Effects of growing up with alcoholic parents

Predisposition to break the rules. Often a protest against a hopeless situation in the family is manifested in the desire for leadership in the team. Often children assert themselves among their peers and seek to attract the attention of adults by committing unseemly acts. In addition, many children of alcoholics are prone to neurotic behavior, impulsive, because they are often in a state of horror and grief, feelings of insecurity, instability, have serious sleep disturbances and nightmares. All these factors lead to regular disciplinary violations at school. Subsequently, such children quickly fall into the field of view of the police. nine0003

Difficulties with adaptation . It is in the family that the child joins the social culture, learns the norms, rules, values ​​of human behavior. In a dysfunctional family, a child often acquires negative social experience and learns a model of deviant behavior through relationships in his family. The presence of psychological problems prevents the child from showing the flexibility and creativity necessary in a number of situations, building healthy relationships, which is why his behavior quite often becomes not only illogical, but also diametrically opposed to what is required in the situation. Often this follows from the feature mentioned in the previous paragraph. nine0003

Excessive impressionability as a special kind of long-term emotional memory. It helps to remember unpleasant events and fix them. The child remembers insult, insult, fear for a long time, returns with his experiences to the past and cannot so easily, like others, start from the present in his actions and deeds.

Impressiveness - a tendency to internal processing of feelings and experiences. It is especially difficult for a child to experience an insult received from parents who, in a state of intoxication, insult and threaten. But a child, neither with his parents nor among his peers, will never talk about this, about his suffering. After all, it is quite natural for a child to be proud of his parents, however, realizing that his family is unfavorably different from others, he experiences everything in his soul. The child is convinced that what is not spoken out loud does not exist. Keeping this "big secret" is more important than talking about your feelings. Almost all children of alcoholics cannot identify or express their feelings. nine0003

Suggestibility. Violation of normal communication in the family leads to the fact that the child becomes overly trusting, it is easier to mislead him. As a result, he often becomes a victim of manipulation.

Persistent guilt complex. Unfortunately, often alcoholic parents, in order to justify their immoral lifestyle, place the entire burden of their actions on the shoulders of their child. Children are very sensitive, especially between the ages of 5 and 12, their logic is still being formed. Therefore, the child has a "saving thought" as a defense: "It's all because of me", "Because I behaved badly." And this is followed by a continuation: “Now I will change, I will not upset my parents, and then dad will no longer drink!” And dad, alas, both drank and drinks, excellent grades and good behavior do not save the situation ... In this case, guilt can take root for decades. nine0003

Difficulties with rapid response in critical situations. In many situations that require the demonstration of resourcefulness, flexibility, creativity, the child of parents with alcohol addiction gives up and cannot find a way out. With any problem, he tries to withdraw into himself, because, as a rule, he is deprived of support and advice from adults.

Increased aggressiveness. In some cases, not wanting to put up with the negative situation in the home, the children of alcoholics turn into rebels. From that moment on, they immediately begin to have serious problems when communicating with peers and teachers. There are many reasons for such behavior: these are disorders of the nervous system, and copying the behavior of one of the aggressive parents, and the inability to express their feelings in a different way. Sometimes it just becomes defensive aggression. Unfortunately, such a pattern of behavior can become one of the most common for a long time if the child's behavior is not corrected in time. nine0003

Thus, the child of alcoholic parents grows up in fear of life, he differs from others, primarily in self-doubt, hostility and aggressiveness. A child who grew up in such conditions has low self-esteem for the rest of his life, he does not believe in himself, in his abilities.

Alas, this is just the tip of the iceberg of the imprint that parental alcoholism leaves in a child's life. ..

Mother's alcoholism and its impact on a child's health

Alcohol is one of the most widespread and most accessible psychoactive substances (surfactants) in the countries of European culture. nine0003

Alcohol dependence, alcohol abuse and its adverse effects, or, according to modern scientific terminology recommended by WHO, alcohol-related disorders, are among the leading contributors to the global burden of disease (burden of disease) and the main causes of risk premature deaths [1].

Excessive drinking in the family, including female alcoholism, has a negative impact on children and hinders their normal development. In our opinion, the adverse effect of mother's alcoholism on the health of the child is carried out in three main ways: hereditary transmission of susceptibility to alcohol abuse; drinking alcohol during pregnancy; unfavorable family environment. nine0003

Numerous studies indicate a significantly higher frequency of addiction to alcohol in relatives of patients with alcoholism compared to people who do not have the appropriate hereditary burden. In children of persons suffering from alcohol dependence, the risk of developing alcohol-related disorders is 4–5 times higher than in the population [2, 3].

A. Finegersh et al. [4], estimating the heritability of alcoholism at approximately 50%, they note that the isolation of genes predisposing to alcohol dependence (for example, genes that control the synthesis of the dopamine D2 receptor, GABA receptors, or the activity of dehydrogenases), and even more so, the establishment of a relationship between different alleles these genes and types of alcohol disorders "still remains a difficult task, despite numerous studies in this area." nine0003

Along with the actual genetic transmission of susceptibility to alcohol abuse, great importance in the occurrence of alcohol disorders is given to epigenetic factors that underlie various variants of addictive behavior [5].

Hereditary predisposition to alcohol-related disorders refers to non-modifiable factors and, unlike alcohol use during pregnancy and drunkenness of a mother raising a child, cannot be a target of medical, psychological or psychotherapeutic influence. At the same time, when developing preventive programs, it is necessary to take into account that children of mothers suffering from alcoholism are in the group of a genetically determined risk of alcohol and other substance abuse; in addition, due to a certain commonality of inheritance of addictive and other mental disorders, primarily depression, anxiety, as well as attention deficit hyperactivity disorder (ADHD), in the offspring of alcoholics, the likelihood of developing borderline mental disorders also exceeds the general population indicators. nine0003

Alcohol use during pregnancy is very common; most often this happens in the early period of pregnancy, when women do not yet know about the conception that has occurred.

Alcohol abuse reduces the possibility of adequate preparation of the future mother for childbirth and has a direct damaging effect on the fetus, which leads to the development of the so-called fetal alcohol spectrum disorders - FAS (fetal alcohol spectrum disorders). nine0003

FRAS, complicating up to 5% of all pregnancies [6], are the most common preventable cause of physical and intellectual impairment in the United States [7] and include the following clinical manifestations [8, 9]: abnormal appearance; small stature; low body weight; poor coordination; cognitive dysfunctions; behavioral disorders; vision and hearing deficits.

The most severe form of FRAS is traditionally referred to as fetal alcohol syndrome. In addition, there are such types of FRAS as partial alcohol fetal syndrome, alcohol-related neurodevelopmental disorder, and alcohol-related birth defects. nine0003

P. May et al. [9] carried out a differentiated assessment of the probability of developing fetal alcoholic injuries depending on the quantitative characteristics of prenatal alcohol consumption. The researchers compared mothers of children with AFRS and mothers included in the control group on the basis of 6 variables reflecting the quantitative alcohol consumption during different periods of pregnancy. A significant correlation was found between doses and frequency of alcohol consumption (especially excessive), morphological changes and negative cognitive and behavioral outcomes in children, primarily low intelligence quotient (IQ), poor attention and behavioral disorders. nine0003

According to logistic regression data, alcohol consumption in the first trimester of pregnancy increases (compared with sobriety during pregnancy) the risk of fetal injury by 12 times, in the first and second trimesters by 61 times, and in all trimesters by 65 times compared to pregnancy without alcohol. On the contrary, linear regression shows that the probability of having a child with FRAS with alcohol consumption in the first trimester is 5 times less than when drinking in all three trimesters. nine0003

The authors come to the conclusion that there is a significant variability in the risks and degree of fetal damage due to prenatal alcohol consumption and the need to completely exclude the latter [9].

A comparative study of 37 children born to women who drank alcohol during pregnancy and showed signs of FRAS, and 21 normally developing children, found more frequent behavioral disorders and a lack of communication skills and social empathy in the former compared with the latter. Children with signs of FRAS are much worse than their healthy peers in coping with tasks that require complex social knowledge [10]. nine0003

Intrauterine alcoholic damage to the nervous system is reflected in the disruption of the processes associated with the formation of cerebral sulci and convolutions (gyrification) [11], which creates the basis for possible cognitive and other neuropsychiatric disorders in the unborn child.

Along with morphological and behavioral changes associated with neurodevelopmental disorders and deficits in cerebral (including cognitive) functions, alcohol exposure to the fetus increases the risk of developing anxiety disorders. nine0003

The relationship between fetal alcohol damage and anxiety has been noted both in clinical observations and in experimental studies involving laboratory animals [12].

The tendency to anxiety associated with FRAS is caused (along with other possible causes) by a change in the transmission of GABA and glutamate in the basolateral amygdala, which is involved in the generation of emotions (including fear and anxiety) [12, 13].

It is important to note that a change in the activity of GABAergic and glutamatergic processes, including in the amygdala, which plays a key role in the functioning of the reward system, underlies the formation of alcohol dependence, as well as dependence on other PAS. nine0003

The possibility of developing FRAS is often overlooked by pediatricians and other specialists, while timely recognition, developmental correction, education and an adequate home environment can largely prevent secondary complications such as substance abuse and criminal behavior [7].

Alcoholism and other addictive disorders in the family severely limit the ability of parents to create a favorable environment for the normal mental development of the child. Severe forms of addiction in parents practically doom children to neglect their emotional and physical needs. nine0003

The most dangerous and dramatic for a child's health is emotional and physical neglect in the first days and months of life, or the so-called infantile stress [14, 15].

D. Coghill et al. [16] provide the following list of factors associated with the negative impact of parental alcoholism on child development: poverty caused by alcohol spending and unemployment; frequent conflicts and violence in the family; increased risk of child abuse and neglect; more chaotic than in prosperous families, life and upbringing of children; increased risk of addictive disorders in children of parents who abuse alcohol; deterioration in the physical health of drinking parents. nine0003

Children of parents who use substances often become victims of abuse, which is represented by the following forms: physical abuse; sexual violence; verbal abuse; physical neglect; emotional neglect.

Child maltreatment is one of the leading causes of deterioration in mental (and in some cases, physical) health, not only in childhood, but throughout the life of an individual [17, 18]. We are talking about an increased risk of developing anxiety disorders, depression, post-traumatic stress syndrome and other mental disorders, as well as dependence on psychoactive substances. nine0003

In the UK, approximately one in four children who are abused due to parental alcohol and drug use are included in special child protection programs [19].

It seems logical to assume that the multiple adverse effects of parents (and primarily mothers) suffering from alcoholism are accompanied by an increase in the risks of addiction to alcohol in children: genetic transmission of genes predisposing to alcohol abuse a priori contributes to alcohol disorders in offspring; alcohol consumption during pregnancy is accompanied by fetal malnutrition, which is considered as one of the causes of ADHD in a child; ADHD (especially in the absence of adequate treatment) forms a susceptibility to the use of psychoactive substances, including alcohol; abuse of a child who bears the burden of increasing risks leads to their further escalation. nine0003

To this list, it should be added that borderline mental disorders, such as anxiety and depression, relatively easily, compared with well-off peers, developing in children of drinking mothers, themselves increase the likelihood of alcohol abuse and alcohol dependence.

The deprivation of parental rights of a mother suffering from alcoholism, the removal of a child from a drinking family and its placement in a children's educational institution is a serious blow to the child's psyche, since the deprivation of the mother in terms of the strength of the traumatic effect is comparable to abuse and is considered as one of its equivalents [16] . Early (occurring shortly after the birth of a child) deprivation of the mother, including those associated with the deprivation of parental rights, is one of the leading causes of infant stress, which can have an extremely adverse effect on the mental and physical health throughout the life of the individual. Numerous clinical observations show that separation of a child from a mother, even an alcohol abuser, negatively affects his development and increases the risk of developing mental disorders, including disorders associated with the use of alcohol and other psychoactive substances [20–22]. nine0003

Parental (including maternal) alcoholism determines the need for special preventive and supportive programs for both parents and children.

One of the main difficulties for parents raising children and substance abusers is insufficient sensitivity and responsiveness to the physical and emotional needs of the child. Special parental support programs (in particular, the "Parents under Pressure" programs used in the countries of the British Commonwealth) are primarily aimed at developing these skills [19].

Successful implementation of support programs for parents raising children and using alcohol and other substances contributes to an improvement in the family atmosphere, a marked reduction in cases of child abuse, neglect of the physical and emotional needs of children, creates opportunities for the normal development of the child's psyche and reduces the likelihood of subsequent development in children inherited addictive disorders [23-26].

According to A.Yu. Ruzhnikova et al. [27], long-term treatment of alcohol dependence based on the use of naltrexone with a gradual release (Vivitrol) in combination with psychosocial support (the "Sobriety Point" program) can have a significant beneficial effect on the course of alcoholism and create the opportunity to leave children in families in cases where when parents, due to severe alcohol addiction, are under threat of deprivation of parental rights. nine0003

In the observations cited by the indicated authors, retention and complete completion of the treatment program allowed 93% of patients (67 out of 72 cases) to retain their parental rights [27].

As mentioned above, mother's alcoholism poses a serious threat to the normal development of the child. Children of mothers suffering from alcoholism are at increased risk of depression, anxiety and other mental disorders, including dependence on alcohol and other psychoactive substances. This determines the need to develop and apply special preventive and corrective programs to help children with alcoholism with the participation of child psychiatrists, psychologists, educators and other specialists.

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