Alcohol misuse is the third leading lifestyle-related cause of death in the United States (Sudhinaraset et al., 2016). In 2018, 7.5 million children under the age of 18 in the U.S. lived with a parent who had Alcohol Use Disorder (Su et al., 2018). Alcohol Use Disorder (AUD) is a medical condition which impairs a person’s ability to stop or control their use of alcohol despite negative impacts, and encompasses frequently used terms such as alcohol abuse, alcohol dependence, alcohol addiction, and alcoholism (National Institute on Alcohol Abuse and Alcoholism, n.d.). Children with parents who have Alcohol Use Disorder are more likely to suffer from depression, anxiety, suicidal ideation, substance abuse, lower academic performance, eating disorders, antisocial attitudes, and more (Park & Schepp, 2015). These children often grow up in dysfunctional households and face severe stress. However, many children of parents who misuse alcohol adapt to their circumstances and become well-adjusted adults (Wlodarczyk et al., 2017). The ability to adapt and achieve positive outcomes despite facing adversity is known as resilience. Risk and protective factors contribute to an individual’s ability to achieve positive outcomes and resilience. Risk factors are attitudes, beliefs, behaviors, or environmental circumstances that put an individual in jeopardy or at risk of negative outcomes. Protective factors shield individuals from the adverse effects of risks and can offset risks, which reduces the likelihood of experiencing associated problems later in life (Moe et al., 2007).
If you are suffering from Alcohol Use Disorder, have a child impacted by parental Alcohol Use Disorder, or know a child with a parent who is misusing alcohol, there are ways you can help. Below you will find some useful information regarding the variety of risk factors that children exposed to parental Alcohol Use Disorder may face and protective factors that can help to promote positive outcomes and resilience.
Helpful Information
Children of parents with Alcohol Use Disorder (AUD) are at greater risk for internalizing problems such as anxiety and depression and externalizing problems such as risk-taking behaviors and delinquency. Studies show that higher levels of internalizing symptoms are seen in children of parents with AUD as early as two years old (Omkarappa & Rentala, 2019). Preschool-age children of parents with AUD are at risk for externalizing behavior problems and temperamental difficulties. While there are many risk factors when it comes to children of alcohol abusers, one of the most apparent concerns is whether these children have parents who can meet their developmental needs (Edwards et al., 2006).
Parental alcohol dependence is associated with lower levels of parental warmth, poor parent-child communication, low parent-child closeness, and low parental involvement. Alcohol misuse or abuse in the home creates an inconsistent and stressful environment (Su et al., 2018). If only one parent has Alcohol Use Disorder, there is still a crossover effect on the parenting abilities of the non-alcohol-dependent parent. For example, a father with alcohol dependence is likely to create high levels of strain and emotional tension for the mother. This stress makes it harder for the mother to maintain positive parenting behaviors such as involvement and communication (Su et al., 2018). The likelihood of adverse childhood experiences, such as abuse or witnessing abuse, also increases in a home where alcohol misuse is present (Omkarappa & Rentals, 2019).
Research shows that the parenting behaviors of mothers tend to be more impactful than those of fathers due to the greater association of mothers’ expected roles with emotion and comfort during stress (Lanjekar et al., 2022). However, it is still challenging for a non-addicted mother to provide full attention to children when navigating parenting and also dealing with an inconsistent partner. This environment can be volatile and disruptive for both parents and children. The alcohol-dependent parent does not have appropriate coping mechanisms and emotional regulation to model for children. The parent without AUD, even if doing their best, is likely to become dysregulated and unable to compensate for the addicted parent over time. Research shows children learn to regulate their emotions by observing parent-child and parent-parent interactions. Children of parents with Alcohol Use Disorder are more likely to develop negative emotionality because they are imitating what is modeled in their household (Haller & Chassin, 2011).
Children of parents with AUD face difficult circumstances when their parents are living in the same household, but separation can also create challenges. The sober parent may not be able to protect their children from the adverse effects of interaction with the alcohol-dependent parent if they are separated but obligated to allow the alcohol-dependent parent to be involved with the children. In most custody cases, separated parents must allow their children to spend time with the other parent (Alexanderson & Näsman, 2017). For children in homes without alcohol and addiction disorders, having contact with both parents and spending time in two separate households can be beneficial. Under these circumstances, it is understandable that those in charge of custody arrangements would encourage shared time between parents. It is the moment-to-moment interactions with parents which best predict outcomes for children and their social, emotional, and physical well-being (Guttmannova et al., 2017). When one parent is abusing alcohol or other substances, their interaction with the children may be developmentally detrimental due to the behaviors modeled and the increased risk of negative parent-child interactions (Haller & Chassin, 2011).
Children of parents suffering from AUD, and the parents themselves, often keep the struggles in their homes well-hidden due to the guilt, stigma, and shame which surround alcoholism. For this reason, it can be more difficult for family members, friends, teachers, and other adults to identify children of parents misusing alcohol. In fact, the parent with alcohol dependence is likely to deny the problem and to try to hide it from outsiders. In addition, the non-alcohol-dependent parent and children often compensate for the parent with AUD in order to avoid stigmatization (Alexanderson & Näsman, 2017). However, when the problem is identified, caring adults will have the chance to implement protective factors into these children's lives.
Research shows that caring and supportive adults significantly impact the outcomes of children who experience parental alcohol abuse. First and foremost, having a secure attachment with the parent who does not have AUD helps reduce the negative side effects of having a parent with AUD. A secure attachment is developed through responsive parenting, nurturance, protection, and guidance, especially during the first few years of life. A secure attachment with the non-alcohol-dependent parent helps to create a positive family atmosphere despite exposure to alcoholism and has been shown to promote resilience (Werner & Johnson, 2004). Secure attachment also helps to ensure that children growing up with an alcohol-dependent parent are better able to regulate their emotional responses and to experience a sense of belonging (Edwards et al., 2006).
While the non-alcohol-dependent parent can promote better outcomes through positive parenting practices, other supportive relationships can also help protect these children. Social support from teachers, extended family members, religious leaders, mental health professionals, coaches, and more can help protect children from the adverse effects of alcoholism (Werner & Johnson, 2004). Children of parents with AUD can also gain perspective and understand what a healthy home looks like when they are exposed to friends with parents who do not have AUD and witness how those families function in healthy ways.
Things You Can Do to Help
While parental alcoholism is devastating and subjects children to a variety of risk factors, research suggests that personal and social resources can be used to help combat vulnerability and increase resilience, or the ability to produce positive outcomes despite adversity, in children of parents with AUD. Children of parents with AUD experience individual, familial, and societal influences that either maximize or minimize the impact of their adverse childhood experiences due to parental alcohol abuse (Park & Schepp, 2015). Helping children of parents with AUD to obtain as many protective factors in their lives as possible is an excellent way for trusted adults to help promote positive outcomes.
At the individual level, children of parents with AUD are more likely to develop resilience if they have high self-esteem, adequate self-regulation, academic achievement, and a positive outlook or temperament. While individual factors are often inherited at birth, there are ways to foster and encourage these factors later in life (Park & Schepp, 2015). The following suggestions are useful in promoting protective factors at the individual level.
- Modeling positive self-talk and emotional regulation
- Encouraging emotional regulation through breathing techniques, reflection tools such as journaling and conversation cards, and conflict resolution practice
- Providing children with access to academic resources such as in-person tutoring, online tutoring, books that interest them, and activities and games that promote problem-solving skills, and promoting the idea of higher education opportunities through college sports or free tours
At the familial level, a powerful protective factor is having one non-alcohol-dependent parent and having a secure attachment with that parent. Extended families, such as grandparents, cousins, aunts and uncles, and other family members who are involved, supportive, and attentive to the child's needs, also promote better outcomes during childhood and later in life. The following suggestions are helpful in promoting protective factors at the familial level.
- Identify the number of adults with Alcohol Use Disorder in the child’s home.
- Determine other risk factors within the household, such as low socioeconomic status.
- Identify healthy extended family members and encourage those relationships.
- Provide resources to non-alcohol-dependent parents and family members, such as support groups, literature on positive parenting and child development, and support specialists within the community.
At the societal level, children of alcoholic-dependent parents benefit from adequate amounts of social support from peers, teachers, coaches, and mental health professionals (Park & Schepp, 2015). As previously noted, children affected by AUD are challenging to identify because alcohol-dependent parents and their families often conceal the issue well. Identifying the problem is a critical first step in helping these children. Once the problem is identified, connecting children of parents or a parent with AUD with the appropriate professional resources is essential. The following suggestions are helpful in promoting protective factors at the societal level.
- Discuss and identify interests or hobbies with the child to help them find a club, school sport, or other after-school activity to participate in.
- Identify peers with healthy home lives and encourage those friendships.
- Help connect the child with school guidance counselors and healthcare professionals.
- Seek out community members with an understanding of child development and healthy habits such as coaches and teachers to act as mentors and provide support.
- Find social activities outside of the school setting to connect the child with their community.
When seeking out academic resources and other activities, it is essential to consider associated costs and transportation. The best place to start is by finding free programs that are already on school property. Helping to extend these programmatic activities outside of school may involve setting up reliable and safe transportation and assisting with costs. The tracking sheet provided at the end of this article allows caring adults to identify the protective factors already in place in the lives of these children and those that are missing. Reviewing and completing this sheet will help caring adults to decide what the next steps are in helping the children of parents with AUD.
Conclusion
Children of parents with Alcohol Use Disorder face a wide range of risk factors and are more susceptible to anxiety, depression, and other internalizing disorders. These children also have a higher risk of exhibiting externalizing behaviors such as alcohol use and violence. While the households these children grow up in are high-stress, having one non-alcohol-dependent parent who is consistent, supportive, and attentive can help to offset the effects of the parent with alcohol dependence. Other protective factors include relationships with extended family, peers, and teachers. These supportive relationships can help children of parents with AUD feel a sense of belonging and promote resilience. While children of parents with Alcohol Use Disorder can be difficult to identify, there are many ways we can support their development into adulthood.
Helpful Resources
The National Institute on Alcohol Abuse and Alcoholism: https://www.niaaa.nih.gov/
Alcoholics Anonymous: https://www.aa.org/
Smart Recovery (an alternative to traditional AA): https://www.smartrecovery.org/
Al-Anon Family Groups (for family and friends of alcoholics): https://al-anon.org/
Alcohol and Public Health information from the CDC: https://www.cdc.gov/alcohol/index.htm
Tracking Chart
Promoting Resilience in Children Affected by Parental Alcohol Use Disorder
Adults with the desire to help children affected by parental Alcohol Use Disorder can use this tracking chart to ensure the necessary protective factors are in place. The child may already have some of these protective factors in place, but this chart will provide an overview of the child’s needs. It will also provide supportive adults with strategies they can implement.
Sources and References
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Edwards, E. P., Eiden, R. D., & Leonard, K. E. (2006). Behavior problems in 18- to 36-month-old children of alcoholic fathers: Secure mother–infant attachment as a protective factor. Development and Psychopathology, 18(02). https://doi.org/10.1017/s0954579406060214
Guttmannova, K., Hill, K. G., Bailey, J. A., Hartigan, L. A., Small, C. M., & Hawkins, J. D. (2017). Parental alcohol use, parenting, and child on-time development. Infant and Child Development, 26(5). https://doi.org/10.1002/icd.2013
Haller, M., & Chassin, L. (2011). The unique effects of parental alcohol and affective disorders, parenting, and parental negative affect on adolescent maladjustment. Merrill-Palmer Quarterly, 57(3), 263–292. https://www.jstor.org/stable/23098047
Lanjekar, P. D., Joshi, S. H., Lanjekar, P. D., & Wagh, V. (2022). The effect of parenting and the parent-child relationship on a child’s cognitive development: A literature review. Cureus. https://doi.org/10.7759/cureus.30574
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Omkarappa, D., & Rentala, S. (2019). Anxiety, depression, self-esteem among children of alcoholic and nonalcoholic parents. Journal of Family Medicine and Primary Care, 8(2), 604. https://doi.org/10.4103/jfmpc.jfmpc_282_18
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Su, J., I Chun Kuo, S., Aliev, F., Guy, M., Derlan, C., Edenberg, H., Nurnberger Jr, J. I., Kramer, J., Bucholz, K., Salvatore, J., & Dick, D. (2018). Influence of parental alcohol dependence symptoms and parenting on adolescent risky drinking and conduct problems — A family systems perspective. Alcohol Clin. Exp. Res., 42(9), 1783–1794. https://doi.org/10.1111/acer.13827
Sudhinaraset, M., Wigglesworth, C., & Takeuchi, D. T. (2016). Social and cultural contexts of alcohol use influences in a social–ecological framework. Alcohol Research, 38(1), 35–45.
Werner, E. E., & Johnson, J. L. (2004). The role of caring adults in the lives of children of alcoholics. Substance Use & Misuse, 39(5), 699–720. https://doi.org/10.1081/JA-120034012
Wlodarczyk, O., Schwarze, M., Rumpf, H. J., Metzner, F., & Pawils, S. (2017). Protective mental health factors in children of parents with alcohol and drug use disorders: A systematic review. PLoS ONE, 12(6). https://doi.org/10.1371/journal.pone.0179140