Effects of paternal alcoholism on the psycho-behavioral outcomes of children: systematic review and meta-analysis

Introduction: Documented literature includes mixed interpretations of the impact of paternal alcoholism on psycho-behavioral well-being in children. A systematic review and a meta-analysis would facilitate the accurate establishment of this association. Aim: To evaluate the effects of paternal alcoholism on the psycho-behavioral well-being of children by a systematic review with a meta-analysis and a narrative review component Methods: This PROPERO registered review (CRD42018114754) was conducted by reviewing searching literature in MEDLINE, EMBASE and PsycINFO databases. Twenty nine articles out of 16398 were selected for data extraction after three selection rounds. Thirteen were included in the meta-analyses for four numerical outcomes and two categorical outcomes. Meta-analysis outcomes included; internalizing behavior, externalizing behavior, depression and anxiety. Heterogeneity, risk of biases and the quality of evidence were assessed. Sensitivity analysis was done by re-analyzing with random-model assumption following the fixed model assumption. Furthermore re-analysis with standardized mean difference was done following the analysis with mean difference. Rev Man (version 5.3) software and “GRADEproGDT” online applications were used. Summary of Findings Tables were prepared. A narrative review was done with studies and sub-groups not included in the meta-analysis, under five identified themes: depression and mood disorders; self-perceived mental health problems and personality; aggression; ADHD and other problems. Results: With meta-analysis, all four numerical outcomes for demonstrated significant mean differences (MD) with higher values in the group with paternal alcoholism. “Low” level was assigned as the GRADE certainty. For the anxiety when it is regarded as a categorical outcome, the resulting relative effect was significant (OR=2.18, 95% CI= 2.03 to 2.33) with “Moderate” certainty. In sensitivity analysis, associations of similar directions were observed. Narrative review reflected other negative psycho-behavioral consequences of children associated with paternal alcoholism, falling under the five identified themes. Conclusions: Robust findings were observed for the positive associations of paternal alcoholism with the selected psycho-behavioral pathologies of children in the meta-analysis. The narrative review further demonstrated negative implications of paternal alcoholism on five identified thematic areas.

School Adjustment and Substance Use in Early Adolescent Boys: Association With Paternal Alcoholism With and Without Dad in the Home

The present study examined the association of paternal alcoholism with early adolescent boys’ school adjustment and substance use, and its moderation by paternal absence, controlling for parents’ socioeconomic resources. A community sample of 653 urban, low socioeconomic status (SES) families from Montreal, Canada, was assessed and information collected from parents, teachers, and adolescents’ self-reports, and school records. Paternal alcoholism was significantly associated with boys’ lower academic performance, lower grades, higher frequency of tobacco, marijuana and hard drugs use, of getting drunk, and using a variety of hard drugs. However, the separation from the alcoholic father represented a significant factor of moderation in regard to boys’ substance use: Sons of alcoholic fathers living with their dad in intact families were more likely to use tobacco and marijuana, to get drunk, and to use a variety of hard drugs than their peers not living with their alcoholic father, whether in single-mother or stepfamilies.

Antisocial Alcoholism in Parents of Adolescents and Young Adults With Childhood ADHD

Objective: Test the hypothesis that alcoholism, including antisocial alcoholism, is more prevalent among mothers and fathers of children with versus without ADHD. Method: Mothers (312 ADHD group, 235 non-ADHD group) and fathers (291 ADHD group, 227 non-ADHD group) in the Pittsburgh ADHD Longitudinal Study were interviewed along with their adolescent and young adult offspring. Results: Maternal and paternal alcoholism, with and without comorbid antisociality, was more prevalent in the ADHD group. Paternal alcoholism without antisociality was only marginally higher for probands after controlling for paternal ADHD. Offspring conduct disorder comorbidity was associated with parental antisociality but not parental antisocial alcoholism. Conclusion: Our findings that 44% of proband fathers and 25% of proband mothers experienced alcohol problems with or without antisociality are further evidence of increased alcoholism prevalence in families affected by ADHD. Maternal alcoholism and antisociality are prominent contributors to this family-level vulnerability. These findings indicate the need to assess long-term offspring outcomes as a function of parental alcohol and externalizing comorbidities, and perhaps other indicators of parental alcoholism phenotype, as familial vulnerability unfolds across development.