Some Parents Drink to Cope with ADHD Child - Parents of ADHD Children

Written by William E. Pelham, Alan R. Lang

Despite the increased distress levels, however, parents of ADHD children as a group did not display the stress-induced drinking shown by college students or parents of normal children. Deviant child behavior resulted in elevated drinking levels only when the investigators conducted the subgroup analyses based on family history of alcohol problems. Thus, parents with a positive family history of alcohol problems exhibited higher drinking levels after interacting with deviant children than after interacting with normal children. Conversely, parents without a family history of alcohol problems showed lower drinking levels after interacting with deviant children than after interacting with normal children.

This finding was somewhat surprising, because the investigators had strongly expected parents of ADHD children as a group to exhibit elevated drinking in response to deviant child behavior. The study results suggest, however, that some parents of ADHD children (i.e., parents without a family history of alcohol problems) may have developed coping techniques other than drinking (e.g., reducing their alcohol consumption or establishing problem-solving strategies) to cope with the stressors associated with raising a child with deviant behavior. Consequently, it is important to measure additional differences among individuals in order to fully explain responses to various types of child behavior.

Notably, the effect of a family history of alcohol problems on drinking levels was comparable for mothers and fathers. Most previous studies had demonstrated an association between a positive family history and alcohol problems in men, whereas the evidence for such an association in women was less convincing (Gomberg 1993). Furthermore, two distinct subgroups of parents, differentiated by their family history of alcoholism, appeared to exist, and they exhibited different coping techniques. Thus, parents with a family history of alcohol problems more commonly used maladaptive, emotion-focused coping techniques (i.e., drinking), whereas parents without such a history more commonly used adaptive, problem focused coping techniques (i.e., not drinking). Accordingly, the researchers continued to explore whether these sub-groups also existed among mothers of ADHD children.

To facilitate data interpretation, the investigators modified the study design in several ways, as follows:

• They determined the subjects' family histories of alcohol problems, defined as having a father with alcohol problems, prior to the study and used this information as a criterion for subject selection.
• They quantified stress-induced drinking for each subject using a within-subject design rather than the between-subject design employed in previous investigations. Thus, rather than comparing subjects who had interacted with a deviant child with subjects who had interacted with a normal child, the investigators had each subject participate in two laboratory sessions 1 week apart. In one session, the subject interacted with a deviant child and in the other session she interacted with a normal child.
• They measured the subjects' heart rate and blood pressure during their interactions with the children in order to obtain physiological information about subjects' stress levels.
• They administered numerous tests in order to identify dispositional characteristics, such as psychopathology, personality, coping, attributional style, alcohol expectancies, life events, family functioning, and drinking history, which might influence the subjects' response in addition to the family history of alcohol problems.

The results of the study confirmed the previous findings on the effects of child behavior on parental stress levels that were obtained from college students and parents of normal children. After interacting with the deviant children, the mothers of ADHD children showed greater physiological distress (i.e., significantly increased heart rate and blood pressure) than after interacting with the normal children. These mothers also showed greater subjective distress (i.e., increased negative affect; decreased positive affect; and increased self-ratings of unpleasantness, unsuccessfulness, and ineffectiveness). Furthermore, the mothers consumed approximately 20 percent more alcohol after interacting with the deviant children than after interacting with the normal children (Pelham et al. 1996a).

These findings clearly demonstrate that interactions with ADHD children engender large stress responses from their mothers in multiple domains. Furthermore, the mothers in this study as a group coped with this distress by drinking more alcohol. Contrary to the family history analysis in the previous study (Pelham et al. 1998), however, the subject's paternal history of alcohol problems (selected in advance) did not affect alcohol consumption in this larger sample.

To further clarify the results of the study among mothers of ADHD children, the researchers also evaluated the mothers' dispositional characteristics before their interactions with the children to identify potential associations with their stress-induced drinking (Pelham et al. 1996b). The investigators correlated these measures with the amount of alcohol the mothers consumed after interacting with a deviant child (i.e., stress-induced drinking), controlling for the amount of alcohol consumed after the interaction with the normal child. These analyses identified numerous factors associated with higher levels of stress-induced drinking, including the following:

• Higher levels of routine drinking (i.e., a greater number of drinks per drinking occasion)
• More negative consequences of drinking
• Higher levels of drinking problems
• A denser family history of alcohol problems (i.e., alcoholic relatives in addition to the father)
• Maternal history of drinking problems
• Higher self-ratings of using maladaptive coping strategies, feeling depressed, and experiencing more daily life stressors