The transmission of psychopathology from parents to offspring: Development and treatment in context

The Transmission of Psychopathology From Parents to Offspring: Development and Treatment in Context* In their research report, Loukas et al. report that parental alcoholism is prognostic of childhood behavior problems, both directly, through genetic and modeling effects, and indirectly, through parental distress and physical problems. They hypothesized that the heightened rate of behavior problems in young children of alcoholics could be traced to the combination of negative interactions with the alcoholic parent (e.g., abuse, neglect) and the generalized stress involved in living with an alcoholic (e.g., chaotic and unpredictable family climate). Loukas et al. point out that the negativity in alcoholic families is likely to be exacerbated by heightened levels of parental distress and by a lack of closeness and "quality time" between parents and children. As a result, children may somehow "act out" their parents' distress in addition to acting out the dysfunction inherent in an alcoholic family. Loukas et al. found that alcoholic fathers with comorbid antisocial personality disorder tended to have sons with the most severe conduct problems, replicating an earlier finding obtained by the same research group (Puttler, Zucker, Fitzgerald, & Bingham, 1998). They argue that this finding may be due to the personal and family antecedents and correlates of antisocial personality disorder, particularly a history of psychiatric problems and childhood conduct disorder, heightened family stress, less "quality time" spent between parents and children, and a chaotic family environment. These factors have all been empirically found to contribute to the genesis of child behavior problems: Negative psychiatric histories and conduct problems have been shown to be transmitted familially (Merikangas & Avenevoli, 2000; Taylor & Carey, 1998). Family stress is a significant predictor of conduct problems in childhood (Kagan & Schlossberg, 1989; Keiley, Bates, Dodge, & Pettit, 2000). The amount of time parents and children spend together (Griffin, Botvin, Scheier, Diaz, & Miller, 2000) and the quality of parent-child communication (Harnish, Dodge, Valente, & Conduct Problems Prevention Research Group, 1995) are protective factors against child behavior problems. Finally, a chaotic family environment is often implicated in the onset of conduct problems (Patterson, 1982; Patterson, Bank, & Stoolmiller, 1990; Weiss, Dodge, Bates, & Pettit, 1992). The risk for problem behaviors is further exacerbated when these risk factors act in combination with one another (beater-Deckard, Dodge, Bates, & Pettit, 1998), especially when risk factors from different contexts act in concert with one another (Dishion, Capaldi, & Yoerger, 1999). The findings reported by Loukas et al. are highly consistent with the extant literature on parental substance abuse, family dysfunction, and childhood conduct problems. The associations among parental substance abuse, family chaos, and childhood conduct disorder have been reported in the literatures on parenting, drug abuse, behavior problems, and psychiatric disorders (e.g., Bukstein, 1995, 1997; Conduct Problems Prevention Research Group, 2000; Dishion et al., 1999; Loeber, Green, Lahey, Frick, & McBurnett, 2000; Pettit, Bates, & Dodge, 1997; Taylor & Carey, 1998). The purpose of this companion paper is to trace some of the antecedents, causes, and treatment implications of the findings of Loukas et al. As treatment- and prevention-oriented researchers, we are particularly interested in the developmental psychopathology of childhood behavior problems, because understanding the etiology and developmental course of any disorder is key to preventing or treating it (cf. Cicchetti, 1984, 1993; Liddle & Hogue, 2000). Moreover, as we will discuss further, childhood conduct disorder occupies a pivotal position in the developmental sequence of behavior problems. …