Maternal Cocaine Use and
the Caregiving Environment During Early Childhood
Rina Das Eiden, Ph.D.,
Melissa Peterson, M.A., and
Tamaira Coleman, B. S.
University at Buffalo’s
Research Institute on Addictions
Abstracted from Psychology
of Addictive Behaviors, 13, 293-302, 1999.
It is well
known that the caregiving environment has a major impact on the development
of children. However, not many studies have examined the nature of
the caregiving environment among children of substance-using mothers.
The goal of the current study was to describe three aspects of the
caregiving environment of cocaine using mothers: the physical and
social settings for development, maternal psychosocial functioning,
and child rearing customs and attitudes. Rina Das Eiden, Ph.D.,
was the principal investigator on the study.
“We expected
that maternal cocaine use would be associated with more negative caregiving
environments but the exact nature of these environments had not been
well described,” according to Eiden. “Our results have implications
for programs designed to improve the quality of the caregiving environments
of these children.”
The starting
point
“The women
who participated in our study were at high risk because of multiple
substance use, poverty, and minority group status,” Eiden explained.
“Women who had at least one child at or below five years of age, were
of minority group status, and living below the poverty limit were
asked to participate in the study, either as part of a cocaine-using
group or a non-cocaine using control group. Mothers were recruited
into the cocaine-using group if they acknowledged using cocaine during
pregnancy or the postnatal period, and if cocaine was their primary
drug of choice. Of the 94 women in the study, 41 used cocaine and
53 did not.”
Most of the
mothers in the cocaine-using group also used other substances such
as alcohol and marijuana. Some mothers in the control group used alcohol
and marijuana. About 80% of the mothers had a high school degree or
equivalency, 15% had one year of vocational education, and the remaining
5% had an associate degree or two years of higher education. Only
17% of the mothers were employed.
Screening
Women who
were interested in the study were interviewed regarding maternal drug
and alcohol use. Included in the interview were questions about patterns
of drug use during pregnancy and the postnatal period, information
on the types of drugs used, amount, and frequency of use.
The assessment
of physical and social settings included assessment of mothers’ and
children’s exposure to neighborhood violence, adequacy of family resources,
and aspects of the children’s social settings such as length of time
spent in foster care, number of changes in primary caregivers, and
the frequency of contact with a male caregiver.
Two interrelated
aspects of mother’s functioning examined in this study were maternal
depression and symptoms of Post Traumatic Stress Disorder (PTSD).
Mother’s child rearing customs and attitudes in the areas of conformity
(e.g., obey parents and teachers), self-direction (e.g., think for
him/herself), and social (e.g., get along with people) were measured.
Lastly, parental discipline consisting of six specific maternal behaviors
was assessed: talking to the child, slapping or spanking, taking away
privileges, sending to a corner or room, ignoring behavior, and yelling
at the child.
What we
learned
The results
indicated that maternal cocaine use was related to adverse situations
in all three aspects of the caregiving environment. Mothers who used
cocaine were more likely to experience or witness community violence.
Their children were more likely to remain in foster care for longer
periods of time, to experience more changes in primary caregivers,
and to be visited by male caregivers less often, compared with non-cocaine
using mothers. These aspects of the caregiving environment are likely
to have significant influences on child adjustment and need to be
considered in future studies focusing on children of cocaine-using
mothers.
Maternal cocaine
use was also associated with higher levels of PTSD symptoms. However,
PTSD symptoms seemed to be a function of both cocaine and heavy alcohol
use in combination. Maternal exposure to violence appeared to partially
mediate the association between cocaine use and PTSD. One pathway
to higher PTSD symptoms among cocaine-using mothers was through the
association between substance use and violence exposure. Future studies
examining child adjustment as a function of maternal cocaine or alcohol
use need to consider the potential impact of maternal PTSD symptoms
and violence exposure on parenting and child outcomes.
Finally, there
was an indication that maternal cocaine use may be associated with
more problematic maternal discipline tactics like ignoring misbehavior
or yelling at their children. Use of such disciplinary techniques
was especially problematic if mothers alternated between ignoring
their child’s behavior and yelling. Apart from differences in parenting
behavior, these results may also be attributed to the likelihood of
more problematic child behaviors in this sample or to differences
in parental values about use of punishment. Studies designed to examine
child contributions, as well as maternal contributions to maternal
discipline, are needed to examine these associations more closely.
“The results
of this study,” according to Eiden, “suggest that maternal cocaine
use is associated with significant problems in the caregiving environment.
These children are at increased risk because of the effects of cocaine
and alcohol during the prenatal period and negative caregiving environments.
Increased maternal exposure to community violence, maternal PTSD,
and problematic parenting behaviors all have the potential for increasing
risk for negative outcomes among children of cocaine-using mothers.”
The generalizability
of these results is limited to African American or Hispanic American
substance-using women living below the poverty limit. The nature of
the caregiving environment may be different for substance-using women
who are non-minority and/or not living in poverty.
In conclusion
“Little is
known about the potential developmental consequences of these aspects
of the caregiving environment for children of cocaine-using mothers
or about potential interactive effects of maternal cocaine use and
the caregiving environment,” Eiden stated. “Further research incorporating
measures of developmental outcomes are needed to understand how these
aspects of the caregiving environment mediate or moderate child adjustment
among children of cocaine-using mothers.”
The authors
thank the mothers who participated in this study and the staff of
the treatment-prevention programs from which many of them were recruited.
Address correspondence to: Rina Das Eiden, 1021 Main Street, Buffalo,
NY 14203;
e-mail: Rina
Das Eiden. National Institute on Drug Abuse Grant 1K21DA00231-01A1
supported this grant.
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