Parental Distress as a Mediator of Problem Behaviors in Sons of Alcohol-Involved Families*
Structural equation modeling was used to test the hypothesis that parental distress would mediate the relations between parental lifetime alcohol and physical health problems and child behavior problems. Participants were 182 alcohol-involved families and 83 matched controls with 3- to 5-year-old biological sons. Results show that sons of parents with alcohol and physical health problems are at elevated risk for behavior problems, partly related to the increased levels of distress their parents are experiencing.
Key Words: child behavior problems, children of alcoholics, parent alcoholism, parent antisocial behavior, parent distress, parent physical health.
Children of alcoholics (COAs) are at increased risk for a number of negative developmental outcomes including behavior problems (West & Prinz, 1987). However, COAs show a great deal of variability in outcome (Johnson & Jacob, 1995), suggesting the involvement of multiple factors in the development of behavioral difficulties. Being the child of an alcoholic may not be the sole determinant of negative outcomes; other variables also may play a role. For instance, the homes of alcoholics have been characterized by high marital discord, inadequate parenting, and low levels of positive stimulation (Reich, Earls, & Powell, 1988).
Many researchers have examined variables in addition to parental alcoholism that may be associated with child outcome, including parental antisocial behavior, stress, and depression (see Kuperman, Schlosser, Lidral, & Reich, 1999; Rubio-Stipec, Bird, Canino, Bravo, & Alegria, 1991; Zucker, Ellis, & Fitzgerald, 1994). Fewer researchers have considered the relations among parental physical health history and these risk factors. Moreover, little work has examined the impact of parental health history on the behavioral development of COAs, even though individuals who drink heavily report elevated levels of health problems (Chou, Grant, & Dawson, 1996) and parental physical symptomatology has been found to be an important predictor of maladjustment in non-COA samples (Stein & Newcomb, 1994).
Research examining the role of parental physical health on child adjustment has focused almost exclusively on differentiating children of physically ill parents from children of parents who are not ill on a variety of factors, with little effort directed toward examining the processes affecting the relationship between parental physical health and child outcome (see Armistead, Klein, & Forehand, 1995, for a review). Likewise, although COAs are at heightened risk for behavioral problems, the pathways through which parental alcoholism influences child outcomes are not yet well understood, particularly with respect to the behavioral development of preschool-aged children.
The purpose of the present study was to examine the processes through which parent lifetime alcohol-related psychopathology and physical health problems are related to the development of behavior problems in 3- to 5-year-old male children. We hypothesized that lifetime levels of parent alcohol-related psychopathology and health problems would be indirectly related to child outcome through current levels of parental distress (daily hassles, stress and depression). Thus, we expected that current levels of parent distress would mediate or account for the relations between parent lifetime alcohol-related psychopathology and health history and the young son's behavior problems (see Figure 1).
Parent Alcohol-Related Psychopathology
It is by now well accepted that there is more than one type of alcoholic, and children may be differentiated on the basis of the type of alcoholism their parent (or parents) exhibits (Puttler, Zucker, Fitzgerald, & Bingham, 1998). In particular, the presence of comorbid antisocial personality disorder not only strongly differentiates the clinical severity and onset characteristics of the adult alcohol disorder (Babor et al. …