Parenting and Addiction: Impact of Trauma and Mental Health on Maternal Reflective Functioning

Background:  Mothers with Substance Use Disorders (SUDs) contend with the complexities of addiction, which in turn impact parenting. Importantly, capacities to reflect upon and understand children’s development and emotional experience (RF, reflective functioning), essential in parenting, are often compromised in these mothers, impacting children’s wellbeing. While a few studies have underscored the relationship between RF, mental health, and trauma, little is known about specific facets of RF, which potentially play different roles in parenting. The aspects of RF include the ability to imagine a young child’s emotional states and experiences (Aspect 1), interest in and curiosity about the child’s experiences and his development (Aspect 2), and rigidity in thinking about those experiences (Aspect 3) (Luyten et al., 2009).  This study examines predictive factors related to Aspect 1 and Aspect 2.  It utilizes baseline data from two related studies examining the effectiveness of a dyadic intervention for mothers with SUDs and their children.

Methods: Participants were 138 mothers with at least one child birth to five that completed a baseline assessment for a parent-child intervention while simultaneously in treatment for addiction to heroin or other opiates.  The majority of the women were Caucasian, single, in their late 20s (M=29 years), high school educated, and unemployed. Mothers reported high levels of psychological distress and extensive trauma histories.  Children had high frequencies of trauma for their age (M=25 months). Baseline measures included those to assess adult mental health (BSI), adult trauma history (LSCR), child trauma exposure (TESI), and parental RF (PRFQ). Correlations and hierarchical multiple regression analyses were computed to examine the relationship of trauma and adult mental health as predictors of aspects of parental reflective functioning.

Results: Two hierarchical regression models were computed, with Aspect 1 and Aspect 2 of RF as dependent variables. IVs were adult trauma, child trauma, and adult mental health, each of which were entered in separate steps. In the first model predicting ability to imagine the child’s experience, child trauma emerged as a significant predictor in the second step.  However, in the final model with all three IVs, adult mental health was the only significant predictor.  In the second model, only adult trauma significantly predicted interest in and curiosity about the child’s experience.

Conclusions:  This study provides a more nuanced understanding of factors impacting RF – specifically the ability to imagine the child’s experiences and interest in those experiences – in the context of SUDs.  The relationship between adult trauma and interest in the child’s experiences may indicate maternal inclination to over-compensate in her curiosity about her child, suggesting that extensive parental trauma may lead to an intrusive style of parenting.  The relationship between mental health and the ability to imagine the child’s experiences suggests the importance of the role of mental health in the mother’s capacity to attune to her child’s experiences. Social work researchers and practitioners can benefit from this knowledge in order to understand specific parenting practices in the context of maternal SUDs, as well as develop interventions that more effectively support these families.