Volume 12, Number 1
Mental Health Problems of Addicted Mothers Linked to Infant
Care and Development
By Robert Mathias
NIDA NOTES Staff Writer
Women who abuse cocaine while they are pregnant often share many characteristics,
such as addiction, poverty, and low literacy levels. However, they differ
in the quality of care they give their children, a NIDA-funded study says.
In fact, how well cocaine-addicted mothers care for their infants appears
to be strongly influenced by the type and severity of psychological problems
these women suffer from, according to the study. The quality of care these
mothers provide is important because it affects the cognitive development
of their cocaine-exposed infants, the study notes.
"Self-reported symptoms of psychological problems among addicted
women really did affect maternal caregiving," says Dr. Judy Howard
of the University of California at Los Angeles (UCLA), who directed the
study. This finding indicates that drug abuse treatment programs should
work on other issues, such as mental health problems, in addition to helping
addicted mothers become abstinent, Dr. Howard says.
The UCLA study of cocaine-addicted women and their infants was one of
NIDA's Perinatal-20 treatment research demonstration projects. The 5-year
program, which ended last year, evaluated the effec-tiveness of providing
comprehensive therapeutic programs that include drug abuse treatment plus
a range of additional social and health services for drug-abusing women
of child-bearing age and their children. The projects in the program have
yielded new information about the characteristics and treatment needs of
pregnant and parenting women who abuse drugs. (See "NIDA's Perinatal-20
Projects," NIDA NOTES, November/December 1994, p. 6.)
The cocaine-abusing women in the study, which was conducted by Dr. Howard
and Dr. Leila Beckwith, also of UCLA, were similar demographically to the
women in many of the other Perinatal-20 projects. On average, they were
about 29 years old, had less than a high school edu-cation, were single,
had a history of being physically or sexually abused, and belonged to minority
groups. The women had a long history of cocaine and other drug abuse.
Despite their similarities, including heavy drug use, "these women
are not a homogeneous group," stresses Dr. Howard. The women in this
study exhibited a wide range of psychological symptoms and maternal caregiving
abilities that affected the development of their infants, she says. Specifically,
mothers who re-ported more symptoms of a narcissistic, paranoid, histrionic,
or borderline personality disorder were the least sensitive caregivers.
In turn, many of these mothers' babies showed signs of delayed cognitive
development at 6 months of age, Dr. Howard notes.
Recently, Dr. Howard and her colleagues conducted a further analysis
of the data collected about the women's drug use and parenting behaviors
6 months after they gave birth. That analysis indicates that although the
women who exhibited the most severe psychological symptoms reduced their
drug use, they were still the least sensitive caregivers.
"These findings suggest a clinically significant relationship between
a mother's psychopathology and her ability to care for her newborn, which,
in turn, might negatively affect her child's development," says Dr.
Elizabeth Rahdert, a research psychologist with NIDA's Division of Clinical
and Services Research, who has been involved with the Perinatal-20 program
since its inception. In addition, the finding that many of these women have
severe mental health problems suggests that treatment programs should include
a psychiatric component to assess and address women's mental health problems
on an individual basis, Dr. Rahdert says. Social service programs that do
not have mental health professionals on their staff can make sure women
receive the therapy they need by establishing strong links to the mental
health care system within their communities, says Dr. Rahdert.
Mental health professionals should play a key role in drug treatment
for drug-abusing mothers, agrees Dr. Howard, but they need to be trained
in addiction-related problems, she says. In the final analysis, the study's
findings argue for comprehensive treatment programs and coordination of
addiction treatment, mental health, and pediatric services to adequately
meet the needs of these women and their children, concludes Dr. Howard.
Howard, J.; Beckwith, L.; Espinosa, M.; and Tyler, R. Development of
infants born to cocaine-abusing women: Biologic/Maternal influences. Neurotoxicology
and Teratology 17(4):403-411, 1995.
Howard, J.; Espinosa, M.; and Beckwith, L. Psychological status and parenting
behaviors in cocaine-using mothers. Abstract presented at the 58th Annual
Scientific Meeting of the College on Problems of Drug Dependence, San Juan,
Puerto Rico, 1996.
From NIDA NOTES, January/February, 1997
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