# When Mothers and Fathers Are ‘Gone’: Predicting Intergenerational Cycles of Risk in Opioid-Involved Parents

## TL;DR

This study explores how opioid-involved parents' childhood trauma affects their attachment to their young children, finding differences between mothers and fathers.

## Contribution

The study identifies gender-specific patterns in how adverse childhood experiences influence parent-child attachment in opioid-involved parents.

## Key findings

- Mothers' adverse childhood experiences predicted disorganized attachment with their children, mediated by depression and trauma symptoms.
- Fathers' adverse childhood experiences did not predict insecure or disorganized attachment patterns with their children.
- Substance use severity was not linked to parent-child attachment patterns for either mothers or fathers.

## Abstract

What are the main findings?

The opioid epidemic and adverse childhood experiences (ACEs) are two major concerns for child welfare systems in the United States of America.This study examined a high-risk sample of 101 parents (75 mothers and 26 fathers) who were opioid-involved, who had a child in the 0- to 5-year age range, and who were receiving medication-assisted treatment in the United States of America.

What are the implications of the main findings?

Mothers’ ACEs significantly predicted their ratings of disorganized attachment patterns with their young children, with depression and trauma symptoms explaining greater variance than ACEs alone.Fathers’ ACEs were not predictive of insecure/disorganized attachment patterns with their young children.

What are the main findings?

The opioid epidemic and adverse childhood experiences (ACEs) are two major concerns for child welfare systems in the United States of America.

This study examined a high-risk sample of 101 parents (75 mothers and 26 fathers) who were opioid-involved, who had a child in the 0- to 5-year age range, and who were receiving medication-assisted treatment in the United States of America.

What are the implications of the main findings?

Mothers’ ACEs significantly predicted their ratings of disorganized attachment patterns with their young children, with depression and trauma symptoms explaining greater variance than ACEs alone.

Fathers’ ACEs were not predictive of insecure/disorganized attachment patterns with their young children.

Background/Objectives: The opioid epidemic and adverse childhood experiences (ACEs) are two major concerns for child welfare systems. Little is known, however, regarding the mechanisms that perpetuate intergenerational cycles of ACEs and insecure/disorganized parent–young child attachment patterns in the context of parents’ opioid use. Methods: A high-risk sample of 101 parents (75 mothers and 26 fathers) who were opioid-involved, who had a child in the 0- to 5-year age range, and who were receiving medication-assisted treatment in the United States of America participated in this study. Parents were mostly White/Caucasian and single. Direct pathways between parents’ reported ACEs and their perceived parent–young child attachment patterns, as well as indirect pathways through substance use severity, depression, and trauma symptoms, were examined. Results: PROCESS analyses suggested that mothers’ ACEs significantly predicted their ratings of disorganized attachment patterns with their young children, with depression and trauma symptoms explaining greater variance than ACEs alone. The results indicated that fathers’ ACEs were not predictive of insecure/disorganized attachment patterns with their young children. Substance use severity was not predictive of parent–child attachment patterns for mothers or fathers. Conclusions: Generally, these findings highlighted different patterns among mothers and fathers’ ACEs, their ratings of parent–young child insecure/disorganized attachment, and their psychological sequelae. These findings further suggested the utility of trauma- and attachment-informed parenting interventions for high-risk mothers and fathers in breaking intergenerational cycles of risk.