Pathways from Parental Alcohol Use to Supervisory Neglect: Understanding the Roles of Poverty, Depression and Low Social Support

Background and Purpose: Neglect is the predominant form of child maltreatment with over 78% of substantiated child maltreatment reports indicating neglect within the household. While children exposed to parental substance abuse are over three times more likely to experience neglect, not all children from these families experience neglect.   In fact, the pathway from parental alcohol use to child neglect remains poorly understood resulting in interventions to prevent child neglect to remain underdeveloped.   This study relied on ecological systems and cumulative risk theories to test a hypothesized path model that parental alcohol use and poverty were positively associated with increased depressive symptoms, which would lead to decreased social support, and ultimately to higher likelihood of supervisory neglect. 

Methods: Data for this study came from a listed-sample telephone survey of 3,023 parents of children ages birth to 12 years, living in 50 mid-sized California cities in 2009.   Only current drinkers were included in the study sample (n = 2,990). The key endogenous dependent variable, supervisory neglect, included three aspects of supervisory neglect from the Multidimensional Neglectful Behaviors Scale.   The key exogenous independent variables were poverty and parental alcohol use (based on a graduated frequency approach that allowed us to calculate the probability of continued drinking after the first drink). The endogenous independent variables included depressive symptoms measured by two items from Primary Care Evaluation of Mental Disorders and low social support measured by the Interpersonal Support Evaluation List. We used structural equation modeling with multiple imputation procedures to analyze the data. Structural model fit was acceptable (RMSEA = .042; CFI = .910; TLI = .872) and standardized factor loadings remained adequately strong.

Results: The direct pathway from continued alcohol use to supervisory neglect was not statistically significant (β=.041, p=.208) after controlling for parent sex, race, and marital status.  The pathways from continued alcohol use to depression (β=.065, p=.009), from depression to low social support (β=.424, p<.001), and from low social support to supervisory neglect (β=.306, p<.001) were significant, suggesting that alcohol use is indirectly associated with supervisory neglect.  Poverty was not directly associated with supervisory neglect but was significant associated with increased depression (β =.299, p<.001) and low social support (β=.175, p < .001), suggesting that the presence of poverty indirectly increases risk of supervisory neglect as well.  Poverty and continued alcohol use were negatively correlated (β= -.059, p<.001).

Conclusions and Implications: The study findings suggest continued drinking of alcohol indirectly increases the likelihood of supervisory neglect through more depressive symptoms and low social support.  Poverty also indirectly increases risk of supervisory neglect but is negatively correlated with alcohol use, suggesting that each plays a unique role in predisposing a family with alcohol use to child maltreatment.  These results suggest that supervisory neglect may emanate from a pathway of risk for parents who use alcohol rather than having a direct influence on parenting. Thus multiple points for intervention exist may exist to more effectively reduce supervisory neglect than focus on reducing alcohol use alone.