LISBON ADDICTIONS 2017 FATHER INVOLVEMENT AND CORRELATES OF

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LISBON ADDICTIONS 2017 FATHER INVOLVEMENT AND CORRELATES OF SYMPTOMS OF DEPRESSION AND ANXIETY AMONG

LISBON ADDICTIONS 2017 FATHER INVOLVEMENT AND CORRELATES OF SYMPTOMS OF DEPRESSION AND ANXIETY AMONG FATHERS WITH DRUG ADDICTION PROBLEMS BARROCAS, J. (1), VIEIRA-SANTOS, S. (2), & PAIXÃO, R. (3) 1) BARLAVENTO’S SPECIALIZED TREATMENT UNIT OF THE DIVISION FOR INTERVENTION ON ADDICTIVE BEHAVIORS AND DEPENDENCIES, REGIONAL HEALTH ADMINISTRATION OF THE ALGARVE, I. P. , MINISTRY OF HEALTH, PORTUGAL 2) CICPSI, FACULDADE DE PSICOLOGIA DA UNIVERSIDADE DE LISBOA, PORTUGAL 3) FACULDADE DE PSICOLOGIA E CIÊNCIAS DA EDUCAÇÃO DA UNIVERSIDADE DE COIMBRA, PORTUGAL

PARENTAL DRUG ADDICTION (DA) Family risk factor for children (Gainey, Haggerty, Fleming, & Catalano,

PARENTAL DRUG ADDICTION (DA) Family risk factor for children (Gainey, Haggerty, Fleming, & Catalano, 2007) STRONG EMPIRICAL EVIDENCE THE AUTHORS DO NOT HAVE ANY CONFLICT OF INTEREST TO DECLARE.

RISKS (a) Physical • The quality and continuity of care is frequently disrupted (Söderström

RISKS (a) Physical • The quality and continuity of care is frequently disrupted (Söderström & Skarderud, 2013) • The evidence linking drug abuse with child maltreatment, particularly neglect, is strong (Testa & Smith, 2009) (b) Social (c) Psychological (Kroll & Taylor, 2003; Palminha, 1983)

Studies have focused primarily Pregnancy and the maternity conditions of women with DA Impact

Studies have focused primarily Pregnancy and the maternity conditions of women with DA Impact of maternal DA on children (e. g. , Coleman, Reardon, & Cougle, 2005; Cotralha, 2007; Grant et al. , 2011; Martin, English, Clark, Cilenti, & Kupper, 1996; Quinlivan & Evans, 2005)

CONSIDERING the multifactorial nature of the relationship between parenting and DA, it is not

CONSIDERING the multifactorial nature of the relationship between parenting and DA, it is not possible to conclude that an “incompatibility” exists between DA and parenting in all families (e. g. , Barrocas, Vieira-Santos, & Paixão, 2016) • Difficulties in fulfilling parental functions are not solely a consequence of DA and substance use per se; rather, they reflect cumulative risk factors that accompany such behavior (Hogan, 2007; Mayes & Truman, 2002) • In high risk contexts, some protective factors might contribute to more adaptive parenting (Scaife, 2008)

PATERNITY HAS BEEN LESS FREQUENTLY STUDIED (MCMAHON, 2013) FATHERS’ PERCEPTIONS IMPACT OF PATERNAL DA

PATERNITY HAS BEEN LESS FREQUENTLY STUDIED (MCMAHON, 2013) FATHERS’ PERCEPTIONS IMPACT OF PATERNAL DA ON PARENTING

POSITIVE AND NEGATIVE CONTRIBUTIONS FOR CHILDREN PRESENCE OF FATHERS WITH DA PROBLEMS (SCAIFE, 2008)

POSITIVE AND NEGATIVE CONTRIBUTIONS FOR CHILDREN PRESENCE OF FATHERS WITH DA PROBLEMS (SCAIFE, 2008)

Findings • Children who live with a father who experiences DA problems: - have

Findings • Children who live with a father who experiences DA problems: - have a higher tendency to present psychiatric disorders and negative behavior throughout their lives compared with children living with individuals who have alcohol-related problems or parents with no substance addiction problems (Kelley & Fals-Stewart, 2004); - have a decreased risk of developing a drug-related problem comparing with children who only live with their mothers (Tarter, Schultz, Kirisci, & Dunn, 2001). Less severe addiction and consumption patterns among substanceconsuming fathers who maintained their marriages and lived with their children, and fewer parental resources available to mothers who lived alone with their children (Tarter et al. , 2001)

A small number of studies have explored the relationship between fatherhood and both psychiatric

A small number of studies have explored the relationship between fatherhood and both psychiatric distress and severity of drug use (e. g. , Stover, Hall, Mc. Mahon, & Easton, 2012; Stover, Urdahl, & Easton, 2012). These studies provided preliminary evidence supporting the need for careful assessment of both parenting behaviors and traumarelated/depressive symptoms in fathers entering substance abuse treatment. In mothers, research evidences that, in addition to the drug abuse problem, psychological symptoms play a complex role in the relationship between maternal DA and parenting.

As substance abuse is not the only determining factor of parental behavior in parents

As substance abuse is not the only determining factor of parental behavior in parents with drug addiction problems, research on individual variables such as depression and anxiety may contribute to a more accurate understanding of the challenges with which these parents are confronted in parenting.

RESEARCH QUESTIONS 1) How is the level of positive father involvement characterized in drug

RESEARCH QUESTIONS 1) How is the level of positive father involvement characterized in drug addicted fathers compared with non-addicted fathers? 2) How are anxiety and depression symptoms related to positive father involvement, parenting stress and parenting styles in drug addicted fathers?

Father Involvement among drug addicted fathers Anxiety and Depression Symptoms RESEARCH QUESTION 2 Father

Father Involvement among drug addicted fathers Anxiety and Depression Symptoms RESEARCH QUESTION 2 Father Involvement Parenting Stress Parental Styles Father Involvement among non addicted fathers VARIABLES RESEARCH QUESTION 1

METHOD Participants (Portuguese Fathers) • A group of 66 drug addicted fathers (with at

METHOD Participants (Portuguese Fathers) • A group of 66 drug addicted fathers (with at least one child under 18 years) enrolled in opioid maintenance treatment and a group of 49 non-addicted fathers matched by age, years of education and number of children. • A subgroup of 34 residential drug addicted fathers. • The drug addicted fathers were recruited from public addiction outpatient treatment centers and the non-addicted fathers from the community.

Variables Age [M (SD)] Residential Status Marital Status Number of Children [M (SD)] Employment

Variables Age [M (SD)] Residential Status Marital Status Number of Children [M (SD)] Employment Completed Years of Education [M (SD)] Non-Addicted Fathers (n=49) Drug Addicted Fathers (n=66) Residential Drug Addicted Fathers (n=34) 39. 39 (4. 47) 38. 79 (4. 69) 39 (4. 80) Non-residential (36. 4%) Residential (63. 6%) Non-residential (40. 5%) Residential (50. 5%) Residential (100%) Married or Living in Common-law Partnership (91, 8%) (50%) (72. 7%) Divorced or Separated (6. 1 %) (30. 3%) (18. 2%) Single (9. 1%) Widower (1. 5%) 1. 71 (. 76) 1. 53 (. 71) 1. 73 (. 80) Yes (89. 8%) No (8. 2%) Yes (53%) No (45. 5%) Other Situations (1. 5%) Yes (63. 6%) No (36. 4%) 7. 96 (2. 59) 7. 91 (2. 27) 8. 55 (2. 49)

Variables Heroin 1 st Use – Age [M (SD)] Heroin Regular Use AUDIT Test

Variables Heroin 1 st Use – Age [M (SD)] Heroin Regular Use AUDIT Test Result [M (SD)] Pharmacologial Treatment Drug Addicted Fathers (n=66) Residential Drug Addicted Fathers (n=34) 18. 79 (3. 93) 19. 42 (3. 73) Smoked (54. 5%) Injected (30. 3%) Both (6. 1%)* Smoked (60. 6%) Injected (21. 2%) Both (6. 1%)** 7. 55 (7. 27) 5. 37 (4. 62)*** Methadone (81. 8%) Buprenorphine (16. 7%) Naltrexone (1. 5%) Methadone (78. 8%) Buprenorphine (18. 2%) Naltrexone (3%) • * Six participants did not state the way of taking heroin regularly. • ** Four participants did not state the way of taking heroin regularly. • *** One participant did not complete the AUDIT items.

METHOD Measures • Semi-structured Interview - Sociodemographic and substance use information. • Inventory of

METHOD Measures • Semi-structured Interview - Sociodemographic and substance use information. • Inventory of Father Involvement–Short Form (IFI-SF) (Hawkins et al. , 2002; Portuguese version: Barrocas, Vieira-Santos, Paixão, Roberto, & Roberto, 2017) – Positive involvement. • Brief Symptoms Inventory (BSI; Derogatis, 1992; Portuguese version: Canavarro, 1999) – Depression and anxiety symptoms. • Parenting Stress Index–Short Form (PSI-SF; Abidin, 1995; Portuguese version: Vieira. Santos, 2008, 2011) – Parental disturbance, difficult child, parent-child dysfunctional interaction. • Parenting Styles and Dimensions Questionnaire-Short Form (Robinson, Mandleco, Olsen & Hart, 2001; Portuguese version: Miguel, Valentim, & Carugati, 2009) – Parenting styles and practices.

RESEARCH QUESTION 1 – RESULTS AND DISCUSSION Drug Addicted Fathers Positive Father Involvement Non-Addicted

RESEARCH QUESTION 1 – RESULTS AND DISCUSSION Drug Addicted Fathers Positive Father Involvement Non-Addicted Fathers M SD t p 4. 71 . 97 5. 13 . 88 -2. 387* . 019 Drug addicted fathers have lower levels of positive father involvement comparing with non-addicted fathers Regardless of whether the drug addiction problem is restrained (e. g. , successful treatment), these results indicates an increased risk for parenting comparing with non addicted fathers, whereby the parent–child attachment and psychological well-being of the child may be at risk (Barrocas, Vieira-Santos, & Paixão, 2016).

RESEARCH QUESTION I 1 – RESULTS AND DISCUSSION Depression Symptoms Anxiety Symptoms -. 18

RESEARCH QUESTION I 1 – RESULTS AND DISCUSSION Depression Symptoms Anxiety Symptoms -. 18 -. 24† -. 37** -. 20 Parental Distress . 47* . 04 Parent-Child Dysfunctional Interaction . 06 . 23 Difficult Child -. 09 . 13 Parental Verbal Hostility . 29 . 38* Permissive Parental Practices * p<. 05, ** p<. 005, † p<. 062 Punitive Parental . 38* . 24 . 15 . 19 Father Involvement Positive Father Involvement Father’s Role Performance There is support for the relation between both depression and anxiety symptoms with parenting dimensions in fathers with DA problems Parenting Stress Parenting Practices Important to monitor psychological symptoms in drug addicted fathers under treatment as research with mothers suggests

CONCLUSIONS LOWER LEVELS OF POSITIVE FATHER INVOLVEMENT REPORTED BY DRUG ADDICTED FATHERS EVEN THOUGH

CONCLUSIONS LOWER LEVELS OF POSITIVE FATHER INVOLVEMENT REPORTED BY DRUG ADDICTED FATHERS EVEN THOUGH THEIR ENROLLEMENT IN DRUG TREATMENT AND DRUG USE RESTRAINING. DIFFICULTIES IN FULFILLING PARENTAL FUNCTIONS REFLECT CUMULATIVE RISK FACTORS THAT ACCOMPANY DRUG USE BEHAVIOR (HOGAN, 2007; MAYES & TRUMAN, 2002) SUCH AS THE PRESENCE OF DEPRESSION AND/OR ANXIETY SYMPTOMS. AS OBSERVED IN DRUG ADDICTED

MONITORING DEPRESSION AND ANXIETY SYMPTOMS IN FATHERS WITH DRUG ADDICTION PROBLEMS SHOULD BE SYSTEMATICALLY

MONITORING DEPRESSION AND ANXIETY SYMPTOMS IN FATHERS WITH DRUG ADDICTION PROBLEMS SHOULD BE SYSTEMATICALLY PERFORMED THROUGHOUT TREATMENT IN ORDER TO PROMOTE POSITIVE PARENTING. IMPLICATIONS NON-PROBABILISTIC SAMPLE LIMITATIONS REDUCED SIZE SAMPLE SELF-REPORT MEASURES

THANK YOU VERY MUCH! jbarrocas@arsalgarve. min-saude. pt

THANK YOU VERY MUCH! [email protected] min-saude. pt