Issues of fatherhood and recovery for VA substance abuse patients

Drug-addicted fathers bring to treatment many uncertainties about their relevance to their children. Whether they are in contact with their children or not, they often believe their children are better off without contact with them. In working with these fathers, the authors have observed these men raising a number of issues concerning the father role. These include having no concept of what a father should be, confusing the roles of manhood and fatherhood, feeling inadequate as a provider, and not knowing how to reconnect with children they have not seen, particularly daughters. The fathers also have to learn to deal with their own guilt concerning their abandonment of their children. Suggestions for interventions with the fathers are given and include offering a workshop for fathers where they are shown visual images of positive fathering and can discuss their own parenting experiences.     

Psychoactive Properties of Methysergide

Abstract

Men can present unique challenges when they come voluntarily or involuntarily to substance abuse groups. Twelve considerations are offered for working with men that include understanding the context of masculinity, how men are socialized, the gender of the therapist, their relationships with their fathers and their children, their male friendships, and sexual issues. Clinical implications are included.     

Invisible victims or competent agents: Opinions and ways of coping among children aged 12–18 years with problem drinking parents

Aims: The article describes the lives of children with problem drinking parents from children's own perspective, emphasizing their experiences, agency and coping.

Methods: The qualitative data were collected with a web-based questionnaire advertised on two children's and adolescents’ help pages. The final sample consisted of 70 volunteers between the ages 12 and 18 years, mostly girls (17% were boys).

Findings: Children with problem drinking parents are a hidden population and neglected by services, which they need. Children have, however, developed their own ways of trying to cope. They also have various practical suggestions and opinions concerning services and the type of help they would find useful.

Conclusions: Harms inflicted to children are an important reason for preventing substance misuse. It is also important that children are heard by professionals and authorities dealing with family problems, and that one understands, supports and respects children's own agency and ways of coping. Children's ways of coping can differ from those of the adults. Further studies on children living with problem drinking parents are needed. The study shows that internet can be one way of collecting research data from this otherwise hard-to-reach group.     

Young Men's Perceived Quality of Parenting Based on Familial History of Alcoholism

ABSTRACT

Parental Bonding Inventories (PBI) were given to 173 males, mean age 22, and analyzed based on the participant's familial risk for alcoholism. Differences in PBI scores were examined based on the recency and severity of paternal drinking problems, and on whether both the mother and father had alcohol problems or only the father. Differences in drinking patterns of sons were also examined based on PBI ratings. Fathers of the high familial risk participants were rated by sons as being significantly less Caring than the fathers of low familial risk participants. Participants who rated their fathers as low in Protection had significantly more days of heavy drinking in the past year compared to those who rated their fathers as high in Protection.     

Parents' and Children's Reports of Parenting Practices and Parent and Child Alcohol Use

SUMMARY

Parents' and children's reports of child and parent alcohol use and parental attitudes/practices were compared. Although the correlations between child/parent and mother/father reports of child alcohol use were significant, they were not high. Parents and children were similar with respect to their reports of overall mean levels of child alcohol use. There were higher correlations between parents' and children's reports of the parents' alcohol use. Comparison of the means of reported parental alcohol use by children and parents showed that children tended to underestimate the alcohol use of both parents.     

A typology of families with parental alcohol or drug abuse

Objectives To estimate the prevalence of parental alcohol abuse (PAA) or parental drug abuse (PDA), to compare families with PAA/PDA to non-PAA/PDA families, and to identify different types of families with PAA/PDA in terms of mental disorders in parents, family separation, financial difficulties and educational level. Methods Register-based data from a complete birth cohort of children born in 1991 in Finland (N?=?62,751), and their biological parents. Data were derived from Finnish administrative registers from 1991 to 2009. Latent class analysis was used to construct typology of families with PAA/PDA. Results 10.5% of families were affected by PAA or PDA before the children’s 18th birthday. Of these families, five family types were identified. The most common type was characterised by father’s alcohol abuse but had no other detectable problems besides parental separation. The second type was a family where the father had a drinking or drug problem, had financial difficulties and had moved away from the family’s home. The two less common family types were characterised by the mother’s drinking or drug abuse and mental disorders. The mothers of these family types were rather commonly living with their children. In the fifth family type, child typically did not live with either of the parents, both parents had alcohol/drug abuse and accumulated problems. Conclusions Early prevention and treatment are needed to avoid the accumulation of parental problems in PAA/PDA families. As both biological parents rather rarely were substance abusers, the parental role of the non-substance abusing parent should be supported and strengthened.     

Passive smoking exposure of sick children in Hong Kong.

1. This study aims to investigate the extent of passive smoking exposure of sick children in Hong Kong; their father's smoking behaviors and their mother's action to protect the child from environmental tobacco smoke (ETS). 2. This cross-sectional survey was the first phase of a randomized controlled trial on a health education intervention provided by nurses in the general paediatric wards of four major hospitals in Hong Kong. The subjects are non-smoking mothers of sick children admitted to hospital and with a smoking husband living together in the same household with the child. Eligible subjects completed a self-administered baseline questionnaire before entering into the trial. 3. All the 848 children whose mothers completed the questionnaire during December 1997 to April 1998 had a smoking father. They constituted about 24% (95% CI: 22.6-24.9%) of all the sick children during the same period. More than half of the children's fathers (55%; 51.6-58.3%) smoked 1-14 cigarettes per day and about 68% (64.7-71.0%) of them were daily smokers for over 10 years. Over half (53%; 49.4-56.2%) of the fathers smoked 1-14 cigarettes at home every day. About 21% of the fathers smoked near the child occasionally and 31% (27.4-33.6%) smoked 1-14 cigarettes near the child per day. About 16% of the children lived with more than one smoker (2-3). About 86% (83.3-88.0%) of the children had 1-3 smokers who smoked at home and 61% (58.1 - 64.7%) of them had 1-3 smokers who smoked near them every day. However, 70% of the children were reported by their mothers as exposed to ETS at home. This percentage (70%) was less than the percentage (86%) of smokers who smoked at home daily. About 31.1% of the mothers reported symptoms of coughing and running nose (20.6%) in their children when they were exposed to ETS. To protect the child from ETS exposure, 43% of the mothers requested the father not to smoke near the child, 33.1% requested the father to smoke less cigarettes and 31.5% advised the father to quit smoking. 4. In conclusion, sick children in Hong Kong are at risk of exposure to ETS, but not all mothers are aware of the health risks and their actions were inadequate. There is a critical need to promote awareness of ETS exposure and the health risks in the family in Hong Kong so as to reduce illness and hospital admission in children.     

Creating visual differences: Methamphetamine users perceptions of anti-meth campaigns

BackgroundBecause of increased law enforcement and subsequent media attention, methamphetamine users appear in the public’s imagination as diseased, zombie-like White trash. We explore methamphetamine users’ perceptions about whether the images, people, and situations in anti-methamphetamine campaigns reflect their own lives and experiences using meth.MethodsTo explore these perceptions, we used photo-elicitation interviews with 47 people who used methamphetamine (30 former and 17 active). Specifically, we presented participants with images from the Faces of Meth and the Montana Meth Project campaigns to stimulate discussion.ResultsWe found that participants believed these ads did not reflect their personal experiences and consequently were ineffective at curtailing their own methamphetamine use. They believed that the ads represented a certain type of methamphetamine user, particularly those they defined as dysfunctional users. They created symbolic boundaries between themselves and those portrayed in the ads to show how they differed, which allowed them to believe that the ads were not relevant to their experiences.ConclusionsFindings suggest that there are unintended consequences to inauthentic/dramatic imagery. Participants did not believe they were like those in the ads—thus saw no reason to quit or seek help. Consequently, overly stigmatizing portraits of users may act as barriers to desistence. The findings have implications for designing anti-methamphetamine campaigns.     

Trusting and misleading. Parents’ and children’s communication and negotiation about alcohol as described by teenagers

Background: Typically, research on parents’ and children’s interactions around alcohol issues focuses on how parenting styles and parents’ examples affect teenager’s drinking habits. In this paper, we approach the theme from the youngsters’ perspective. We ask how teenagers describe the interaction on alcohol-related issues with their parents and how they would like their parents to act during these interactions.

Data and methods: The article applies the concept of trust, which is seen as a feature connecting all kinds of communities, and especially families. We pay attention to whether alcohol issues challenge trustful relations and give rise to contradictions and complications in the interactions between parents and children.

Results: The analysis shows the ways how trust is maintained and challenged in teenagers? accounts of communication regarding alcohol with their parents. It also shows that although trust is tested in several ways, it is essential for teenagers. Even though teenagers tell how they can mislead their parents by using strategies that challenge trust, they nevertheless highlight the importance of trusting ties with parents. Teenagers do not exclude their parents from alcohol-related discussion but expect rules, communication and authority from them. Our data suggest that teenagers also want to protect their parents from disappointments caused by their own actions.

Conclusions: A trusting parent–child relationship, based on dialog rather than opposition, seems to play a significant role in guiding teenagers’ alcohol-related attitudes and practices.     

Examination of Veteran Fathers' Parenting and Their Adolescent Children's Substance Use in the United States

Background: Adolescent children of U.S. military veterans may be at increased risk for engaging in substance use; however, this has yet to be examined using nationally representative data. Parental involvement and communication are potential protective factors to target with prevention efforts, but veterans' parenting has not been studied in general, nonclinical populations. Objectives: This study presents data on parenting characteristics among fathers who are veterans of the U.S. military and the substance use behaviors of their adolescent children. Methods: Data were analyzed from approximately 2,200 veteran fathers, 13,100 nonveteran fathers, and their children aged 12 to 17 who participated in the National Survey on Drug Use and Health from 2004 to 2013. Parenting characteristics and adolescent substance use were compared by fathers' veteran status. Results: Compared with nonveteran fathers, veteran fathers were less likely to have talked with their children about the dangers of substance use, were more likely to believe that their children used substances, and were just as likely to be parentally involved. Higher percentages of adolescent children of veterans than those of nonveterans engaged in tobacco use and nonmedical use of psychotherapeutic drugs. Parental involvement and father-child communication about the dangers of substance use did not explain differences in substance use among adolescents with veteran versus nonveteran fathers. Conclusions/Importance: Adolescent children of veterans appear to be a group in particular need of substance use prevention services. Parental involvement and father-child communication may be appropriate protective factors to address in prevention efforts.     

Role Reversals in Families of Substance Misusers: A Trans-generational Phenomenon

Fifty adult methadone maintained opiate misusers were seen with their spouse and/or family of origin in outpatient therapy as part of a Veterans Administration Research project supported by NIDA. Family treatment was offered in an attempt to improve and enhance family relationships/social supports and to aid in the decrease or cessation of drug use. In this study, 42 of the 50 patients had parents who were substance misusers. The subjects were evaluated by constructing a Three-Generational Family Tree to define and clarify the nature of problems across the generations. Success or failure was measured by the Addiction Severity Index (ASI) which assessed drug use, problems with family, health, social relationships, legal difficulties, and employment as well as psychiatric symptoms. A recurrent problem of the “absent father” was identified across both generations studied. Thirty of the 50 opiate misusing men had absent fathers (usually due to alcohol or other drug misuse) and 27 of these 30 became absent fathers (also usually due to substance misuse) when they had children of their own. The absence of a father produced major developmental problems seen in these families. Particularly important was the “Parentified Child,” forced to prematurely assume adult responsibilities. This age inappropriate role assumption was common in both the patients and their children, and was seen as a contributor to the initiation of drug misuse. A structured clinical intervention is described using the three-generational family tree to bring out these relationship issues, followed by supportive family therapy to restructure wounded family relationships from the family of origin and to bring about appropriate role expectations in the marital families. The findings suggest an improvement in legal difficulties, drug use, and psychiatric symptoms     

Children of alcoholic fathers and recovered alcoholic fathers: personal and family functioning

Twenty-one adolescent children of recovered alcoholic fathers and 14 children of alcoholic fathers were compared with 35 sociodemographically matched children on aspects of family and personal adjustment, the parent-child relationship and perceptions of alcoholism. Children of recovered alcoholics and controls rated their families as happier and more trusting, cohesive, secure and affectionate than children of families where father still drank alcohol. Adolescents scored similarly on measures of self-esteem and locus of control, but children of alcoholics were less happy with their lives. The three groups did not differ in their relationships with either parent. Children of alcoholic or recovered alcoholic fathers were less likely to attribute alcoholism to internal causes than controls, however, and were more positive about alcoholics and their recovery.     

Child Maltreatment,Relationship With Father,Peer Substance Use,and Adolescent Marijuana Use

Abstract

This longitudinal prospective study examined the relationship between child maltreatment as per reports to child protective services (CPS) and adolescent self-reported marijuana use, and the association between relationships with mothers and fathers and use of marijuana. The association between relationships with parents early in childhood (ages 6 to 8?years) and during adolescence with adolescent marijuana use were also probed. Another aim examined whether relationships with parents moderated the link between child maltreatment and youth marijuana use. The sample included 702 high-risk adolescents from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), a consortium of five studies related to maltreatment. Children were recruited at age 4 or 6?years together with their primary caregiver. Some were recruited due to their risk for child maltreatment, others were already involved with CPS, and children in one site had been placed in foster care. Logistic regression analysis was performed using youth self-report of marijuana use as the criterion variable and child maltreatment and the relationships with parents as predictor variables, controlling for youths’ perceptions of peer substance use and parental monitoring, parental substance use, race/ethnicity, sex, and study site. Approximately half the youths had used marijuana. Most of them described quite positive relationships with their mothers and fathers. Participant marijuana use was associated with a poorer quality of relationship with mother during adolescence, and with peer and parental substance use. A better relationship with father, but not mother, during adolescence attenuated the connection between child maltreatment and youth marijuana use.     

Information sources used by parents to learn about medications they are giving their children

BackgroundPrevious studies have indicated the use of medication by children to be dependent on the attitudes of knowledge of their parents; however, little is known about sources parents might use in driving medication use decisions.ObjectiveThe aim of this study was to describe the information sources that parents use regarding their children’s medication and their perceptions of the reliability of these information sources.MethodsThis study is part of a cross-sectional population survey with a random sample of 6000 children younger than 12 years. The response rate of the questionnaire was 67%. Parents were asked about the use of information sources and their perception of reliability with a list of 16 information sources.ResultsThe information sources that parents reported having used were physicians (72%), patient information leaflets (PILs) (67%), public or school health nurses (52%), and pharmacists (44%). Regardless of the child’s age, physicians were the parents’ most-used information source. Physicians were the most-used information source also when the child had at least 1 of the 4 most common long-term diseases among children in Finland (asthma, diabetes, epilepsy, and juvenile idiopathic arthritis). Parents considered physicians (50%), PILs (31%), pharmacists (27%), nurses (20%), and public or school health nurses (17%) very reliable information sources.ConclusionsFinnish parents seek information from health care professionals and PILs when looking for information concerning their children’s medication. Furthermore, they find health care professionals and PILs to be reliable information sources.     

Pharmacotherapy to control behavioral symptoms in children with autism

Introduction: Autistic disorder, Asperger's disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS) are pervasive developmental disorders (PDDs) frequently associated with behavioral symptoms that may require pharmacotherapy to manage.

Areas covered: Behavioral symptoms in children with autism include interfering repetitive behaviors, irritability, and hyperactivity and inattention, among others. The psychotropic medications examined in this review include: serotonin reuptake inhibitors, typical and atypical antipsychotics, medications used to treat attention-deficit/hyperactivity disorder, naltrexone, buspirone, divalproex sodium, lamotrigine, levetiracetam, memantine, mirtazapine, riluzole, pioglitazone, and topiramate.

Expert opinion: For the treatment of interfering repetitive behaviors, serotonin reuptake inhibitors demonstrate less efficacy and are more poorly tolerated in children with autism compared to adults. Antipsychotics are the most efficacious drugs for the treatment of irritability in children with autism and other PDDs. For the treatment of hyperactivity and inattention, psychostimulants demonstrate some benefit. However, they are overall less efficacious and cause more side effects in children with PDDs compared to typically developing children with attention-deficit/hyperactivity disorder. Results from double-blind, placebo-controlled trials of these agents and others for the treatment of the behavioral symptom domains described above will be discussed in this review.     

Physical and psychosocial factors associated with psychostimulant use in a nationally representative sample of French adolescents: Specificities of cocaine,amphetamine, and ecstasy use

PurposePatterns of psychostimulant (PST) use, psychological and physical factors, and family relationships were investigated in a nationally representative sample of adolescents. The differences between users of cocaine (Cc), ecstasy/MDMA, and amphetamine (EA) were analyzed, taking into account gender differences.MethodsSubstance use, psychological factors (lifetime suicide attempts, suicidal thoughts in the previous year, visits to a mental health professional), physical factors (health and body shape perceptions (BSP), body mass index (BMI)), and family relationships (existence of disagreements with parents, relationships with mother and father) were investigated in 26,351 17-year-old French adolescents.ResultsLifetime suicidal behavior was strongly associated with EA use only. Suicidal ideation in the previous year was associated with Cc use among both boys and girls and associated with EA use among girls. Compared to Cc users, more EA users were overweight, while more Cc users were underweight compared to EA users. BSP, BMI, and EA use were related in girls only. Having a good or very good relationship with both mother and father was negatively associated with Cc use in boys and girls. Girls who had a good or very good relationship with their fathers seemed to be less prone to use EA. Boys with a good or very good relationship with their mothers seemed to be less prone to use EA.ConclusionThe results of the present study could serve as a basis for prevention and harm reduction strategies/programs targeting youth use and for the adaptation of these strategies/programs according to substance and gender.     

Neuropsychological characteristics in children of alcoholics: familial density.

OBJECTIVE: The purpose of high-risk studies is to find characteristics that allow the identification of subjects with a higher vulnerability to alcoholism. The aim of this research was to verify if the familial density criterion is useful for subtyping children of alcoholics with different neuropsychological characteristics. METHOD: A battery of neuropsychological tests was administered to 102 boys and girls of 7-15 years of age; 66 were children of alcoholics with a high (n = 32) and low (n = 34) familial density of alcoholism, and 36 were children of nonalcoholic fathers with a negative family history of the disorder. The battery included tests to assess attention, visuospatial abilities and frontal functions. RESULTS: MANCOVAs showed that high-density children scored lower than children of nonalcoholic fathers in attentional and visuospatial tasks. There were no differences between low-density and negative family history children in these cognitive domains. CONCLUSIONS: These results suggest that children of alcoholics are not a homogeneous group. Children with multigenerational alcoholism, but not children with an alcoholic father, showed reduced performance in specific cognitive areas.     

Substance-abusing mothers and fathers' willingness to allow their children to receive mental health treatment

The purpose of this study was to examine attitudes of substance-abusing mothers and fathers entering outpatient treatment toward allowing their children to participate in individual- or family-based interventions. Data were collected from a brief anonymous survey completed by adults at intake into a large substance abuse treatment program in western New York. Only one-third of parents reported that they would be willing to allow their children to participate in any form of mental health treatment. Results of chi-square analyses revealed that a significantly greater proportion of mothers reported that they would allow their children to participate in mental health treatment (41%) compared to fathers (28%). Results of logistic regression analyses revealed even after controlling for child age, mothers were more likely than fathers to indicate their willingness to allow their children to receive mental health treatment; however, type of substance abuse (alcohol versus drug abuse) was not associated with parents' willingness to allow their children to receive treatment. Parental reluctance to allow their children to receive individual or family-based treatment is a significant barrier in efforts to intervene with these at-risk children.