Trauma Symptoms and Social Support Mediate the Impact of Violence Exposure on Parenting Competence Among Substance Dependent Mothers

Purpose:  Women with substance use disorders experience high rates of violence exposure and post-traumatic stress (Cohen & Hien, 2006). This has implications for parenting, as 73% of women entering treatment for substance use disorders (SUD) are mothers of children under the age of 18 (SAMHSA, 2009). Per the Process Model of parenting (Belsky, 1984), contextual stressors and supports influence both parenting practices and perceptions of one’s parenting.  While violence exposure may be one contextual parenting stressor, social support may offer contextual support for parenting. However, little is understood about the pathways through which social support, violence exposure, and trauma related symptoms impact parenting sense of competence among mothers with SUD. The purpose of this study was to test one pathway through which trauma related symptoms and social support sequentially mediated the influence of violence exposure on mothers’ perceptions of their competence.

Methods:  Using linear regression and path analysis in MPlus, we examined the impact of violence exposure, trauma symptoms, and interpersonal support, on the parenting competence of 291 mothers upon intake to a substance abuse treatment program. Eligibility criteria included having been in treatment for one week, and having a diagnosis of alcohol and /or drug dependence. The Exposure to Violence Scale assessed women’s experiences of violence during the past year.  Social support was examined using the Interpersonal Support Evaluation Scale. Trauma symptoms were measured using the Trauma Symptom Checklist, and parenting competence was measured using the Parenting Sense of Competence Scale.   

Results:   Women’s average age was 36.12 and ranged from 18-58. More than half, 62.6% (n=184) identified as Black-African American, and more than 70% (n=212) were diagnosed with a dual substance and mental health disorder. For violence exposure during the previous year, 45.2% of women were victims of violence in their homes, 44.2% in their neighborhoods, and 9.9% at work or school. Of the 65.3 % who experienced violence, 31% had been slapped/punched/kicked, 22.8% had been beaten or mugged, 7% were stabbed with a knife, 8 women had been shot or shot at, and 22.1% had been forced to do a sexual act against their will.  The final regression model significantly predicted parenting competence, F(9, 291) = 3.433, p<.01 and R² = .119. The hypothesized sequential mediation model, with trauma symptoms and interpersonal support fully mediating the relationship between violence exposure and parenting competence, fit the data well (χ²(6)=99.46, p<.001).  The CFI was 1.00, SRMR was .02, and RMSEA was .00, all within the parameters suggested by Weston and Gore (2006).   

Implications:  Current models for intervening with mothers with addiction and violence exposure have focused primarily on developing skills for coping with affect dysregulation and impulsivity, and focus minimally on the interpersonal consequences of violence exposure. Interventions that reduce the impact of trauma symptoms on social relationships are important to building parenting sense of competence in mothers with addictions. Interventions to enhance interpersonal support in this population should be specifically targeted to reduce trauma related barriers to creating, perceiving, and utilizing support to enhance successful parenting.