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Does Parent Substance Use Always Engender Risk for Children? An examination of the relationships between substance use patterns, social support type, and child maltreatment behaviors

Abstract

Background and Aims. Parent substance use is associated with an added risk for child maltreatment, yet little is understood about how the continuum of use behaviors contributes to differential risk. Social supports also may provide resources and social engagement that mitigate substance-related risks. However, the protective nature of social support is likely to vary by the type of support and the level of parents’ substance-related impairments. Guided by social information processing models of abuse and neglect, this study examined the relationships between parent substance use patterns, social support types, and child maltreatment frequencies.

Methods. Secondary data analyses were conducted using the National Survey of Child and Adolescent Well-Being (NSCAW I). The study sample was composed of 2,100 parents from Wave 4. Weighted negative binomial regression models assessed key relationships, controlling for prior service history, risk factors, and demographics.

Results. Substance use disorder (SUD) was associated with a higher frequency of general maltreatment compared to lifetime abstinence or former use. When decomposed by type, any current alcohol or illicit drug use was associated with a higher frequency of physical abuse, and higher substance use intensity was associated with a higher frequency of emotional abuse. Only SUD was associated with a higher frequency of neglect. For physical abuse, current substance users with moderate levels of resource-based support were associated with a higher frequency compared with abstainers/ex-users with moderate levels of resource-based support. For neglect, moderate levels of social companionship among parents with SUD were associated with a higher neglect frequency than non-problematic and problematic users with the same level of social companionship. Among problematic users, moderate levels of social companionship were associated with lower neglect frequency than low levels of social companionship.

Conclusions. Substance use behaviors vary in their contribution to risk for different type of child maltreatment, and the protective nature of social supports differ across substance use patterns. Assessment and prevention efforts should factor in the complexity of these relationships when engaging substance-using parents. Future research would benefit from incorporating more nuanced substance use measures, examining the role of social context in mitigating harms, and directly measuring neuropsychological impairments.

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