Exploring the Impact of Substance Mis-Use, Trauma and Mental Health on Parenting Young Children

Background:

Mothers in treatment for Substance Use Disorders (SUD) often have extensive trauma histories and symptoms (Kaltenbach, 2013) and difficulties regulating emotions (Kober, 2013), leading to parenting challenges. Young children experiencing parental substance mis-use often suffer traumas (Salo & Flykt, 2013). Furthermore, mothers’ awareness of their children’s painful experiences can add to guilt and stress already integral to parenting with a SUD (Kuo, et al., 2013). In order to tailor parenting interventions for substance mis-using mothers, recent research explored approaches to improving dyadic relationships (Suchman, et al., 2013). However, to further develop best practices, greater understanding is needed regarding complexities among parents’ and children’s experiences and emotions. This study explores the impact of parental substance mis-use, trauma and emotion regulation, and child trauma on the experience of parenting.

Methods:

Baseline data were used from a study of mothers with young children in methadone treatment participating in a dyadic parenting intervention. We utilized measures to assess mothers’ lifetime heroin use (ASI), emotion regulation (DERS), adult trauma history and symptoms (LSCR and PSS), child trauma exposure (TESI), parenting stress (PSI) and parental sense of competence (PSOC).  Participants were 44 mothers with young children (M= 3 years), who were predominantly Caucasian, single, in their 20s/30s (M=30 years), high school/college educated and unemployed. Mothers reported long term heroin use (M=4.6 years) and extensive trauma histories and symptoms (11.6 episodes, range= 1-21; 69% met criteria for PTSD).  Children had high trauma frequency for their age (M=4 episodes, range= 0-15). More than half of the mothers were at risk regarding parenting stress (M=80, range= 49-151) and 22% reported low/moderate parental confidence (M=75; range=44-97). Bivariate and multivariate analyses were computed to examine the roles of substance use, child’s experience of trauma and maternal mental health symptoms in predicting the parenting experience.

Results:

Two hierarchical regression models were computed, one predicting parenting stress, the other parenting competence. In model 1, longer use of heroin (step 1) and child’s trauma exposure (step 2) significantly predicted parenting stress. In the final step, mother’s mental health (emotion regulation) mediated the impact of child trauma and substance mis-use. Length of heroin use was negatively associated with parenting competence in model 2, (step 1) but child trauma was not (step 2). Notably, in step 3, mothers’ trauma symptoms predicted competence and they mediated the impact of substance mis-use. Both final models were highly statistically significant.

Conclusions:

Results demonstrate that heroin use is associated with mothers’ experience of parenting, both stress (positively) and competence (negatively). Although each are important aspects of parenting, results show they are associated with different trauma-related predictors. Parenting stress increases with greater child trauma, and with mothers’ difficulty regulating her emotions. Whereas parental competence is not associated with child trauma, but strongly dependent on a mother’s own trauma symptoms. Moreover in both models, mothers’ mental health more strongly predicts parenting experience than heroin use.  Social work researchers and practitioners can use these results in order to tailor parenting programs for families struggling with SUDs.