Predictors of Effortful Control among Children of ...

Predictors of Effortful Control among Children of Alcoholic and Nonalcoholic Fathers* RINA D. EIDEN,

PH.D.,f

ELLEN P. EDWARDS,

PH.D., AND

KENNETH E. LEONARD,

PH.D.

Research Institute on Addictions, University at Buffalo, State University of New York, 1021 Main Street, Buffalo, New York 14203

holism and effortful control. Maternal warmth was a unique predictor of effortful control for boys. For girls, fathers' alcoholism was associated with lower paternal warmth, which was in turn a significant predictor of effortful control. Child activity level and negative affect were associated with effortful control for boys but did not account for significant variance when entered in regression models with fathers' alcoholism and parenting variables. Conclusions: Sons of alcoholic fathers are at an increased risk of problems in self-regulation when they are ages 2 to 3 years. Patemal warmth mediates the association between fathers' alcoholism and self-regulation for both boys and girls, although the nature of mediation may vary by child gender. (J Stud. Alcohol 65: 309319, 2004)

ABSTRACT. Objective: The purpose of this study was (I) to examine the association between fathers' alcoholism and children's effortful control and (2) to examine the role of parental warmth and toddler temperament as mediators or moderators of this relationship. Method: Families were recruited through New York State birth records when their infant was age 12 months. The final sample consisted of 226 families (116 boys) constituting two major groups: a nonalcoholic group consisting of parents with no or few current alcohol problems (n = 102) and a father alcoholic group (n = 124). Families were assessed when their child was ages 12, 18, 24 and 36 months. Results: Results indicate that boys of alcoholic fathers exhibit lower overall levels of effortful control than boys of nonalcoholic fathers. For boys, fathers' warmth over the second year of life mediated the association between fathers' alco-

AS

EARLY AS PRESCHOOL age, children of alco-

The purpose of this study was to examine longitudinal predictors of one aspect of self-regulation among children of alcoholic fathers, that involving active inhibition of a dominant response or inhibitory control. Inhibitory control is an aspect of self-regulation that emerges over the second and third years of life and denotes active processes of effortful or willful control of impulses. Inhibitory control has been defined as "the capacity to plan and to suppress inappropriate approach responses under instruction" (Kochanska et al., 1996, p. 491; Rothbart et al., 1994). Inhibitory control has also been termed effortful control in recent publications (e.g., Murray and Kochanska, 2002; Rothbart and Bates, 1998) because it involves not only inhibition of a dominant response but also initiation of a subdominant response according to contextual demands. It is an important dimension of developing self-regulation and has been consistently linked to impulsivity in later years and to externalizing behavior problems in general (Kooijmans et al., 2000; Krueger et al., 1996; Murray and Kochanska, 2002; Olson et al., 1999). Theoretical perspectives on the development of self-regulation have proposed that the quality of parenting plays a key predictive role in such development (Kopp, 1982). Empirical studies on this topic have also highlighted the role of parental warmth, sensitivity and disciplinary strategies as predictors of self-regulation (e.g., Eisenberg et al., 2003; Olson et al., 1990). Parents who are high in warmth and positive emotions and low in negativity have children who

holic fathers, especially boys, have been shown to display increased levels of externalizing behavior problems in comparison with children of nonalcoholic fathers (Puttler et al., 1998). Indeed, it has been hypothesized that one pathway to the greater risk for alcohol problems among children of alcoholics is through the likelihood of early behavior problems among these children leading to antisocial behavior, which in turn is associated with greater substance use problems. Empirical support for this hypothesis has been established at later ages for boys of alcoholic fathers in studies by Wong et al. (1999; see also Zucker et al., 1995) and by Chassin and her colleagues (e.g., Chassin et al., 1991, 1996). The early antecedents of this pathway, however, have not been investigated to date, and not all children with alcoholic fathers display a trajectory toward externalizing problems and substance use problems (see Russell, 1990; Zucker et al., 1995). Few studies have examined the role of other risk and protective factors in moderating regulatory problems among young children of alcoholics.

Received: October I, 2003. Revision: January 15, 2004. *Research for this study was supported by National Institute on Alcohol Abuse and Alcoholism grant IROI AA 10042-OlAI and National Institute on Drug Abuse grant I K2 I DA0023 1-01 Al. t Correspondence may be sent to Rina D. Eiden at the above address, or via email at: [email protected].

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JOURNAL OF STUDIES ON ALCOHOL / MAY 2004

display lower levels of hostility, fewer internalizing and extemalizing problems and higher self-regulation (Eisenberg et al., 1998, 2001; Kochanska and Murray, 2000; Kochanska et al., 2000). Parenting behavior has also been hypothesized to be one pathway that links fathers' alcoholism to problems in selfregulation among children (e.g., Jacob and Leonard, 1994). This viewpoint suggests that parental alcoholism interferes with being consistently warm and supportive during parent-child interactions. Empirical studies linking fathers' alcoholism with parenting have noted that alcoholic fathers and mothers with alcoholic partners are less sensitive and have lower positive engagement with their infants than nonalcoholic fathers and mothers (Eiden et al., 1999, 2003; Eiden and Leonard, 1996) and have more negative parentchild interactions during preschool years (e.g., Whipple et al., 1995) and adolescence (e.g., Jacob et al., 2000). Theoretical discussions on this topic, however, have generated few empirical studies that examine the question of whether the association between fathers' alcoholism and children's self-regulation may be explained by parenting behavior. Child temperament has been hypothesized to be a second pathway that links fathers' alcoholism to self-regulatory problems in children. Theoretical discussions and empirical investigations of the link between fathers' alcoholism and child temperament have been somewhat confusing, with different review articles and investigations focusing on different aspects of temperament. Three aspects of temperament have been linked to self-regulation, development of substance use disorders and to family history of alcoholism: negative affect, activity level and attention. Various studies have discussed the importance of negative affect and attention in the development of regulation of affect and behavior. A few studies, for instance, have provided evidence linking children's effortful control to low levels of negative affect (Eisenberg et al., 1993; Kochanska et al., 1998). In a study of the factor structure of a temperament measure, Rothbart et al. (2001) reported that attentional focusing loaded onto a factor reflecting effortful control for younger and older children across different cultures. High activity level and negative affect have also been associated with the development of problem behaviors among children of alcoholics (Wong et al., 1999) and later substance use (Dawes et al., 1997; Tarter et al., 1999; Wills et al., 1995). The literature on children of alcoholics also highlights the heterogeneity in outcomes within this high-risk group (e.g., Werner, 1986; Zucker et al., 1995). Although a number of studies of high-risk children have focused on risk and protective influences on developmental outcome (see Rolf et al., 1990), few studies have examined this issue among children of alcoholics (see Loukas et al., 2003, for an exception). Moreover, it has been suggested that boys of alcoholic fathers are at greater risk for a developmental

trajectory toward externalizing problems and substance use problems (Carbonneau et al., 1998; Loukas et al., 2003; Tarter et al., 1997; Zucker et al., 1995). Thus, we examined the potential interactive effects of father's alcoholism status and child gender, alcoholism and parenting, and alcoholism and toddler temperament on effortful control. The purpose of this study was to examine the association between fathers' alcoholism and children's effortful control in a sample of children of alcoholic fathers. A related goal was to examine two potential pathways relating fathers' alcoholism to effortful control at 3 years of age, one through parental warmth during mother-child and father-child interactions over the second year of life and the other through toddler temperament. Given the lack of previous studies on children of alcoholics with regard to moderators, we had two tentative hypotheses regarding interaction effects: (1) Children of alcoholics experiencing lower levels of parental warmth would be more likely to display lower effortful control than would children of alcoholics who experienced higher levels of parental warmth. (2) Children of alcoholics who had more negative toddler temperaments (higher activity level, higher negative affect or lower attention levels) would be more likely to display lower effortful control than would those with more positive toddler temperament. Method Participants The final sample consisted of 226 families with 12month-old infants at recruitment (116 boys). Families were classified in one of two major groups: the nonalcoholic group consisting of parents with no or few current alcohol problems (n = 102) and the father alcoholic group (n = 124). Families were assessed at their children's ages of 12, 18, 24 and 36. All 226 families provided complete data at the 12- and 18-month visits; 222 mothers and 218 fathers provided data at the 24-month visit; 205 mothers and 194 fathers provided data at the 36-month visit. We used imputation for families providing partial data to reach an analysis sample size of 226. Our assumption that the data were missing at random (Little and Rubin, 1989) allowed us to use the expectation-maximization (EM) algorithm to derive maximum likelihood estimates of missing values. The majority of the parents in the study were white, with high school and some post high school education. Annual family income ranged from $4,000 to $95,000. At the first assessment mothers were residing with the biological father of the infant in the study. About 61 % of the mothers and 91% of the fathers were working outside the home at the initial assessment. The majority of families had one to two children, including the target child (see Eiden et al., 2001, for further details).

EIDEN, EDWARDS AND LEONARD Procedure The names and addresses of these families were obtained from the New York State birth records for Erie County (see Eiden et al., 2001, for details of recruitment procedures). Parents who indicated an interest in the study were screened by telephone for sociodemographic characteristics and additional eligibility criteria. Families were provisionally assigned to one of two groups on the basis of parental screens (nonalcoholic, father alcoholic), with final group status assigned on the basis of both the phone screen and questionnaires administered at the first visit. Mothers in the nonalcoholic group scored below 3 on an alcohol screening measure (TWEAK; Chan et al., 1993), drank less than two drinks per day on average, did not acknowledge heavy drinking and did not meet the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994) for abuse or dependence. Fathers in the nonalcoholic group did not meet Research Diagnostic Criteria (RDC) for alcoholism according to maternal report, did not acknowledge having a problem with alcohol, had never been in treatment and had alcohol-related problems in fewer than two areas in the past year and three areas in their lifetimes (according to responses on a screening interview based on the University of Michigan Composite Diagnostic Index, UM-CIDI; Anthony et al., 1994). A family could be classified in the father alcoholic group by meeting any one of the following three criteria: (1) the father met RDC for alcoholism according to maternal report; (2) he acknowledged having a problem with alcohol or having been in treatment for alcoholism, was currently drinking and had at least one alcohol-related problem in the past year; or (3) he indicated having alcohol-related problems in three or more areas in the past year or met DSM-IV criteria for abuse or dependence in the past year. Most fathers in the alcohol group met two or more of these criteria, with 12 meeting RDC only and 3 having been in treatment in the past. The remainder met DSM-IV criteria for alcohol abuse or dependence. A small number (n = 31) of mothers in the alcoholic father group also had postnatal alcohol problems. The average TWEAK score for these mothers was I (range = 0-4). Of mothers in this group, 60% (n = 19) met DSM-IV criteria for abuse or dependence, and the remainder engaged in heavy drinking (five or more drinks on a single occasion) or drank more than seven drinks per week. Alcoholic and nonalcoholic families were group matched on race/ ethnicity, maternal education, child gender, parity and marital status. Families visited the Research Institute on Addictions, University of Buffalo, when their infant was at five different ages (12, 18, 24 and 36 months and upon entry into kindergarten), with three visits at each age. This article focuses on the 12-, 18-, 24- and 36-month questionnaires and observational assessments. At each assessment age, mother-

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infant observations were conducted at the first visit and followed by a developmental assessment at the second visit. Father-infant observations were conducted at the third visit. There was a 4-6 week lag between the mother-infant and father-infant visits. Measures Parentalalcohol use. A self-report instrument based on the IJM-CIDI interview (Anthony et al., 1994; Kessler et al., 1994) was used to assess alcohol abuse and dependence. Several questions of the instrument were reworded to inquire "how many times" a problem had been experienced instead of whether it happened "very often." DSMIV criteria for alcohol abuse and dependence diagnoses for current alcohol problems (in the past year) were used to assign final diagnostic group status. FOr abuse criteria, recurrent alcohol problems were described as those occurring at least three to five times in the past year or one to two times in three or more problem areas. Toddler temperament. Maternal and paternal reports of toddler temperament were assessed at 2 years of age using the Toddler Behavior Assessment Questionnaire (TBAQ; Goldsmith, 1996). Three theoretically relevant subscales were used in this study: Anger or Negative Affect, Activity Level and Attention. Maternal and paternal reports were only moderately correlated (r = 0.20 to 0.30) and were analyzed separately to examine the possibility that maternal and paternal reports might be associated in different ways both with fathers' alcohol group status and with effortful control. The internal consistencies of maternal and paternal reports on each of the subscales were as follows: a= 0.59 and 0.61 for Activity Level, a = 0.78 and 0.80 for Negative Affect and a = 0.53 and 0.55 for Attention. Parental warmth. Mothers and fathers were asked to interact with their infants as they normally would at home for 5 minutes at 12 and 18 months and for 10 minutes at 24 months in a room filled with toys. These free-play interactions were followed by 10 minutes of structured play. During structured play, parents were given four sets of problem-solving tasks. They were asked to help their infants complete these tasks one at a time and then to move on to the next task. Mother-child and father-child interactions were conducted separately about a month apart from each other. The free-play and structured play interactions were coded using a collection of global five-point rating scales developed by Clark et al. (1980), with higher scores indicating more positive behavior. These scales have been found to be applicable for children ranging in age from 2 months to 5 years (Clark, 1999; Clark et al., 1980) and to be associated with fathers' heavy drinking (Eiden and Leonard, 1996). Because we were primarily interested in the prediction of effortful control at 3 years from parental warmth across the second year of life, we created two composite scales reflecting maternal and paternal warmth by taking the aver-

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age of the Maternal Warmth subscale for free-play and structured play interactions across the three time points-12, 18 and 24 months-and doing the same for fathers. Parental Warmth across time was significantly correlated (Pearson r ranging from 0.41 to 0.67), and both the final scales had internal consistencies of a = 0.81 (coefficient alpha). Two coders rated the free-play interactions and structured play interactions at each of three time points-12, 18 and 24 months. All coders were trained on the Clark scales by the first author and were unaware of group membership and all other data. The interrater reliability was calculated for 10% of the sample (n = 25) and was high for the Warmth subscales, ranging from an intraclass correlation coefficient of 0.84 to 0.92. Effortful control Effortful control was assessed at child ages of 2 and 3 years by using the battery developed by Kochanska et al. (1996). The effortful control battery used in this study consisted of three tasks: a snack delay, whisper and "lab" gift. In snack delay, the child has to wait until a bell is rung by the experimenter before he or she can retrieve an M&M from under a glass cup (four trial delays of 10, 20, 30 and 15 seconds). Halfway through the delay, the experimenter lifts the bell but does not ring it. Coding ranges from 0 to 4 (0 = eats the snack before bell is lifted; 4 = waits for bell to ring before touching cup or snack). The mean score on all four trials was used as the effortful control score on this task. In the whisper task the child is asked to whisper the names of 10 consecutively presented cartoon characters, some familiar and some unfamiliar, with codes ranging from 0 to 3 (0 = shout, 3 = whisper). During the lab gift delay task, the child is asked to sit on a chair facing away from the table where the experimenter is noisily wrapping a gift for the child. The child is asked not to peek. After wrapping the gift, the experimenter leaves the room for 2 minutes, asking the child not to touch the gift until she returns. The child is observed during these 2 minutes. Coding involves a peeking score on a three-point scale, a latency to peek score and latency to touch score. As in previous studies of effortful control among young children (e.g., Kochanska et al., 1997, 2000), we created composite scores for effortful control at 24 and 36 months. The scores on all three tasks were standardized, and a final effortful control score was computed by taking the average of all the scores. The internal consistency of this scale at 2 years was a 0.78 and at 3 years was a = 0.79. Results Gender difference in effortful control To examine potential gender differences in effortful control, a repeated measures ANOVA was conducted with child

gender as the between-subjects factor and child age as the within-subjects factor. This analysis indicated a significant gender difference in effortful control (F = 8.06, 1/224 df, p < .01). Boys (mean [SD] = -0.13 [0.68]) had lower effortful control than girls (mean [SD] = 0.10 [0.73]). Given the gender difference in effortful control, all further analyses were conducted separately for each gender. Group difference in effortful control Because we had a small number of mothers (n = 31) in the father alcoholic group who themselves had alcohol problems, the first step was to examine if families with two alcoholic parents differed in effortful control from those with only an alcoholic father. Two repeated measures ANOVA were accordingly conducted separately for boys and girls, with effortful control at 2 and 3 years as the dependent variables, alcohol group status (nonalcoholic, only father alcoholic, both parents alcoholic) as the betweensubject factor and child age as the within-subject factor. Simple contrasts were used to compare families with two alcoholic parents with alcoholic father only families. This analysis yielded no significant results for either boys or girls. The next step was to examine whether fathers' alcohol status was associated with effortful control. A repeated measures ANOVA was conducted with effortful controls at 2 and 3 years as the dependent variables, alcohol group status (nonalcoholic vs father alcoholic) as the between-subject factor and child age as the within-subjects factor. For boys, this analysis yielded a significant effect of group status (F = 4.51, 1/114 df, p < .01). Boys with alcoholic fathers had lower effortful control (mean [SD] = -0.23 [0.61]) than did boys of nonalcoholic fathers (mean [SD] = 0.01 [0.74]). For girls, there were no significant effects of group or interaction of group and child age. Group difference in temperament Next, we examined whether parents' alcohol status was associated with the three aspects of temperament included in this study: toddler activity level, negative affect or anger, and attention. Accordingly, two MANOVA were conducted with fathers' alcohol status as the independent variable and maternal and paternal reports on the toddler temperament subscales as the dependent variables. For girls, these analysis did not yield any significant differences on fathers' reports. Using maternal reports, there was no multivariate effect of group status, but at the univariate level there was a significant effect of group status on toddler negative affect (F = 4.51, 1/108 df, p < .05) and a marginal effect of group status on toddler activity level (F = 2.84, 1/ 108 df, p = .09). Daughters of alcoholic fathers were reported by their mothers as displaying higher negative affect

EIDEN, EDWARDS AND LEONARD or anger (mean [SD] = 3.86 [0.81]) and higher activity level (mean [SD] = 4.17 [0.61]) compared with daughters of nonalcoholic fathers (mean [SD] = 3.57 [0.58] and 3.97 [0.61] for negative affect and activity level, respectively). For boys, this analysis yielded no significant effects of group status on toddler temperament.

also yielded a significant multivariate effect of group status (F = 3.14, 2/113 df, p < .05). Univariate analyses indicated a significant effect of group status for fathers' warmth (F = 6.02, 1/114 df, p < .05). Alcoholic fathers displayed lower warmth toward their sons (mean [SD] = 3.46 [0.56]) compared with nonalcoholic fathers (mean [SD] = 3.75 [0.72]). There were no group differences in maternal warmth for boys.

Group diference in parental warmth

Associations among study variables

To determine whether alcoholic fathers and mothers with alcoholic partners displayed lower levels of warmth during play interactions with their infants, two separate MANOVA were conducted with alcohol status as the independent variable and maternal and paternal warmth as the dependent variables. For girls, this analysis yielded a significant multivariate effect of group status (F = 5.27, 2/107 df, p < .05). Univariate analyses yielded significant effects of group status for both maternal warmth (F = 5.15, 1/108 df, p < .05) and paternal warmth (F = 8.61, 1/108 df, p < .01). Mothers with alcoholic partners displayed lower warmth (mean [SD] = 3.97 [0.64]) toward daughters than mothers with nonalcoholic partners did (mean [SD] = 4.22 [0.46]). Alcoholic fathers displayed lower warmth toward daughters (mean [SD] = 3.69 [0.60]) than did nonalcoholic fathers (mean [SD] = 4.00 [0.48]). For boys, this analysis TABLE 1.

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The correlations among study variables are presented in Table I separately for girls and boys. For girls, results indicated that there was moderate stability in effortful control from 2 to 3 years. Higher maternal warmth over the second year of life was associated with higher effortful control at 3 years. Higher paternal warmth was associated with higher effortful control both concurrently (at 2 years of age) and longitudinally (at 3 years of age). There was a significant association between Activity Level at 2 years, according to maternal report, and effortful control at 3 years. Results for boys also indicated moderate stability between effortful control at 2 and 3 years of age. For boys, both maternal and paternal warmth over the second year of life were associated concurrently and longitudinally with higher

Correlations among study variables for girls and boys

Variables 2. Effortful control-2 years Girls Boys 3. Effortful control-3 years Girls Boys 4. Maternal warmth Girls Boys 5. Paternal warmth Girls Boys 6. Activity level-M Girls Boys 7. Activity level-F Girls Boys 8. Negative affect-M Girls Boys 9. Negatve affect-F Girls Boys 10. Attention-M Girls Boys 11. Attention -F Girls Boys

1

2

3

4

5

6

7

8

9

10

.00 -.23* .01 -.10

.41t ,35t

-.21* -.14

.06 .40t

.29t .40t

-.27t -.22*

.20* .30t

.25t .19t

.16§ .05

-.07 -.19*

1.19* ,.34t

,35t .41t -.16 -.20*

-.11 .04

-.12 -.03

.09 -.08

-.02 1.19*

.05 -.04

.41t .26t

.20* .09

.03 -.13

.08 -.19*

-.06 -.26t

-.05 .02

.55t .46t

.20* .20*

.16§ .08

.09 -.08

.11 -.31t

.11 ,.30t

-.02 -.20*

.25t .25t

.50t ,59t

,34t .31f

.14 -.08

-.03 -.11

.15 .21*

.06 .04

.06 .10

.16§ .05

-.24* -.21*

-.23* -.2t*

-.21* .01

-.09 -.06

.03 .08

.07 .13

-.02 .15

-.04 .17§

.13 .20*

-.11 -.05

-.27t -.21*

-.07 .07

-.38t -.22*

Notes: M = maternal report; F = paternal report. §p