The Complex Nature of Parental Substance Use: Examining Past Year and Prior Use Behaviors as Correlates of Child Maltreatment Frequency
Substance Use & Misuse
Child maltreatment studies typically have focused on dichotomous substance use variables, resulting in limited understanding about how a range of substance use is related to child maltreatment. Objectives: To examine how dichotomous measures conflate the unique contribution of specific substance use behaviors to child maltreatment frequency and to assess the utility of considering recent history of substance use disorder within the past 4 years. Method: Cross-sectional, secondary data analyses
... dary data analyses were conducted using the National Survey of Child and Adolescent Well-being (NSCAW I). The study sample is composed of 2,100 high-risk parents with complete child maltreatment and substance use history. The study used weighted negative binomial regression to examine the relationships between child maltreatment frequency and different ways of operationalizing substance use behaviors. Results: Dichotomous approaches overestimated the unique contribution of past year heavy drinking and/or illicit drug use and underestimated the unique contribution of past year substance use disorder. When recent history was considered, previously concealed relationships were observed: child maltreatment incidence was 64% lower on average among parents with a recent but not current substance use disorder compared to parents reporting current substance use disorder (Holm's p = .002). Conclusions/Importance: Substance-using parents may need tailored interventions to address a range of substance-related maltreatment risk. Future studies would benefit from exploring longitudinal effects of use reduction on parenting behaviors and underlying mechanisms that may explain observed differences in maltreatment frequency. Keywords: heavy drinking; illicit drug use; substance use disorder; child maltreatment Glossary of Key Terms & Concepts: Child Maltreatment: a constellation of harmful, interrelated behaviors directed toward a child; limited to physical abuse, emotional abuse, and neglect within this study. Drinking Patterns: ordinal categories that capture the maximum number of drinks an individual will imbibe during one time period, behaviors range from no use (0 drinks at most) to heavy drinking (4-5 drinks or more). Illicit Drug Use: intended ingestion of marijuana/hashish, sedatives, tranquilizers, analgesics, heroin, cocaine/crack/freebase, amphetamines, inhalants, and/or LSD/hallucinogens for non-medical use. Substance Use Disorder: past year heavy alcohol and/or illicit drug use associated with at least 2 substance-related problems in biological, cognitive, social, or educational/occupational functioning as defined by the DSM-5.