Shadows of Dependence: Temperament and Behavioural Changes among Children of Fathers with Opioid Dependence
Main Article Content
Keywords
Opioid dependence, Parental substance use, Child behaviour, Child Psychopathology, Temperament, Father with opioid dependence
Abstract
Background: Parental opioid dependence has been associated with increased behavioural and emotional difficulties in children, including internalizing and externalizing problems. Despite the high prevalence of opioid use in our region, research on its impact on children of fathers with opioid dependence remains scarce. This study aimed to assess temperament and behavioural problems among children of fathers with opioid dependence.
Methodology: In this observational case-control study, 30 children of fathers with opioid dependence were compared with 30 age and gender matched controls. Information was collected from mothers. Mothers were screened for psychopathology using the General Health Questionnaire (GHQ), and children’s behavioural and temperamental characteristics were assessed using the Child Behaviour Checklist (CBCL) and Malhotra's Temperament Schedule (MTS).
Results: No significant differences were observed between groups regarding age and gender. Children of opioid-dependent fathers exhibited significantly higher CBCL scores across internalizing domains (Anxious/Depressed: p=0.021; Withdrawn/Depressed: p=0.043; Somatic Complaints: p=0.004) and externalizing domains (Aggressive: p=0.001; Rule-Breaking: p=0.003). Significant temperament differences were observed, with lower sociability (p<0.001), higher emotionality (p<0.001), and greater distractibility (p=0.001) in these children in comparison to controls, while energy and rhythmicity did not differ significantly.
Conclusion: Based on our findings, early identification and clinical screening are recommended to detect these behavioural and temperamental problems in childhood, as they may otherwise increase the risk of substance use and psychiatric disorders later in life. Family-centered interventions, along with supportive policy measures, can help prevent long-term adverse mental health outcomes in this vulnerable population.
References
2. Stanger C, Higgins ST, Bickel WK, et al. Behavioural and emotional problems among children of cocaine- and opiate-dependent parents. J Am Acad Child Adolesc Psychiatry. 1999;38(4):421–8.
3. Kumpfer KL, Demarsh J. Family environmental and genetic influences on children's future chemical dependency. J Child Contemp Soc. 1986;49:91.
4. Hussong AM, Cai L, Curran PJ, Flora DB, Chassin LA, Zucker RA. Disaggregating the distal, proximal, and time-varying effects of parent alcoholism on children’s internalizing symptoms. J Abnorm Child Psychol. 2008;36:335–46.
5. Puttler LI, Zucker RA, Fitzgerald HE, Bingham CR. Behavioural outcomes among children of alcoholics during the early and middle childhood years: familial subtype variations. Alcohol Clin Exp Res. 1998;22:1962–72.
6. Mun EY, Fitzgerald HE, Von Eye A, Puttler LI, Zucker RA. Temperamental characteristics as predictors of externalizing and internalizing child behaviour problems in the contexts of high and low parental psychopathology. Infant Ment Health J. 2001;22:393–415.
7. Luthar SS, Cushing G, Merikangas KR, Rounsaville BJ. Multiple jeopardy: risk and protective factors among addicted mothers' offspring. Dev Psychopathol. 1998;10(1):117–36.
8. Patterson GR, Reid JB, Dishion TJ. Antisocial boys. Vol. 4. Eugene, OR: Castalia; 1992.
9. Wilens TE, Biederman J, Kiely K, Bredin E, Spencer TJ. Pilot study of behavioural and emotional disturbances in the high-risk children of parents with opioid dependence. J Am Acad Child Adolesc Psychiatry. 1999;34(6):779–85.
10. Clarke C, Fitzpatrick C. Psychiatric problems of children exposed to opiates in utero – a descriptive study. Ir J Psych Med. 2005;22(4):121–3.
11. Behnke M, Smith VC; Committee on Substance Abuse and Committee on Fetus and Newborn. Prenatal substance abuse: short- and long-term effects on the exposed fetus. Pediatrics. 2013;131(3):1009–24.
12. Lester BM, Lagasse LL. Children of addicted women. J Addict Dis. 2010;29(2):259–76.
13. Romanowicz M, Vande Voort JL, Shekunov J, Oesterle TS, Thusius NJ, Rummans TA, et al. The effects of parental opioid use on the parent–child relationship and children’s developmental and behavioural outcomes: a systematic review of published reports. Child Adolesc Psychiatry Ment Health. 2019;13:5.
14. Goldberg D, Williams P. A user’s guide to the General Health Questionnaire. NFER-Nelson; 1988.
15. Malhotra S, Varma VK, Verma SK, Malhotra A. Childhood psychopathology measurement schedule: development and standardization. Indian J Psychiatry. 1988;30(4):325–31.
16. Malhotra S, Malhotra A. Manual of Malhotra’s Temperament Schedule. Agra: National Psychological Corporation; 1988.
17. Thomas A, Chess S. Temperament and development. New York: Brunner/Mazel; 1977.
18. Lee SJ, Bora S, Austin NC, Westerman A, Henderson JMT. Neurodevelopmental outcomes of children born to opioid-dependent mothers: a systematic review and meta-analysis. Acad Pediatr. 2020;20(3):308–18.
19. McGovern R, Bogowicz P, Meader N, Kaner E, Alderson H, Craig D, et al. The association between maternal and paternal substance use and child substance use, internalizing and externalizing problems: a systematic review and meta-analysis. Addiction. 2023;118(5):804–18.
20. Adams ET, Williams J, Palen LA, Wondimagegnehu F, Elek E, Cance JD. Parental opioid misuse and adolescent-reported positive parenting behaviours: an analysis of parent-child dyads from the National Survey on Drug Use and Health. J Adolesc Health. 2025;77(4):636–42.
21. Sarkar S, Patra BN, Kattimani S. Substance use disorder and the family: an Indian perspective. Med J DY Patil Univ. 2016;9(1):7–14.
22. Nunes EV, Weissman MM, Goldstein RB, McAvay G, Seracini AM, Verdeli H, et al. Psychopathology in children of parents with opiate dependence and/or major depression. J Am Acad Child Adolesc Psychiatry. 1998;37(11):1111–9.
23. Wilens TE, Yule A, Martelon M, Zulauf C, Faraone SV. A family study of the high-risk children of opioid and alcohol-dependent parents. Am J Addict. 2002;11(1):41–51.
24. Essau CA, de la Torre-Luque A. Parent’s psychopathological profiles and adolescent offspring’s substance use disorders. Addict Behav. 2021;112:106611.
25. Cioffi CC, DeGarmo DS. Improving parenting practices among fathers who misuse opioids: Fathering Through Change Intervention. Front Psychol. 2021;12:683008.
26. Bauman PS, Dougherty FE. Drug-addicted mothers’ parenting and their children’s development. Int J Addict. 1983;18:291–302.
27. Borelli JL, Luthar SS, Suchman NE. Discrepancies in perceptions of maternal aggression: implications for children of methadone-maintained mothers. Am J Orthopsychiatry. 2010;80(3):412–21.
28. Ravindran OS, Hima K, Natarajan S, Sathianathan R. Behavioural problems and temperamental characteristics among children in alcoholic families. J Ment Health Hum Behav. 2018;23(1):52–6.
29. Waddell JT, Sternberg A, Eisenberg N, Chassin L. Longitudinal relations among parental substance use disorder and adolescent drinking behaviour: the role of temperament, negative urgency, and maternal parenting. J Youth Adolesc. 2024;53(4):833–48.
30. Klein RJ, Gyorda JA, Lekkas D, Jacobson NC. Dysregulated emotion and trying substances in childhood: insights from a large nationally representative cohort study. Subst Use Misuse. 2023;58(13):1625–33.
31. Weissman MM, McAvay G, Goldstein RB, Nunes EV, Verdeli H, Wickramaratne PJ. Risk/protective factors among addicted mothers' offspring: a replication study. Am J Drug Alcohol Abuse. 1999;25(4):661–79.
32. Parvaresh N, Mazhari Sh, Nazari-Noghabi M. Frequency of psychiatric disorders in children of opioid or methamphetamine-dependent patients. Addict Health. 2015;7(3–4):140–8.
33. Eslami Shahrbabaki M, Ziaaddini H, Saieedi H, Nakhaiee N. Disruptive behaviour disorders in 8 to 14 years old offspring of opium- and heroin-dependent parents: a case-control study. Addict Health. 2009;1(2):81–5.
34. Ziaaddini H, Amirkafi A, Nakhaie N. Prevalence of conduct disorder in students of primary schools in the city of Kerman in educational year 2003–4. Hormozgan Med J. 2007;11(2):221–8.
35. Smith JC, Alderman L, Attell BK, Avila Rodriguez W, Covington J, Manteuffel B, et al. Dynamics of parental opioid use and children’s health and well-being: an integrative systems mapping approach. Front Psychol. 2021;12:687641.
36. Suchman NE, Luthar SS. The mediating role of parenting stress in methadone-maintained mothers’ parenting. Parent Sci Pract. 2001;1:285–316.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.