Association of Constellations of Parental Risk With Children’s Subsequent Anxiety and Depression
Findings From a HUNT Survey and Health Registry Study
Original Investigation
Summary
Kids may be more likely to develop depression and anxiety when their parents are regular alcohol users, even when neither parent consumes enough to be considered an alcoholic. Researchers studied 8,773 children from 6,696 two-parent families who participated in a health survey when the kids were 13 to 19 years old. Overall, 2,132 of the children, or about 24 percent, had depression or anxiety, or both.
Children were 52% more likely to have anxiety or depression when both parents regularly consumed alcohol and when fathers themselves had symptoms of mental health issues than when parents didn’t use alcohol or have any mental health issues.
The findings suggest that in some family settings, even “normal” levels of parental alcohol use might trigger children to develop anxiety and/or depression in adolescence and early adulthood.
This is significant, as the level of alcohol consumption discussed in this study rarely appears to be problematic,” said lead author Ingunn Olea Lund.
Alcohol consumption that doesn’t reach the level of disorder affects far more children and families than alcohol use disorders, according to Linda Richter, of the Center on Addiction in New York City.
We know that parenting practices, which have a very strong influence on a child’s well-being, are definitely affected by alcohol use and mental health problems and these effects can manifest in a number of ways,” Richter, who wasn’t involved in the study, told Reuters via mail.
They can be obvious, like abuse or neglect of the child, or more subtle like modeling unhealthy behaviors for the child or failing to identify and address early signs of risk for childhood anxiety or depression and addressing it accordingly.
Alcohol use and mental health problems in adults and children often go hand in hand, as people tend to ‘self-medicate’ their anxiety or depression with alcohol or other addictive substances, especially if they do not have adequate access to professional help due to limited financial resources or education.”
Abstract
Importance
The research focus on children of parents with alcohol use disorder has eclipsed the potentially wider-reaching detrimental effects of subclinical parental alcohol use, both alone and in combination with other parental risk factors.
Objective
To identify constellations of early parental risk characterized by variations in alcohol use, mental health, and education in both parents and examine their prospective associations with children’s contact with the health care system for anxiety and/or depression (ie, diagnoses or treatment).
Design, Setting, and Participants
This prospective study was based on linked survey and health registries data. The sample included 8773 children from 6696 two-parent families in Norway who participated in the Nord-Trøndelag Health Study (HUNT) survey in 1995 to 1997 or 2006 to 2008, when the children were aged 13 to 19 years. Data were analyzed from January to September 2018.
Exposures
Five constellations of early parental risks, characterized by variations in drinking frequencies and amounts, mental health, and education for both parents, as identified through latent profile analysis.
Main Outcomes and Measures
Children’s diagnoses or treatment of anxiety and/or depression from 2008 to 2016 were recorded in 3 health registries. The primary outcome was the total number of registries where participants presented (ranging from 0 to 3).
Results
Of the 8773 included children, 4404 (50.2%) were boys, and the mean (SD) age at the time of participation in the Nord-Trøndelag Health Study was 16.1 (1.8) years. Prevalence of anxiety and/or depression, as evidenced in at least 1 registry record, was 24.3% (2132 of 8773). Early parental risk profiles risks marked by (1) the lowest parental education (adjusted relative risk, 1.13; 95% CI, 1.01-1.25) and (2) elevated alcohol use in both parents and elevated mental health symptoms in fathers (adjusted relative risk, 1.52; 95% CI, 1.03-2.22) were associated with a significant increase in risk of anxiety and/or depression in children from those families compared with children from no-risk families.
Conclusions and Relevance
Studies seeking to understand prospective associations of parental alcohol use with children’s mental health need to consider additional risk factors in combination with one another as well as parental behaviors and characteristics below clinically defined levels. When accumulated at a family level, even seemingly innocuous characteristics contributed to meaningful increases in risk of anxiety and/or depression among children, potentially translating into poorer mental health outcomes for many young people.