Using the CBCL to Identify Problems Among Children of Cocaine and Opiate Dependent Parents

To test associations between parental drug abuse and children’s problems, Catherine Stanger of the University of Vermont and colleagues from other universities compared children of drug abusers (CDA) with children who were referred for mental health services (RC) and nonreferred children (NRC). Cocaine and opiate dependent parents in treatment completed the Child Behavior Checklist for 410 children from ages 2 through 18 years. CDA were demographically matched to RC and NRC. RC scored lower than CDA and NRC on most competence scales, and higher than CDA and NRC on all problem scales.

CDA scored lower than NRC on most competence scales, and higher than NRC on Withdrawn, Thought Problems, Delinquent Behavior, Aggressive Behavior, Internalizing, Externalizing, and total problems. Results showed that about one-third of the CDAs had problem scores in the clinical range, especially delinquent or “rule-breaking” behaviors such as lying, running away, stealing, swearing, and, for older children, drug or alcohol use. CDA also had elevated rates of internalizing problems (withdrawal, anxiety, depression, somatic complaints), attention problems, and aggressive behavior.

Although some children of drug abusers manifested problems as severe as those reported for children referred for mental health services, most did not. These findings indicate that CDA are at risk for developing behavioral and emotional problems that may, in turn, place them at risk for alcohol and drug abuse. Clinicians treating adults for drug abuse could help to identify children at risk by asking parents to complete standardized questionnaires such as the CBCL about their children. Families with children found to have problems could then receive interventions to reduce these problems.

Reference: Stanger, C., Higgins, S., Bickel, W., Elk, R., Grabowski, J., Schmitz, J., Amass, L., Kirby, K., & Seracini, A. (1999). Behavioral and emotional problems among children of cocaine and opiate dependent parents. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 421-428.