Neuropsychological functioning, psychopathology, and parenting behaviours in the context of substance use disorders: which are the implications for treatment?

Background: Parental Substance Use Disorder (SUD) constitutes a high-risk condition for parenting, parent-child relationships, and child development. Individuals with SUD often present low-quality parenting behaviors, being less sensitive, more hostile and intrusive towards their children. Moreover, empirical evidence suggests high rates of psychopathology and neuropsychological impairments in individuals with SUD, which could further compromise quality of parenting. The present study aimed to investigate the impact of neuropsychological functioning and psychopathology on parenting behaviors in mothers with SUD.

Methods: The study involved 29 mothers (M age=30.52 yrs , SD=7.37) with SUD and their children (16 females, M age=22.97 mths, SD=28.64) in treatment in an Italian Therapeutic Community (TC). After admission to the facility, the mothers were assessed with respect to neuropsychological functioning (Brief Neuropsychological Examination; ENB-2 by Mondini et al., 2003), psychopathological symptoms (Symptom Checklist-90 Revised; SCL-90-R by Derogatis, 1975), and parenting behaviors (Emotional Availability Scales; EAS by Biringen, 2008), which were rated during free-play parent-child interactions.

Results: The mothers presented high rates of neuropsychological impairments and of psychopathological symptoms. Moreover, they showed low-quality parenting behaviors, being less sensitive and structuring, as well as highly intrusive towards their children. Further analyses reported consistent associations between maternal neuropsychological impairments, psychopathology, and parenting behaviors, with a greater impact of neuropsychological functioning on maternal sensitivity.

Conclusions: Parental SUD constitute a complex clinical condition which could impact at different levels on parenting, affecting neuropsychological functioning, psychological wellbeing and finally observed parenting behaviors. Clinical implications of the findings in terms of treatment are presented.