Perceptions of Genetic Risk for Transmission of Substance Abuse Among Parents with Substance Use Disorders

Background and Purpose: A growing body of research has explored genetic risk factors associated with the development of substance use disorders (SUD) (Bevilacqua & Goldman, 2009). Yet the science behind the etiology for SUDs is complex and multi-factorial, involving complex transactional developmental processes involving environmental and biological contributions. Additionally, there is limited research on how parents with a SUD understand the risk of transmission of SUD to their children. This study examines how parents of young children with SUD make meaning of their children’s risk for addiction, adding important insight into potential areas for intervention.

Methods: Data from this study is drawn from a larger project examining treatment for caregivers with SUD and their young children ages zero to five being served by three child and family serving agencies in a Northeastern state in the United States. Agencies were selected based on their involvement in a new initiative to adopt and implement a Trauma-Informed Care intervention, the Attachment, Regulation, and Competency (ARC) model. Twenty-nine in-depth, semi-structured Working Model of the Child Interviews (WMCI) were conducted with mothers receiving treatment for SUD. The WMCI (Zeanah, Benoit, & Barton, 1986) assesses caregiver internal representations of their child and the relationship with the child. WMCI interviews were then clinically coded and in a separate process, qualitatively analyzed using content analysis, to examine maternal concerns related to intergenerational risk for the development of SUDs in their children.

Findings: Data analysis reveals that 20% of mothers report very high levels of genetic anxiety about their children’s risk factors for developing a SUD. Mothers reported that they believed their children already had traits of being an addict or were almost certain that their children were destined to inherit their addiction. These statements are indicative of pre-determined narratives about their children's future trajectories.

Conclusion and Implications: : Findings suggest that among mothers with SUD, a subset experiences overwhelming anxiety about their children's future risk for developing a SUD. This anxiety may speak to intergenerational histories of SUD in families and may also represent a misunderstanding of genetic science in this area. While biological and disease models of addictions have served to reduce stigma and remove blame from individuals, these practice frameworks may have the unintended consequence of heightening parental anxiety that they may have passed a genetic predisposition to their child. Lack of nuance around the importance of environments in practice models may leave parents with SUDs underappreciating their capacity to shift their children’s’ trajectories through seeking help. These areas are ripe for intervention. Future research may focus on working both with parents and frontline treatment providers to better explain the nature of genetic risk and the power of environments and sensitive caregiving to promote resilience.