems and parental drug use," said Dr. Jeffrey J. Wilson, with the Columbia University College of Physicians and Surgeons, in New York, New York, United States. "Our findings were consistent with our hypothesis, which was that parental drug use is a predictor of child behaviour problems."

People who are struggling with addictions may not voluntarily disclose this type of problem. Therefore, the initial manifestation of parental addiction may be the child's behaviour, according to Dr. Wilson, who defined externalising problems as being characterised by overt problematic behaviour, such as argumentativeness, tantrums, and aggression.

When the presenting problem is externalising behaviour in the child, clinicians may want to ascertain whether the parents are struggling with problems, or whether other problems are occurring in the family, he said.

In a study presented here October 27 at the 49^th annual meeting of the American Academy of Child and Adolescent Psychiatry (AACAP), Dr. Wilson and colleagues sought to evaluate child behaviour problems in their relationship to severity of ongoing parental addiction among parents who were undergoing methadone treatment for opiate addiction.

In the first phase of a pilot study, the investigators recruited 14 consecutive parent-child dyads. The children were an average of 5.9 years old. The investigative team used the Addiction Severity Index to assess parent addiction severity and the Achenbach Child Behaviour Checklist to evaluate child behaviour.

Over three visits, the researchers also assessed for child and parent psychopathology, parent-child interactions, and parent addiction severity.

They found that the parents in the study continued to exhibit a high degree of addictive behaviours, and they reported a high degree of child externalising behaviour problems. The children's behaviour problems were highly associated with parental addiction severity (r=0.716, p=0.013) as well as measures of parent drug use over the previous 30 days.

Dr. Wilson said that in ongoing research, the investigators will use the Structured Clinical Interview from the Diagnostic and Statistical Manual-IV to ascertain comorbid parental cycle pathology, the Hamilton Depression Scale to assess parental depression severity, the Dominic-R questionnaire to elicit the children's self-report of behaviour problems, and the Dyadic Parent-Child Interaction System to measure videotaped parent-child interactions.

As the study progresses, they hope to see a sufficient number of parents with ongoing abstinence from drug use, so that the investigators can compare the behaviours of children whose parents are recovering to the behaviours of children whose parents are still actively using.

"Parents in recovery may be seeing behaviour problems in their children, too," he said. This information will help clinicians to counsel patients more effectively about the relationship between their children's behaviour and their own addictions, he said.

"Our information suggests a relationship between parental drug use and child externalising behaviour problems," he said. "However, larger prospective studies involving several levels of observation will be necessary to comprehensively determine what that relationship is."

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