Moderation and Mediation in the Relationship Between Mothers' or Fathers' Serious Psychological Distress and Adolescent Substance Use: Findings from a National Sample

doi:10.1016/j.jadohealth.2008.01.010

Journal of Adolescent Health

Volume 43, Issue 2, August 2008, Pages 141-150

https://doi.org/10.1016/j.jadohealth.2008.01.010 Get rights and content

Abstract

Purpose

This study estimated percentages of adolescents living with a mother or father with serious psychological distress (SPD), and examined moderation and mediation of the relationships between mother or father SPD and adolescent substance use.

Methods

We analyzed data from nationally representative samples of adolescents interviewed with their mothers (n = 4734) and fathers (n = 3176) in the combined 2002 and 2003 National Surveys on Drug Use and Health (NSDUHs).

Results

An estimated 4.1% of adolescents living with their father had a father with SPD during the past year, and 11.5% of adolescents living with their mother had a mother with SPD during this time period. A positive association was found between mothers' SPD and adolescent binge drinking (OR = 1.49, 95% CI = 1.01–2.21), but no association was found between fathers' SPD and adolescent binge drinking. Mothers' SPD was associated with increased risk of binge drinking among adolescents aged 14–15 years (OR = 2.52, 95% CI = 1.38–4.60), and fathers' SPD was associated with lowered risk of binge drinking among black adolescents (OR = .08, 95% CI = .01–.79). A positive association was found between mothers' SPD and adolescent illicit drug use (OR = 1.55, 95% CI = 1.08–2.23), but no association was found between fathers' SPD and adolescent illicit drug use. Mothers' SPD was associated with increased risk of illicit drug use among female adolescents (OR = 2.14, 95% CI = 1.24–3.70) and among adolescents of white ethnicity (OR = 1.78, 95% CI = 1.19, 2.68). Parental involvement partially mediated the relationship between mothers' SPD and daughters' illicit drug use; mothers' SPD was associated with lower levels of parental involvement, which in turn were associated with an increased probability of daughters' illicit drug use.

Conclusions

Overall, parents' SPD is associated differentially with adolescent substance use depending on the gender of parent and adolescent, adolescent age, race/ethnicity, and substance used. Parental involvement appears to be one mechanism through which mothers' SPD influences daughters' illicit drug use. Future research should further consider the interindividual effects of parents' SPD and associated parenting behaviors on adolescent risk behaviors.

Section snippets

Potential moderators

Our research is guided by Goodman and Gotlib's Integrative Model for Transmission of Risk [1]. The model developers explored whether some children are more vulnerable than others to the interpersonal context or the dysfunctional neuroregulatory mechanism associated with psychological disorder. A few studies have found that adolescent girls are more susceptible to mothers' depression, possibly because of girls' sensitivity to resulting family discord [7]. Some researchers attest that parents'

Methods

Data for this study were from the combined 2002 and 2003 National Surveys on Drug Use and Health (NSDUH); the NSDUHs provide annual estimates of SPD and substance use in the noninstitutionalized, civilian U.S. population [12], [13]. Combining 2 years of data was necessary to obtain adequate sample sizes of fathers with SPD to conduct moderation analyses. The original survey procedures were approved by RTI International's Committee for the Protection of Human Subjects and the Office of

Results

As shown in Table 1, approximately 11.5% of adolescents living with their mother had a mother with SPD, and 4.1% of adolescents living with their father had a father with SPD.

Mothers' SPD was positively associated with adolescent binge drinking (OR = 1.49, 95% CI = 1.01–2.21) after controlling for mothers' substance use and family structure. However fathers' SPD was not associated with adolescent binge drinking. The association between mothers' SPD and adolescent binge drinking was moderated by

Discussion

Our estimates that fathers' SPD affects 4.1% of adolescents living with their father and that mothers' SPD affects 11.5% of adolescents living with their mother are comparable to findings in a recent report that, in 2002, an estimated 8.9% of parenting adults experienced serious psychological distress during the past year [30], and to the estimate of frequent mental distress as assessed by the CDC's Behavioral Risk Factor Surveillance System (BRFSS) (8.6%) [31]; but our findings are higher than

Conclusions

Mothers' or fathers' SPD was associated with different substance use outcomes among subgroups of adolescents. Thus prevention, early identification, and outreach targeting adolescents may need to be sensitive to important factors such as gender of the parent with SPD; race/ethnicity, gender, and age of the adolescent; and different substance use behaviors. Our moderation findings render consideration only of direct effects of mothers' or fathers' SPD inappropriate. In particular daughters,

References (40)

W.A. Collins et al.
Mother–child and father–child relationships in middle childhood and adolescence: A developmental analysis
Dev Rev
(1991)
S.H. Goodman et al.
Risk for psychopathology in the children of depressed mothers: A developmental model for understanding mechanisms of transmission
Psychol Rev
(1999)
S.L. Hans et al.
Offspring of parents with schizophrenia: Mental disorders during childhood and adolescence
Schizophr Bull
(2004)
J. Nicholson et al.
Critical issues for parents with mental illness and their families
(2001)
D. Oyserman et al.
Parenting among mothers with a serious mental illness
Am J Orthopsychiatry
(2000)
M.P. DelBello et al.
Review of studies of child and adolescent offspring of bipolar parents
Bipolar Disord
(2001)
C.T. Mowbray et al.
Diversity of outcomes among adolescent children of mothers with mental illness
J Emot Behav Disord
(2004)
P. Davies et al.
Gender-specific pathways between maternal depressive symptoms, family discord, and adolescent adjustment
Dev Psychol
(1997)
C.T. Mowbray et al.
Mothers with a mental illness: Stressors and resources for parenting and living
Fam Soc
(2000)
Mental health: A report of the Surgeon General
(2000)

D.R. Williams et al.

Racial/ethnic discrimination and health: Findings from community studies

Am J Public Health

(2003)

J.D. Harnish et al.

Mother–child interaction quality as a partial mediator of the roles of maternal depressive symptomatology and socioeconomic status in the development of child behavior problems

Child Dev

(1995)

Results from the 2002 National Survey on Drug Use and Health: National findings

(2003)

Results from the 2003 National Survey on Drug Use and Health: National findings

(2003)

J.R. Chromy et al.

Estimation for person-pair drug-related characteristics in the presence of pair multiplicities and extreme sampling weights

(2001)

T.A. Furukawa et al.

The performance of the K6 and K10 screening scales for psychological distress in the Australian and National Survey of Mental Health and Well-Being

Psychol Med

(2003)

R.C. Kessler et al.

Short screening scales to monitor population prevalences and trends in non-specific psychological distress

Psychol Med

(2002)

Early release of selected estimates based on data from the 2004 National Health Interview Survey

R.C. Kessler et al.

Screening for serious mental illness in the general population

Arch Gen Psychiatry

(2003)

Results from the 2004 National Survey on Drug Use and Health: National findings

(2005)

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Original articleModeration and Mediation in the Relationship Between Mothers' or Fathers' Serious Psychological Distress and Adolescent Substance Use: Findings from a National Sample

Abstract

Purpose

Methods

Results

Conclusions

Section snippets

Potential moderators

Methods

Results

Discussion

Conclusions

Dev Rev

Risk for psychopathology in the children of depressed mothers: A developmental model for understanding mechanisms of transmission

Psychol Rev

Offspring of parents with schizophrenia: Mental disorders during childhood and adolescence

Schizophr Bull

Critical issues for parents with mental illness and their families

Parenting among mothers with a serious mental illness

Am J Orthopsychiatry

Review of studies of child and adolescent offspring of bipolar parents

Bipolar Disord

Diversity of outcomes among adolescent children of mothers with mental illness

J Emot Behav Disord

Gender-specific pathways between maternal depressive symptoms, family discord, and adolescent adjustment

Dev Psychol

Mothers with a mental illness: Stressors and resources for parenting and living

Fam Soc

Mental health: A report of the Surgeon General

Racial/ethnic discrimination and health: Findings from community studies

Am J Public Health

Mother–child interaction quality as a partial mediator of the roles of maternal depressive symptomatology and socioeconomic status in the development of child behavior problems

Child Dev

Results from the 2002 National Survey on Drug Use and Health: National findings

Results from the 2003 National Survey on Drug Use and Health: National findings

Estimation for person-pair drug-related characteristics in the presence of pair multiplicities and extreme sampling weights

The performance of the K6 and K10 screening scales for psychological distress in the Australian and National Survey of Mental Health and Well-Being

Psychol Med

Short screening scales to monitor population prevalences and trends in non-specific psychological distress

Psychol Med

Early release of selected estimates based on data from the 2004 National Health Interview Survey

Screening for serious mental illness in the general population

Arch Gen Psychiatry

Results from the 2004 National Survey on Drug Use and Health: National findings

Original article
Moderation and Mediation in the Relationship Between Mothers' or Fathers' Serious Psychological Distress and Adolescent Substance Use: Findings from a National Sample