IMPACT OF CHILD NEGLECT IN SUBSTANCE ABUSE FAMILIES

本研究采用小组设计对患有或不患有DSM-IV物质使用障碍（SUD）的先证父亲的男女子女（N=300）进行前瞻性研究，以确定父母的SUD对医疗/牙科心理和教育忽视的影响。在后一种忽视领域中，严重程度将根据“未能提供”和“监督水平”来衡量。在当代发展精神病理学研究和理论的指导下，假设父母（药物滥用、精神病理学、自我调节）和孩子（自我调节）的特征共同决定了最终导致忽视的二元关系的质量。身体、心理和教育结果的严重程度（例如，忽视牙齿会导致蛀牙、疾病、牙齿骨折等；忽视教育会导致学业失败、逃学等）被假设与物质使用和健康风险行为相关，并预测这些行为。环境因素（如是否有其他成年人提供支持、年长的兄弟姐妹代替父母等）对父母忽视影响的相对影响将被确定。此外，还将描述忽视的影响在多大程度上可以通过个人保护资源（例如应对技能、高智商、高自尊）来减弱，从而产生有弹性的结果。该项目在几个关键方面具有创新性：1)它侧重于未被系统研究的老年青年和青少年人口中的忽视问题；2)与发展理论相一致，本项目将忽视作为父母和儿童特征的结果进行研究；3)它可以前瞻性地跟踪家庭环境中增加或减少忽视风险和后续结果的个体因素；4)在由3种类型的忽视x 2种类型的父母表现（见上文）组成的对称测量图式中，它以适合年龄的方式描述忽视；并且，5)它提供了描述物质使用障碍对儿童忽视的影响以及预示着恢复力和不良后遗症的后续结果的机会。

Male and female children (N=300) of proband fathers with or without DSM-IV Substance Use Disorder (SUD) will be prospectively studies in a panel design to determine the impact of parental SUD on medical/dental psychological and educational neglect. In each of these latter neglect domains, severity will be measured according to "failure to provide" and "level of supervision". Guided by contemporary developmental psychopathology research and theory, parent (substance abuse, psychopathology, self- regulation) and child (self-regulation) characteristics are hypothesized to conjointly determine the quality of the dyadic relationship culminating in neglect. The severity of physical, psychological and educational outcomes (e.g., dental neglect yields cavities, disease, tooth fractures, etc.; educational neglect yields school failure, truancy, etc.) is hypothesized to covary with and predict substance use and health risk behaviors. The relative influence of contextual factors (e.g. availability of supportive other adults, older sibling serving as a parent substitute, etc.) on the impact of parental neglect will be determined. In addition, the extent to which the impact of neglect can be attenuated by individual protective resources (e.g. coping skills, high intelligence, high self-esteem) to result in resilient outcomes will also be delineated. The project is innovative in several key respects: 1) it focuses on neglect in the population of older youth and adolescents which has not been systematically researched; 2) consistent with developmental theory, this project investigates neglect as the outcome of both parent and child characteristics; 3) it enables prospectively tracking intraindividual factors in familial context that increase or decrease the risk for neglect and subsequent outcomes; 4) it characterizes neglect in an age appropriate manner within a symmetrical measurement schema consisting of 3 types of neglect x 2 types of parental manifestation (see above); and, 5) it provides the opportunity to delineate the impact substance use disorder on child neglect and subsequent outcomes which portend resilience as well as adverse sequelae.