MedicalResearch.com Interview with:
Dr. Ingunn Olea Lund, PhD
The Norwegian Institute of Public Health
MedicalResearch.com: What is the background for this study?
Response: There are significant amounts of research on children of parents with alcohol use disorders – where the children are shown to be at risk of several adverse outcomes, including mental disorders, substance use disorders, suicide, impaired school performance, and employment problems. There is very little previous research on how other, more normal levels of parental drinking may influence child outcomes, such as mental health. This is a grave oversight, as there are vastly more parents with normal drinking patterns than there are parents who suffer from an alcohol use disorder. This means that there are potentially a lot more cases of adverse effect for children, and the number of children at risk may be higher than previously assumed.
In addition to parents’ alcohol use, several other risk factors in the family that may affect child mental health outcomes, such as parents’ mental health and socio-economic status. Researchers have tended to look at these risk factors separately, but as these risks tend to co-occur, it may be more informative to consider them together.
To our knowledge, this is the first study that examines possible harm from normal levels of parental drinking, alone or in combination with other parental risk factors, on children’s anxiety and depression.
The sample consists of more than 8700 triads: children and both their parents. We combined information from three health registries with survey data where both adolescents and their parents provided information about health and social conditions. The health registers include information about the children ‘s actual contact with the health care system; we used information about whether children received diagnoses and/or treatment for anxiety and/or depression.
MedicalResearch.com: What are the main findings?
Response: Based on information about mothers and fathers ‘drinking amount, drinking frequency, the parents’ mental health and their level of education we identified five risk profiles – in some families there was generally low risk; in other families, it was especially one risk factor that was prominent; and some families had several risk factors. We compared the profile with the lowest risk – where both parents drank little, had somewhat higher education and good mental health with the other risk profiles.
We found that despite seemingly harmless levels of parental behaviors and characteristics, some constellations of parental risk factors were associated with significant increases in the risk of subsequent anxiety and/or depression among children, compared with children growing up in families where none of these risk factors are present. One such constellation is where both parents drink about 6-7 units of alcohol per week and where the father had elevated mental health symptoms. Children in these families were more likely to be diagnosed with and/or receive treatment for anxiety and/or depression than children in overall low-risk families.
The second risk profile that was related to increased likelihood of anxiety/depression in the children was low education among both parents, even though both mothers and fathers in this group drank little, approx. 1-2 alcohol units per week, and they did not have symptoms of mental health problems.
MedicalResearch.com: What should readers take away from your report?
Response: Parents should consider their alcohol consumption in the context of other conditions in the family. Even normal levels of drinking may be a trigger for children’s anxiety and depression if there are other risk factors present in the family.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: We recommend that studies seeking to understand prospective associations of parental drinking with children’s mental health need to consider additional risk factors in combination with one another as well as parental behaviors and characteristics below clinically defined levels. When accumulated at a family level, even seemingly innocuous characteristics contributed to meaningful increases in risk of anxiety and/or depression among children, potentially translating into poorer mental health outcomes for many young people”.
MedicalResearch.com: Is there anything else you would like to add?
Response: It should also be noted that this is the first study examining the association between normal levels of parental drinking, alone or in combination with other parental risk factors, and there is still a lot we do not know about the consequences for children.
We have no disclosures.
Lund IO, Skurtveit S, Handal M, et al. Association of Constellations of Parental Risk With Children’s Subsequent Anxiety and Depression: Findings From a HUNT Survey and Health Registry Study. JAMA Pediatr. Published online January 07, 2019. doi:10.1001/jamapediatrics.2018.4360
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