Preventing adolescent substance use may need to start in early childhood

"The children of parents with alcohol problems are at much greater risk for underage drinking and developing a substance use disorder," says the study's author, Rina Das Eiden, PhD, senior research scientist at RIA. "It's important to understand when and under what circumstances such problems develop, so we can craft interventions to steer this high-risk population away from substance use and its attendant problems."

Eiden examined different pathways to adolescent substance use, starting in infancy, for children of parents with alcohol use disorder (AUD), and found that maternal warmth and sensitivity in early childhood played a significant role.

"When mothers can be warm and sensitive during interactions with their toddlers, even under the stresses associated with their partners' alcohol problems, there is a lower likelihood of adolescent substance use," Eiden says. Parents with AUD demonstrated lower rates of maternal sensitivity toward their toddlers, continuing into kindergarten age, Eiden found. As the children entered middle school (6th grade), their mothers were less likely to monitor peer groups and activities, leading to higher engagement with substance-using and delinquent peers and drinking in early adolescence (8th grade). These children also displayed lower self-regulation, or the ability to behave according to rules without supervision, at preschool age, leading to problem behaviors from kindergarten age to early adolescence and higher alcohol and marijuana use in late adolescence.

The results have implications for both the timing and content of preventive interventions against substance use among adolescents of parents with AUD. Timing interventions in early childhood and before major developmental transitions, such as transition to school and moving from elementary to middle school, may be most beneficial.

For content, the most helpful interventions would be to encourage and support mothers in being warm and sensitive during interactions with their toddlers, and to keep a close eye their children's activities and peer groups during the transition from middle childhood to early adolescence. "This attention also would promote children's self-regulation in the preschool years, which may lead to a decrease in problem behaviors from school age into adolescence," Eiden says.