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Article Date: 26 Sep 2006 - 16:00pm (PDT)
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* During some assessments of child
psychopathologies, parental observations can be
helpful.
* New research looks at how helpful parents may be
in terms of assessing their children's alcohol
and/or drug use and abuse.
* Findings indicate that parents do not provide
valuable information about their children's use of
alcohol and drugs because they are often unaware of
it.
Previous assessments of child psychopathology have
shown that parents can be helpful in reporting
symptoms of Attention Deficit Hyperactivity Disorder
(ADHD) and Oppositional Defiant Disorder (ODD). A
new study examines just how helpful parents are in
assessing their children's alcohol and/or drug use
and abuse. The answer? Not much.
Results are published in the October issue of
Alcoholism: Clinical & Experimental Research.
"'Externalizing' disorders such as ADHD and ODD have
behaviors associated with them that are obvious and
affect others," explained Laura Jean Bierut,
associate professor of psychiatry at Washington
University School of Medicine. "For example, a child
who cannot sit still or focus on his or her work at
school and is disruptive in the classroom, or a
child who argues with his or her parents or refuses
to do the things that they ask. However, the
symptoms associated with 'internalizing' disorders
such as depression can be much more subtle and not
as easily recognized. Things like feelings of
worthlessness or loss of interest in favorite
activities can be very troubling to a child, but
they don't necessarily impact others and might go
unnoticed unless the child chooses to talk about
them." Bierut is also the corresponding author for
the study.
In terms of psychiatric disorders in general, added
Sherri Fisher, project coordinator of the St. Louis
site of the Collaborative Study on the Genetics of
Alcoholism (COGA) as well as co-author, this
"disconnect" points out the importance of talking to
both parents and children about the child's behavior
and symptoms. "In terms of a child's substance use
or substance-related problems, however, parents may
be unaware of what's going on with their children,
or simply repeat information that has already been
reported by their child," she said.
To further test this hypothesis, researchers used
data gathered as part of COGA, a multi-center family
study that was initiated in 1989. For this analysis,
591 adolescent-parent pairs who participated in COGA
between the years of 1991 and 1998 were interviewed:
12- to 17-year-olds were administered the child
version of the Semi-Structured Assessment for the
Genetics of Alcoholism (C-SSAGA), and one
corresponding parent - usually the biological mother
- was also interviewed about each adolescent using
the parent version of C-SSAGA.
"The three most commonly used substances as reported
by adolescents in our study were alcohol at 54
percent, tobacco at 44 percent, and marijuana at 23
percent," said Bierut. "We then compared the answers
given by the teens and parents to see how often they
agreed on this use."
The primary finding was that parents often failed to
report that their children had used a substance when
the children themselves reported that they had.
"Specifically, if a child reported having used
alcohol, the parent said their child had used
alcohol only 50 percent of the time," said Bierut.
"Similarly, when a child reported having used
tobacco, the parent reported this only 55 percent of
the time, and when a child reported having used
marijuana, the parent report agreed only 47 percent
of the time."
Parents were even more unaware of their child's use
of other drugs, added Bierut. "When a child reported
using any of the other drugs we asked about - for
example, cocaine, speed, downers - the parent agreed
that their child had used any of these drugs in only
28 percent of the cases."
Even among children who reported experiencing
symptoms of alcohol or marijuana abuse or
dependence, there were parents who did not know that
their child had ever used these substances, added
Fisher.
Both Bierut and Fisher noted that "age of the child"
was one of the most influential factors in terms of
parental awareness of adolescent substance use.
"Specifically, there was higher agreement between
the reports of parents and older adolescents," said
Bierut. "Parental agreement was highest with 16- to
17-year-olds, and lowest with 12- to 13-year-olds.
This is very troubling because research has shown
that starting to use alcohol and drugs at a young
age is a risk factor for developing substance abuse
or dependence in the future."
"In general," said Fisher, "we found that parent
reports added very little information to our
knowledge about adolescent substance use beyond what
adolescents themselves were reporting, particularly
when compared to other types of psychiatric
disorders like ADHD and ODD. Our conclusion is that
parents do not provide valuable information about
their children's use of alcohol and drugs because
they simply don't know about it." She added that
researchers may want to reconsider using time and
resources to question parents at all when it comes
to issues of adolescent substance use, abuse or
dependence.
The take-home message, said Bierut, is two-part in
nature: research clearly indicates that teens are
using alcohol and drugs. "Parents who were surveyed,
however, were largely unaware of this. Although as
parents we might like to think that our children are
not reflected in these percentages, it is important
to realize that our kids do have access to
substances and might very well be using them."
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Alcoholism: Clinical & Experimental Research
