Developmental Pathways to Substance Use from Infancy to Adolescence in a High-Risk Sample

Introduction: Past research indicates that children of alcoholic fathers are at high risk for adolescent alcohol and substance use. Using a developmental cascade model framework, the main goal of this study was to examine a conceptual model with three hypothesized pathways to adolescent substance use beginning in infancy: a parenting pathway, a child self-regulation to externalizing pathway, and a social competence pathway. A secondary goal was to examine if there remained direct associations between parent’s alcohol problems in infancy and adolescent substance use, after accounting for these theoretically significant developmental pathways. The final goal was to examine if associations were different for boys and girls.

 Methods: The sample consisted of 227 families (97 non-alcoholic families, 100 families with alcoholic fathers, and 30 families with two parents who had alcohol problems) with 12-month-old infants at recruitment (116 girls, 111 boys). The prospective design included 9 assessments (child ages 12, 18, 24, and 36 months, in kindergarten, and in 4^th, 6^th, 8^th, and 11^th/12^th grades). Measures at different ages included a combination of mother and father reports, observational assessments, teacher reports, peer nominations, and adolescent self-reports.

Results: Structural Equations Modeling results were supportive of a conceptual model that included direct and indirect paths from parents’ alcohol problems in infancy to adolescent substance use, χ2 (138) = 158.2, p = .10; RMSEA = .03 [.00-.04]; CFI = .96; TLI = .93. The model supported a developmental cascade from parents’ alcohol problems in infancy to low maternal warmth/sensitivity at 24 months, which in turn, predicted low child self-regulation at 36 months, and continuity in externalizing problems from kindergarten to 6^th grade. Externalizing problems then predicted engagement with delinquent and substance using peers and drinking in 8^th grade, which were proximal predictors of adolescent substance use in 11^th/12^th grades. Parental monitoring beginning in middle childhood had a significant protective effect on the proximal predictors of substance use risk. The direct association between having two parents with alcohol problems and adolescent substance use was significant for boys but not girls.

Conclusions: These results are generally supportive of recent findings about the enduring effects of maternal sensitivity in early childhood for children’s social-emotional competence through adolescence by a process of cascading effects, the important protective role of high self-regulation in the preschool period, and high parental monitoring beginning in middle childhood.