Alcohol and Alcoholism Advance Access published online on May 8, 2008
Alcohol and Alcoholism, doi:10.1093/alcalc/agn034
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Mediators and moderators of parental alcoholism effects on offspring self-esteem
Utah Valley University, UT 84058, USA
* Author to whom correspondence should be addressed at: Utah Valley University, FA 721, 800 West University Parkway, Orem, UT 84058, USA. Tel: +1-801-863-6802; Fax: +1-801-805-4924; E-mail: Sripriya.Rangarajan{at}yahoo.com
Received 3 December 2007; ; accepted 7 April 2008
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ABSTRACT |
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 TOP ABSTRACT IntroductionParental Alcoholism and...Methodological ConsiderationsMethodPlan for Data AnalysesResultsDiscussionReferences |
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Aims: The goal of the proposed study was fourfold: (i) to examine the effects of parental alcoholism on adult offspring's self-esteem; (ii) to identify and test possible mediators and moderators of parental alcoholism effects on the self-esteem of adult offspring; (iii) to examine the utility and relevance of attachment theory (Bowlby J. (1969) Attachment and Loss: Vol. 1. Attachment. New York: Basic Books) in explaining parental alcoholism effects on self-esteem and (iv) to address some of the methodological limitations identified in past research on adult children of alcoholics (ACOA). Methods: Participants (N = 515) completed retrospective reports of parental alcoholism, family stressors, family communication patterns, parental attachment and a current measure of self-esteem. Results: The results showed support for the detrimental effects of parental alcoholism on offspring self-esteem and offered partial support for family stressors as a mediator of parental alcoholism effects on parental attachment and parental attachment as a mediator of parental alcoholism effects on offspring self-esteem, respectively. Finally, support was found for family communication patterns as a moderator of the effects of family stressors on attachment. Conclusions: The study findings offer preliminary support for the utility of attachment theory in explicating parental alcoholism effects on the self-esteem of adult offspring. Findings from the present study make salient the need to consider factors beyond the identification of parental alcohol abuse when explicating individual differences in offspring self-esteem in adulthood. The identification of protective and risk factors can contribute to the development of optimal intervention strategies to help ACOAs better than simply the knowledge of family drinking patterns.
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Introduction |
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It is estimated that there are about 28 million children of alcoholics in this country (Walker and Lee, 1998
) and recent statistics indicate that one in four children under the age of 18 is exposed to some degree of family alcohol abuse (Grant, 2000). Although researchers continue to emphasize the effects of parental alcoholism on children and adolescents, the last two decades have witnessed widespread and sustained interest in examining the impact of parental alcoholism on adult children of alcoholics as well. Adult children of alcoholics are generally conceptualized as individuals over the age of 18 raised in homes where alcohol was abused to the neglect of the maintenance of the family unit (Black, 1982). The idea of an adult child is based on the twin assumptions that a parent's drinking is the central factor in the life of a child of an alcoholic and has, more than any other factor, the greatest influence on outcomes of the offspring and that parental alcoholism effects persist into adulthood. Despite the widely endorsed idea that individuals exposed to parental alcoholism in childhood are at risk for a number of psychosocial problems in adulthood, research has shown that not all individuals experience distress in adulthood, suggesting the presence of protective factors that likely diminish parental alcoholism effects.
Researchers’ interest in explaining and understanding why some individuals become resilient despite being at risk led to an increased emphasis on testing models that illustrate how the risk–outcome relationship is explained or qualified. Although this has greatly enhanced our understanding of children who grow up with parental alcoholism, inconsistencies in research findings have made generalizations about the population extremely difficult. For example, although the detrimental effect of parental alcoholism on offspring self-esteem, the outcome variables of interest in the current study, is extremely well documented (e.g. Rearden and Markwell, 1989; Currier and Aponte, 1991; Williams and Corrigan, 1992; Bosworth and Burke, 1994; Bush et al., 1995), several investigators have reported results indicating little or no difference between adult children of alcoholics and adult children of non-alcoholics with regard to self-esteem (e.g. Churchill et al., 1990; Werner and Broida, 1991; Thomas-Shepherd, 1995; Walker, 1996).
The goal, therefore, of the present study is to examine what effect, if any, parental alcoholism has on offspring self-esteem in adulthood. Self-esteem was chosen as the outcome variable of interest in the proposed study because of its established relationship with a number of outcomes associated with psychosocial adjustment and functioning in adulthood. For instance, low self-esteem is associated with depressive reactions, including suicidal ideation (Harter, 1993), alcohol and drug use (Skibbee, 2001), verbal aggressiveness (Rancer et al., 1992), decreased marital satisfaction (Larson et al., 1998), increased loneliness (Brage et al., 1993) and relational jealousy (White and Mullen, 1989). Related goals of the study include (i) evaluating the relevance and utility of attachment theory (Bowlby, 1969) in explaining individual differences in offspring self-esteem, (ii) identifying and testing variables that potentially mediate or moderate the relationship between parental alcoholism and offspring self-esteem and (iii) addressing some of the methodological limitations often cited in defense of the failure to consistently find support for the detrimental effects of parental alcoholism.
Individual differences in self-esteem
Rosenberg (1965) defined self-esteem as a sense of self-worth and fundamental respect for oneself and described low self-esteem as feelings of unworthiness, inadequacies and deficiencies. According to attachment theory (Bowlby, 1969), a primary caregiver's (e.g. mother’s) availability and sensitivity during infancy and early childhood shapes the child's internal representations of self (Bretherton, 1991). Thus, caregivers who are generally available and respond sensitively to their children's distress influence the children's evaluation of the self as worthy of attention and affection. However, failure of one or both parents to provide sensitive and responsive care could result in a model of self as unworthy and undeserving of attention and love. In other words, the development of a secure attachment relationship to primary caregivers lays the groundwork for the growth of positive self-esteem. If significant others are perceived as rejecting or insensitive, the child is likely to develop negative self-cognitions (Cicchetti and Toth, 1998). As Laible et al. (2004, p. 704) suggested, ‘Warm and positive interactions between attachment figures and children facilitate positive representations of the self not just within the family context, but in more global self-evaluation contexts as well.’ Research has consistently found support for the relationship between secure parental attachment and positive representations of the self, including high levels of self-esteem and self-efficacy (see Thompson, 1999 for a review). In other words,
- Hypothesis 1: Parental attachment has a direct, positive effect on offspring self-esteem.
From an attachment perspective, to the extent that there are individual differences in caregiving, there should be individual differences in offspring self-esteem as well. Therefore, identifying factors that potentially contribute to variability in caregiving may provide us with insights into the observed variability in self-esteem among adult offspring of alcoholic parents.
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Parental Alcoholism and Attachment Security |
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Belsky et al. (1991
), in their description of a model of human social development, contended that early contextual factors in the family of origin (e.g. stress, conflict and resources) affect early child-rearing experiences (e.g. the level of sensitive, supportive and responsive caregiving), which, in turn, affect psychological and behavioral development (e.g. patterns of attachment). Within the context of an alcoholic family, caregiving quality may be compromised by parents’ preoccupation with either their own or their partner's alcoholism. When parental response to children is impaired by these factors, children react in disorganized, detached and disruptive ways and become high risk for the development of insecure attachment (Erdman, 1998).
In a similar vein, Carmichael-Olson et al. (2001) suggested that a young child's development of self-esteem relies upon appropriate interaction with caregivers. The development of a secure attachment relationship to primary caregivers lays the groundwork for the growth of the child's internal representational model of self and thus for the growth of positive self-esteem. In alcoholic families, parental drinking is likely to result in periodic, if not chronic, emotional and physical unavailability of one or both parents. Thus, children growing up with parental drinking are at risk for the development of insecure attachment (Ballard, 1993), particularly to the alcoholic parent. Further, if the caregiver abuses alcohol, he/she may find it stressful to negotiate normal developmental tasks, such as responding with a combination of supportive guidance and appropriate control to the child's needs. Over time, a caregiver struggling with alcohol abuse may even behave in a manner that is abusive and/or neglectful, also increasing the probability of the child developing insecure attachment, making more likely the development of feelings of low self-esteem (Carmichael-Olson et al., 2001). As suggested earlier, even if the primary caregiver is himself/herself not an alcoholic, preoccupation with partner's alcoholism may compromise the quality of caregiving and increase the risk for low self-esteem.
Theoretically, although the degree to which parental alcoholism undermines caregiving should have implications for child's attachment to the parents, research has not always found support for this relationship. In fact, much of the research findings (e.g. Gordon, 1995; Warka, 2001) appear to suggest that there is no direct relationship between parental alcoholism and parental attachment. There are at least two possible explanations why past research may have failed to support a direct relationship between parental alcoholism and attachment security. The first is methodological and involves the use of parental alcoholism measures with dichotomous response choices and arbitrary cut-off scores to categorize participants into ACOA and non-ACOA groups in past research; the use of such measures increases the likelihood of the relationship between parental alcoholism and attachment becoming understated or, in some cases, reduced to near-zero levels due to range restriction issues (Hamilton and Hunter, 1998).
Not surprisingly, researchers (e.g. Mintz et al., 1995) have begun to highlight the disadvantages of treating parental alcoholism as a single categorical variable, given the richness of data that may be lost. Because alcoholism likely exists on a continuum of seriousness, it is possible that studies that assign participants into groups of adult children of alcoholics and adult children of non-alcoholics are losing valuable information related to the effects of parental alcoholism. Simply put, rating parental alcoholism on a continuum allows both deviant and normative parental drinking to be captured by the same scale, thereby fostering quantitative and statistical comparisons not possible with categorical measures of alcoholism.
In other words, even though there is theoretical justification to expect that parental alcoholism would undermine parental attachment security, but research has not yet found support for the direct effects of parental alcoholism on parental attachment, we ask:
- RQ1: Is there a direct relationship between parental alcoholism and parental attachment?
- RQ2: Does parental attachment mediate the effects of parental alcoholism on offspring self-esteem?
- RQ2: Does parental attachment mediate the effects of parental alcoholism on offspring self-esteem?
Although range restriction issues may be one possible explanation for the failure to find support for the relationship between alcoholism and attachment, a second possible explanation could also be that the relationship between parental alcoholism and parental attachment is mediated by other family factors. For example, Hill et al. (1992) suggested that the detrimental effects of a positive family history of alcoholism likely vary with the degree of family impairment caused by a parent's drinking. In other words, when parental alcoholism leads to increased conflict, abuse and instability, the family environment is likely to be perceived as stressful, unsafe and threatening by children.
According to attachment theory, when children feel threatened by environmental factors that endanger their sense of ‘felt security’, they attempt to regain that security by establishing proximity with the attachment figure. If the attachment figure responds by providing reassurance and nurturance, the child develops a secure attachment to the caregiver, but if the attachment figure responds by either ignoring or, worse, punishing the child's attempts to establish contact, the child becomes high risk for the development of insecure attachment.
Once again, despite being theoretically intuitive, drawing definitive conclusions about the indirect effects of parental alcoholism on attachment security through disruptive family functioning has been made difficult because of a general lack of consistency with regard to the conceptualization and measurement of family functioning in past research; it is beyond the purview of the current study to resolve this issue in any depth. In the current study, the term family stressors is used to describe contextual factors (e.g. amount of stress, conflict, abuse, instability) that shape an individual's experience growing up in his or her family-of-origin, consistent with the basic premise of Belsky et al. (1991) model of human social development. There is preliminary evidence that some features of the family environment (e.g. conflict, abuse, instability) undermine parental responsivity and sensitivity to the child (e.g. Menees and Segrin, 2000) and that these, in turn, have implications for the development of secure parental attachment (e.g. Brown, 1988; Lease, 2002). In view of the foregoing, it is hypothesized:
- Hypothesis 2: Family stressors [partially] mediate parental alcoholism effects on parental attachment.
In describing the relationship between family stressors and attachment security, Kobak (1999) suggested that disruptive events that a child or adult encounters in attachment relationships cannot be equated directly with threats to caregiver availability, adding that attachment disruptions, which include conflict, instability or abuse, become threats only when the child or adult perceives them as jeopardizing the availability of an attachment figure. He further posited that one of the aspects of availability, open communication, plays a critical role in modifying the child's or adult's appraisals of disruptive events, stating, ‘Open communication can greatly reduce the extent to which disruptive events are perceived as threatening the availability of an attachment figure’ (p. 33). For example, whether a child will perceive parental anger expressions as a signal that the child needs to alter his or her behavior to maintain a cooperative relationship or as a rejection or threat of abandonment depends on the nature of parent–child communication that accompanies parental behavior or stressful events.
Family stressors, family communication and attachment
When communication is open, children are encouraged to discuss their feelings and fears and parents respond in a manner that provides the child with a clear understanding of the specific source and context for the experiences in the family. As a result, contextual factors in the family may be less likely to connote parental rejection or abandonment, decreasing the likelihood that the child will develop insecure attachment. In contrast, if disruptive parental behavior or stressful events are not qualified in an appropriate and sensitive manner by the parent, perhaps as a means of denying the problems in the family, children may misperceive parental behaviors as rejecting, increasing the probability of insecure parental attachment. In other words, the nature and quality of communication that accompany stressful family events will determine what effect, if any, family stressors will have on offspring-attachment security.
In their revision of McLeod and Chaffee's (1972) model, Ritchie and Fitzpatrick (1990) described family communication as ‘a set of norms governing the tradeoff between informational and relational objectives of communication’ (p. 524). They also changed the name ‘concept orientation’ to ‘conversation orientation’ and ‘socio-orientation’ to ‘conformity orientation’ (p. 526) to enable better interpretation of empirical findings and to use language consistent with notions of supportive and control messages used within the family communication literature.
It is important that Ritchie and Fitzpatrick's idea of conformity orientation family communication pattern not be confused with the ‘Don't talk’ rule described by Black (1982) and others in the clinical literature. Conformity orientation communication pattern refers to parents’ use of communication to assert parental authority, establish boundaries between parental and offspring roles in the families and/or elicit cooperation from children. This may actually promote attachment security because parents assume the responsibility for providing adequate clarification following a disruptive event and assuring the child of their continued availability. The ‘Don't talk’ rule, on the other hand, involves a complete lack of communication from parents following disruptive parental behavior or stressful events in the family. In extreme cases, children are even socialized to pretend that nothing unusual is going on. Such behavior has the potential to confuse the child's working models of not just the alcoholic parent, but the non-alcoholic parent as well. Examples of these effects may be inferred from the response given by some of the participants in the current study under conditions of anonymity. One participant in the current study had this to say about her relationship with her alcoholic father: ‘My dad was an alcoholic. Till the day he died, I assumed that meant he could not love me, or anybody else. No one told me otherwise.’ Another admitted, ‘I hated my dad more than I hated my mother, even though she was the alcoholic, because he just wouldn't talk to me or listen to what I was feeling at the time.’ By contrast, in families without an alcoholic parent, children who experience daily childhood problems may be encouraged to openly discuss them with other family members, helping them to understand and effectively deal with the problems.
Although these conceptualizations of family communication patterns have not been studied in the context of alcoholic families, perhaps because few communication researchers have contributed to this body of research, it is logical to expect that both conformity and communication patterns would function to reduce the adverse effects of family stressors on parental attachment because they implicate the assumption and enactment of appropriate roles in the family as opposed to the dysfunctional parentification (the assumption of adult roles by children before they are emotionally or developmentally ready to manage those roles) that occurs in families with an alcoholic caregiver. In view of the foregoing, it is posited,
- Hypothesis 3: Family communication patterns moderate the effects of family stressors on parental attachment security.
In addition to being limited theoretically and conceptually, research examining the effects of parental alcoholism on off-spring outcomes has been criticized for a number of methodological limitations, including over-reliance on samples comprising entirely college students (Domenico and Windle, 1993), failure to consider the differential effects of paternal and maternal alcoholism (Hardin, 2000) and lacking adequate power to detect the moderating effects of offspring sex. The present study discusses each of the limitations in turn and attempts to address them by (i) recruiting a sample comprising both college and non-college students; (ii) considering the effects of both paternal and maternal alcoholism within the same study and (iii) examining the sex of offspring as a possible moderator of parental alcoholism effects.
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Methodological Considerations |
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Over-reliance on college samples
Research examining effects of parental alcoholism on offspring has often relied on college samples, largely because they are convenient. In fact, a recent preliminary meta-analytic review of studies (1992–2002) comparing children of alcoholics and children of non-alcoholics found that 50% of studies (n = 21) had used college-student-only samples (Rangarajan, 2004
). This is problematic in at least two ways: (i) college samples possess particular characteristics that cannot be generalized to a larger population—some level of adequate functioning and resiliency is expected—and (ii) when data come from a restricted population, consisting of a subset of people selected from the reference population, problems are encountered in terms of range restriction. When the population range is restricted, as is the case with college samples, the relationships between the study variables are understated and, in some cases, can be reduced to near zero levels (Hamilton and Hunter, 1998). The typical at-risk population is likely to be more heterogeneous than a population of college students. Participants in the current study were, therefore, carefully recruited to ensure greater heterogeneity than is afforded by samples comprising entirely college students.
Differential effects of paternal and maternal drinking
Vail et al. (2000) reviewed 98 empirical studies and found that participants in 48 studies were classified using Children of Alcoholics Screening Test (CAST) cut-off scores, showing that the CAST is one of the most favored diagnostic instruments among researchers. Despite its widespread use, the CAST, and other instruments similar to it, suffer from one key limitation: they assess the presence of family alcoholism, without providing any real insights into the seriousness of maternal and paternal drinking. In appreciation of the significant roles that mothers and fathers each play in the development of their children, it is important to explore the differences with regard to the impact of maternal and paternal alcoholism. The majority of the research on adult children of alcoholic parents has examined the nature of their differences from children who did not have alcoholic parents. Because mothers and fathers have unique roles in the family, it is reasonable to expect that there would be different effects on children depending on which parent was dysfunctional (Bradley and Schneider, 1990). Research investigating maternal versus paternal alcoholism suggests that maternal alcoholism may more negatively impact children's social development. For these reasons, the effects of both paternal and maternal alcoholism were assessed on a continuum of seriousness in the present study.
Sex of offspring as a moderator
Evidence from some of the earliest studies on ACOAs offer some support for offspring sex as a mitigating factor among ACOAs. For example, Winokur et al. (1970) found that sons of alcoholics demonstrated increased risk for developing alcoholism while daughters of alcoholics were at higher risk for developing affective disorders. This was supported by Goodwin (1977) who found that the rate of alcoholism among sons of alcoholics was 
18% while the rate for daughters was 4%. The higher rates of alcoholism among sons of alcoholics may be preliminary evidence that a sizable percentage uses substance abuse as a means of coping while most daughters of alcoholics employ other coping skills. Indeed, Werner (1986) found that female ACOAs tended to be more resilient than male ACOAs. Sex of offspring was, therefore, explored as a possible moderator of parental alcoholism effects.
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Method |
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Research participants
In an effort to ensure greater heterogeneity and limit issues resulting from range restriction in terms of key theoretical variables, participants (N = 515) were recruited from undergraduate communication classes at a mid-sized northeastern university (n = 295) and by posting links to the study on About.com bulletin boards (n = 220). The overall sample comprised 28% males (n = 145) and 72% females (n = 370), and the mean age was 29.7 years (SD = 9.36). Fifty-five percent of participants (n = 283) reported being single (never married), 21% (n = 107) reported being married, 12% (n = 59) reported being in a serious, committed relationship, 9% (n = 47) were divorced and the remaining 3.7% (n = 19) reported either being widowed or separated.
Participants were also asked to report on the primary male and female caregivers during the first 16 years of their life. Eighty-four percent identified their biological father as the primary male caregiver, 6% reported having been raised by a step-father and 3.2% either identified an uncle (1.2%), brother (1.2%) or legal guardian (0.8%) as the primary male caregiver. The remaining 6.8% did not identify any specific person as the primary male caregiver. In terms of primary female caregiver, 95% reported having been raised by their biological mother and 3.3% of participants did not identify any specific individual as the primary female caregiver.
Informed consent
The online nature of the study assured participants that their responses would be completely anonymous. Additionally, participants’ responses were stored in an online database that was password protected and accessible only to the researcher. Given that both anonymity and confidentiality were guaranteed, the study was treated as exempt from full review and approved by the Institutional Review Board (IRB). All prospective participants were recruited through online channels—a brief description of the study and the link to the study were provided. Once participants clicked on the link to the study, it took them to the website where the study was hosted. Participants were greeted with a Study Information page that summarized, in brief, the goals of the study, informed participants about the nature of the study and apprised them of their rights as research participants, including having the option of refusing to answer questions that they felt uncomfortable answering and/or withdrawing from the study entirely at any time. Participants were given the choice of clicking on either the ‘Proceed to Study’ button if they wished to participate or clicking the ‘No, thanks–Exit’ button if they decided against participating. Only those who clicked on the ‘Proceed to Study’ button were taken to the actual study page.
Once there, participants were asked to fill out a demographic form that asked them questions related to their sex, age, education, employment and marital status, as well as questions about their own alcohol use. In addition, they were asked to complete retrospective measures of parental alcoholism, family stressors, parental attachment, and family communication and current measure self-esteem. After completing the survey, participants were taken to a Closing Page that thanked them for their time and effort and debriefed them in detail about the study. Participants were given the option of providing the researcher with their name (optional) and email ID if they wished to receive a copy of the study's results when it became available. This information was stored in a different database to ensure participant anonymity.
Measures
Parental drinking
The parental alcoholism measure was specifically developed to asses participants’ perceptions of their parents’ alcohol use during the first 16 years of the their (the participants’) life. The scale comprised 14 items (7 items each to assess paternal and maternal alcoholism) that assessed the following: (i) participants’ perception that their parent(s) had an alcohol problem; (ii) that their parent(s) needed help to overcome the problem; (iii) perception of the seriousness and intensity of the problem; (iv) the extent to which parents’ alcohol use bothered the participant; (v) the extent to which participant perceived parents’ alcoholism as affecting parents’ roles and responsibilities as primary caregivers and (vi) participants’ perception of themselves as adult children of alcoholics. Participants responded to these questions on a 7-point Likert scale. The scales were subject to Confirmatory Factor Analyses (CFA; Hamilton and Hunter, 1988) and the results showed good support for the factor structures of both paternal and maternal alcoholism sub-scales; reliabilities of the scales were high (
= 0.98 for paternal alcoholism and = 0.98 for maternal alcoholism).
As a validity check, an objective measure of the number of drinks consumed by parents on any given occasion was also included in the study. The item for the latter was adapted from the AUDIT questionnaire employed by the Medical College of Wisconsin to determine alcohol disorders. The correlations between the participants’ perceptions of their parents’ alcoholism seriousness and the number of drinks consumed by father [r(296) = 0.89, P < 0.01] and mother [r(281) = 0.85, P < 0.01] were high, providing some support for the validity of the continuous measures. The discrepancies in sample sizes given in parentheses reflect missing values on those variables in the study.
Family stressors
A modified version of the 39-item Children of Alcoholics Life Events Schedule (COALES; Roosa et al., 1988) was used to assess participants’ recollections of stressors in their family-of-origin during the first 16 years of their life. In the present study, the scale was modified by: (i) shortening the scale to 16 items by combining some of them to reduce redundancy, (ii) changing the response format to a 7-point Likert scale with higher scores indicating greater agreement with an item and (iii) rephrasing/rewording statements, where necessary, to increase clarity and facilitate understanding. The resulting scale had 16 items (after combining some of them and excluding the 1 problematic item that is generally not included in the scoring).
Because the emphasis was on assessing family stressors during the first 16 years of the participant's life, participants were instructed to respond to the questions in terms of the person or persons who had the primary responsibility for their upbringing as a child. Where a question inquired about the behaviors of both parents and parents differed in their behavior, participants were asked to respond by thinking of the parent whose behavior was the more severe or worse. The scale was subject to CFA and results indicated that 12 out of 16 items loaded onto the family stressors factor. The reliability of the resulting 12-item family stressors scale ( = 0.95) was high.
Parental attachment
Parental attachment in the present study was assessed using the parental sub-scales of the Inventory of Parent and Peer Attachment (IPPA; Armsden and Greenberg, 1987). The parental sub-scales comprise 50 items (25 items each to assess paternal and maternal attachment) and responses are generally scored on a 5-point Likert scale. The IPPA assesses perceptions of relationships with parents (and close friends) and taps into the degree of mutual trust (e.g. ‘My mother respects my feelings’), quality of communication (e.g. ‘I like to get my mother's point of view on things I am concerned about’) and degree of anger and alienation (e.g. ‘My mother expects too much from me’). The dimensions are highly correlated within each relationship type and are, therefore, aggregated to yield a composite index of security versus insecurity with respect to parents (or peers).
Two modifications were made to the original scale for use in the current study: (i) because parental attachment was assessed retrospectively in this study, all the statements were reworded in the past tense and (ii) the response format was changed from a 5-point Likert scale to a 7-point Likert scale with higher scores indicating greater attachment security. The scale was subject to CFA and results of the analysis indicated that 20 of the 25 items in each of the two sub-scales loaded onto their respective factors, the remaining 5 (e.g. ‘My father/mother expected too much from me,’ ‘I got easily upset around my father/mother’) were excluded from all subsequent analyses because of poor factor loadings (r = 0.26 to r = 0.39). Reliabilities of the resulting paternal and maternal attachment sub-scales were high ( = 0.97).
Family communication
Family communication was measured using the Revised Family Communication Patterns instrument (RFCP; Fitzpatrick and Ritchie, 1994). The RFCP contains 26 Likert-type items that measure communication norms in the family. The RFCP has two sub-scales, conversation orientation, which refers to the open exchange of ideas and feelings between parent(s) and child (e.g. ‘My parents liked to hear my opinions, even when did not agree with me’), and conformity orientation, which refers to the use of parental control to enforce conformity (e.g. ‘My parents sometimes became irritated with my views if those views were different from theirs’). Based on the results of the CFA, one item (‘In our family, we often talked about topics like politics and religion where some members disagreed with others’) in the conversation orientation subscale and four items from the conformity orientation subscale (e.g. ‘If I did something my parents didn't approve of, they preferred not to know about it") were excluded from the final analysis because of poor primary factor loading (r = 0.15 to r = 0.38). The resulting reliabilities of both the conversation orientation ( = 0.97) and the conformity orientation ( = 0.88) dimensions were high.
Self-esteem
Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1965). The RSES is a 10-item instrument designed to assess self-esteem on a continuum ranging from low to high self-esteem. In the present study, the 10-items were aggregated to yield a composite index of self-esteem. The scoring was changed from the original 4-point scale to a 7-point scale. Results of the confirmatory factors analysis confirmed the unidimensional factor structure of the Rosenberg self-esteem measure and the reliability of the scale was high ( = 0.92).
The means and SDs of the variables measured in the current study are summarized in Table 1.
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Plan for Data Analyses |
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All the measures used in the current study were validated using Confirmatory Factor Analysis (CFA), a scale validation procedure that allows researchers to propose, test and confirm a hypothesized factor structure by specifying the number of factors, whether or not factors are correlated, and which factor loadings are allowed to be nonzero. Correlational and multiple regression analyses were employed to answer research questions and test hypothesized relationships. Offspring sex, age and family socio-economic status (the latter was assessed on a 7-point scale with 1 = very low to 7 = very high) were entered as covariates in Step 1 of all regression analyses. Mediation and moderation in the present study were assessed using Baron and Kenny's (1986
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Results |
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Between group differences
College versus non-college samples First of all, to rule out the possibility that relationships among key theoretical variables differed between the college sample and participants recruited by posting links on About.com bulletin boards (substantive differences across the two samples would require the construction and validation of separate risk-outcome models), inter-correlations among study variables across the two samples were generated and compared. Results of the analysis using Meta-Cor (Hamilton, 1991
), a statistical software program used to test if correlations are statistically different from one another, indicated that the pair of correlations between maternal attachment and offspring self-esteem in the two samples was the only one that was statistically different between the two groups. In view of the foregoing, both samples were pooled together and all analyses, unless otherwise noted, were run on the entire sample.
Offspring sex as moderator
Meta-Cor (Hamilton, 1991) was once again used to test if offspring sex moderated parental alcoholism effects by generating and comparing inter-correlations among study variables for males and females. Substantive differences in magnitude and/or direction among pairs of correlations would be evidence that offspring sex moderates the effects of parental alcoholism and requires testing the hypothesized relationships among study variables separately for males and females. Results of the analyses indicated that there were no significant differences between male and female offspring in terms of parental alcoholism effects. However, results did reveal statistically significant differences (P < 0.05) between males and females with regard to the relationships between family stressors and maternal attachment, with the relationship stronger for females (r = –0.75, P < 0.01) than for males (r = –0.65, P < 0.01), and between conformity orientation communication pattern and offspring self-esteem, once again the relationship stronger for females (r = –0.38, P < 0.01) than for males (r = –0.09, P < 0.01). Although a few other sex differences in terms of magnitude emerged, these differences were not statistically significant. In view of the foregoing, the male and female sub-samples were pooled into a single sample (N = 515), increasing the study's statistical power to detect meaningful effects. The inter-correlations among study variables within the male and female sub-samples are summarized in Table 2.
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Summary of major findings
Hypothesis 1: parental attachment and offspring self-esteem Hierarchical linear regression analysis was run to test the hypothesis that parental attachment has a direct, positive effect on offspring self-esteem. As indicated earlier, offspring sex, age and family socio-economic status were entered in Step 1 as covariates and paternal and maternal attachment in Step 2. Results of the analysis showed support for the hypothesis, with the overall model explaining 26% of the variance in offspring self-esteem [F(5, 505) = 36.57, P < 0.01]. Maternal attachment had a moderately larger effect on offspring self-esteem (β = 0.40, P < 0.01) than did paternal attachment (β = 0.21, P < 0.01) and, together, they explained 15% of the variance in offspring self-esteem. While offspring sex (β = –0.11, P < 0.05) and age (β = 0.12, P < 0.05) had small, but significant, effects on self-esteem, family socio-economic status did not (β = 0.05, P > 0.10).
Research question 1: parental alcoholism and parental attachment
Hierarchical regression analysis was run to determine what effects, if any, parental alcoholism has on maternal attachment security—as indicated earlier, participant gender, age and family socio-economic status as covariates in Step 1. Results showed support for the detrimental effects of paternal (β = –0.10, P < 0.05), but not maternal (β = –0.05, P > 0.10), alcoholism on maternal attachment [F(5, 505) = 68.63, P < 0.01, R2 = 0.41]. Participant age (β = –0.44, P < 0.01) had the largest effect on maternal attachment followed by family socio-economic status (β = 0.20, P < 0.01) and together accounted for 40% of the variance in maternal attachment. In terms of paternal attachment, results once again showed support for the detrimental effects of paternal alcoholism (β = –0.38, P < 0.01), but not maternal (β = –0.02, P < 0.05) alcoholism on attachment [F(5, 509) = 73.63, P < 0.01, R2 = 0.42]. As with maternal attachment, participant age (β = –0.26, P < 0.01) and family socio-economic status (β = 0.15, P < 0.01) explained most of the variance (
R2 = 0.33) in paternal attachment followed by paternal alcoholism (R2 = 0.09).
Research question 2: parental attachment as a mediator of alcoholism effects Before testing if parental attachment mediated effects of parental alcoholism on offspring self, regression analysis was run to determine if parental alcoholism had an effect on offspring self-esteem. Results of the analysis revealed that both paternal (β = –0.14, P < 0.05) and maternal alcoholism (β = –0.10, P < 0.05) had effects on offspring self-esteem in the expected direction [F(5, 509) = 15.86, P < 0.01, R2 = 0.14]. Regression analysis was then run to assess if attachment mediated parental alcoholism effects on offspring self-esteem. Mediation is established if the effects of parental alcoholism on offspring self-esteem are reduced to zero, after controlling for the effects of the hypothesized mediating variables. Results indicated that parental attachment completely mediated effects of paternal (β = –0.02, P > 0.10), but not maternal (β = –0.08, P < 0.05), alcoholism on offspring self-esteem [F(7, 503) = 26.82, P < 0.01, R2 = 0.27].
Hypothesis 2: family stressors as a mediator of alcoholism effects
Hypothesis 2 was that family stressors partially mediate parental alcoholism effects on parental attachment. According to Baron and Kenny (1986), the effects of the hypothesized mediating variables on the outcome variable as well as the test of mediation are usually established in the same regression equation. Recall that paternal alcoholism diminished both paternal and maternal attachment, but maternal alcoholism did not. Therefore, regression analysis was run to determine if family stressors mediated the effects of paternal alcoholism on paternal and maternal attached. Results revealed that not only did family stressors not mediate the effects of paternal alcoholism on maternal attachment, but it actually suppressed the effects of paternal alcoholism on maternal attachment (β = 0.12, P > 0.05)—suppression results when the relationship between the independent or causal variables (i.e. paternal alcoholism and family stressors) hides their real relationship with the outcome variable (i.e. maternal attachment). This is evidenced when adding a predictor (family stressors) to a regression equation increases or changes the sign of the B of another predictor (paternal alcoholism).
Demographic variables accounted for 40% of the variance in maternal attachment, followed by family stressors (R2 = 0.16) and parental alcoholism (R2 = 0.01). Support, however, was found for family stressors as a partial mediator of paternal alcoholism effects on paternal attachment—after controlling for family stressor effects (β = –0.46, P < 0.01), the effect of paternal alcoholism on paternal attachment diminished from β = –0.38 (P < 0.01) to β = –0.22 (P < 0.01). The overall regression equation was significant [F(6, 508) = 88.01, P < 0.01, R2 = 0.51], with demographic variables explaining 33% of the variance, followed by parental alcoholism (R2 = 0.09, P < 0.01) and family stressors (R2 = 0.09, P < 0.01).
Hypothesis 3: family communication patterns as a moderator of the effects of family stressor on attachment
As Baron and Kenny (1986) pointed out, the most complicated moderation test involves a moderator variable that is measured continuously and recommend using the value of the moderator at the mean and at ±1 standard deviation from the mean as levels of the moderator variable. Generally, moderator effects are indicated by the interaction of the predictor variable and hypothesized moderator variable in explaining the criterion variable. In the present study, levels of the moderators were set at the mean (4.63 for conformity orientation and 3.57 for conversation orientation) and ±1 standard deviations from the means. Interaction terms were then computed and entered into the regression equation; while demographic variables were entered in Step 1, the main effects of family stressors, conformity orientation and conversation orientation communication were entered as covariates in Step 2 of the regression equation.
Results of the regression analysis offered support for the hypothesis that family communication patterns moderate the effects of family stressors on maternal attachment. The effect of family stressors on maternal attachment (β = –0.29, P < 0.01) was reduced by the interaction of family stressors with both conformity orientation (β = –0.16, P < 0.05) and conversation orientation communication patterns (β = –0.13, P < 0.05). The overall regression equation was significant [F(8, 499) = 124.74, P < 0.01, R2 = 0.67); the interaction terms accounted for only 1% of the total variance explained. With regard to paternal attachment, results once again supported the role of family communication patterns in moderating the effects of family stressors on paternal attachment. The effect of family stressors on paternal attachment (β = –0.26, P < 0.01) weakened when the interaction of family stressors with conformity (β = 0.04, P < 0.01) and conversation orientation communication patterns (β = –0.09, P < 0.01) were entered into the regression equation [F(8, 502) = 95.02, P < 0.01, R2 = 0.60]. Demographic variables accounted for 33% of the variance, followed by family stressors and family communication patterns (R2 = 0.27, P < 0.01). As with maternal attachment, the interaction terms explained only an addition 1% of the variance. Because moderation is generally established when there is a weakening of the causal effect, it appears that family communication patterns moderate the effects of adverse family stressors on both maternal and paternal attachment security. Hypothesis 3 was, therefore, supported.
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Discussion |
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TOPABSTRACTIntroductionParental Alcoholism and...Methodological ConsiderationsMethodPlan for Data AnalysesResultsDiscussionReferences |
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Findings from the current study showed support for: (i) the detrimental effects of parental alcoholism on offspring self-esteem; (ii) partial mediating effects of family stressors and mediating effects of parental attachment and (iii) the moderating effects of conformity and conversation orientation communication patters. Methodologically, results from the current study highlighted the utility and relevance of using a sample comprising both college and non-college students and assessing both paternal and maternal alcoholism on a continuum. Each of these study findings is discussed in detail in the following sections and the discussion concludes with a summary of study limitations and directions for future research.
Parental alcoholism and offspring self-esteem
Consistent with findings by Bosworth and Burke (1994), Bush et al. (1995) and others, the current study found support for the deleterious effects of parental alcoholism on offspring self-esteem. Because both paternal and maternal alcoholism were assessed in this study, results also revealed that paternal alcoholism had a more detrimental effect on offspring self-esteem than maternal alcoholism, highlighting the utility in assessing the differential effects of paternal and maternal alcoholism within a single study. This finding is especially significant because it reinforces the need to treat parental alcoholism as a heterogeneous variable that likely differs in terms of seriousness and intensity, at minimum, and this variability likely produces considerable variability in ACOA outcomes as well, including self-esteem. This may be why, despite fitting the clinical description of an ACOA, some individuals do not exhibit the presumed attributes of a child raised in an alcoholic family. It must be noted that this explanation is tentative, at best, and more research is needed using multi-dimensional conceptualizations of parental alcoholism before any definitive conclusions can be drawn about the presumed relationships between parental alcoholism and offspring self-esteem.
Parental alcoholism, parental attachment and offspring self-esteem
According to attachment theory, caregiver availability and sensitivity in infancy and childhood create expectations for children's representations of the self and this framework is thought to be relatively stable over the lifespan. However, caregivers are likely to differ in their degree of availability and sensitivity to the child during this developmental period due to a number of individual and family factors; consequently, differences exist in children's attachment security to the caregiver. Within the context of an alcoholic home, caregiver availability and responsivity to the child is impaired either because the caregiver himself/herself is an alcoholic or is too pre-occupied with the alcoholic to care for the child. Such a child then develops an internal model of self as unworthy, leading to the development of low self-esteem.
Results from the current study indicated that paternal, but not maternal, alcoholism had a detrimental effect on parental attachment security. This is not to suggest that ACOAs are unaffected by maternal alcoholism; rather, it may be that it is normative for children to forge secure attachments to their mothers and seek her during times of distress, even if she is generally unavailable or unresponsive, to ensure their own survival.
In contrast, paternal alcoholism may have impacted paternal attachment security in the current sample by: (i) impacting the availability and responsivity of the alcoholic father during times of distress and/or (ii) increasing marital conflict, which may have contributed to the child's negative perceptions of the father, undermining the formation of secure attachment (Belsky, 1999). Even though more research is needed to confirm the proposed explanation, the results are suggestive that fathers promote attachment security in different ways than do mothers.
In terms of the role of attachment in mediating the effects of parental alcoholism on offspring self-esteem, results showed that parental attachment mediated the effects of paternal, but not maternal, alcoholism on offspring self-esteem. In other words, it may be that some of the ACOAs developed a relatively secure attachment to either the non-alcoholic parent or the parent whose alcoholism was not as severe and this likely buffered them from the more serious consequences of parental alcoholism. This finding is heartening because it suggests that it is possible for children raised in alcoholic homes to be protected from the ill-effects of family alcoholism and grow up to have healthy self-esteem; a high self-esteem buffers ACOAs from serious psychosocial outcomes including depression, drug abuse and/or suicide ideation, to name a few.
Methodologically, it must be noted that data on parental alcoholism as well as parental attachment security were collected using retrospective reports that are susceptible to the vagaries of memory and recall, halo effects, and likely colored by current life experiences, including the status of ACOAs’ relationships with their parent(s) at the time of this study. Future studies must systematically control for these potential confounds to more fully and accurately explicate the unique effects of parental alcoholism on offspring outcomes.
Parental alcoholism, family stressors and attachment
Hill et al. (1992) suggested that the detrimental effects of a positive family history of alcoholism likely vary with the degree of family impairment caused by the parent's drinking and should, therefore, contribute to variability in the formation of parental attachment security as well. The study found that family stressors partially mediated the effects of paternal alcoholism on paternal attachment but suppressed1 the effects of paternal alcoholism on maternal attachment. Simply put, family stressors accounted for some of the observed variability in paternal attachment, reinforcing the importance of considering family factors, beyond the identification of parental alcoholism, in explicating parental alcoholism effects.
It must be acknowledged, however, that family stressors and the environments they create are likely dynamic in nature and influenced by complex factors, making the development, measurement and tests of inclusive and comprehensive conceptualizations of family stressors difficult. Perhaps, researchers’ interests in understanding the role of biological and environment factors in the development of alcoholism, especially among ACOAs who have a fourfold higher risk (Schuckit et al., 1997), will, over time, lead to conceptually more precise and inclusive definitions of family stressors.
Family stressors, family communication patterns and attachment
Finally, support was found for the hypothesis that conformity and conversation orientation family communication patterns moderate the effects of family stressors on attachment security. Family communication patterns, both conformity and conversation orientations, moderated the effects of family stressors on parental attachment, as indicated by a weakening of the causal effect of the former (family stressors) on the latter (attachment security). This is a particularly significant finding because, as Brown (1988) suggested, it is not simply the presence of family stressors that produces dysfunctional outcomes in ACOAs, but the denial and distortion that surrounds any type of family dysfunction that affect children's ability to form positive parental attachments. When disruptions that threaten ACOAs sense of felt security in their family-of-origin are accompanied by explanations that clarify the source and nature of those disruptions, those [explanations] may help offset the risk of insecure attachment, thereby facilitating the development of positive self-esteem.
Implications of study findings
Because self-esteem has been posited as a possible antecedent of alcohol and drug use, it represents a key variable in ACOA research. Baumeister et al. (2003) suggested that the importance of high self-esteem lies in that people intuitively recognize its value in enhancing psychological well-being and try to protect it and enhance it whenever possible and research has consistently found that people with high self-esteem are significantly happier than others. McKay and Fanning (1995), in their review, noted that self-esteem is essential to psychological adaptation and the fulfillment of basic needs and Harter (1993) called for increased attention to the study of self-esteem because low self-esteem individuals are at risk for depressive reactions, including suicidal ideations.
Recently, researchers investigated the role of self-esteem as an antecedent to alcohol and drug use among adolescents (Skibbee, 2001). Higher levels of self-esteem have been shown to decrease the risk for depression, with depression increasing the chances of alcohol dependency (Workman and Beer, 1989). Studies examining treatments for depression tend to find that an increase in self-esteem is associated with decreases in depression symptomatology (Maynard, 1993). For these reasons, a primary goal of this study was to determine what effect, if any, parental alcoholism has on offspring self-esteem and to explain variability in offspring self-esteem by examining parental attachment and family communication patterns as a mediator and moderators of parental alcoholism effects, respectively.
Considered together, findings from the present study reinforce and advance our understanding of the effects of parental alcoholism on offspring self-esteem in at least four key ways: (i) growing up with parental alcoholism is not necessarily synonymous with dysfunctional outcomes, including low self-esteem, for ACOAs; (ii) protective factors like secure attachment to parent and appropriate parent–child communication patterns can function to minimize the ill effects of parental alcoholism on offspring self-esteem such that, despite fitting the label ‘ACOA’, individuals raised in alcoholic homes may not display the presumed characteristics of an ACOA; (iii) considerable variability in both the type and seriousness of parental alcoholism should, arguably, produce statistically and socially significant variability in offspring outcomes as well, treating ACOAs as a homogeneous group is, therefore, both inappropriate and counterproductive; and (iv) interventions aimed at helping ACOAs must recognize the relevance and utility of taking into consideration factors beyond the identification of parental alcohol abuse, including family stressors and parent–child relationships, when explicating offspring self-esteem in adulthood.
The identification of protective (e.g. parental attachment and family communication patterns) and risk factors (family stressors) and processes can contribute to the development of optimal intervention strategies to help ACOAs better than simply the knowledge of family drinking patterns.
Limitations and directions for future research
The current study was limited in its use of non-probability sampling methods that limit generalizability, self-reports that do not provide direct evidence of actual behavior and retrospective data that vary in accuracy, are subject to halo effects and possible item overlap, and likely influenced by current experiences and a cross-sectional study design that is suggestive but not definitive of the flow of causal influence. Although the use of purposive, targeted sampling is justified, in part, by the desire to limit range restriction issues and discriminant analyses were run on all the measures to rule out possible item overlap, future research must work to overcome these methodological limitations if meaningful generalizations are to be made to the population at large.
Future research must also consider psychosocial as well as biological influences, including genetic contributions to alcoholism and co-morbid psychiatric disorders when considering parental alcoholism effects. Despite researchers’ attempts to develop and test developmental models of alcoholism effects, as in the current study, most studies of ACOAs are almost exclusively cross-sectional (Lewis-Harter, 2000). Longitudinal studies allow greater articulation of individual and family processes that influence ACOA development over the lifespan than is afforded by cross-sectional research designs.
In the interest of ACOA intervention and treatment, a call is also extended to researchers and clinicians to work on building effective intervention strategies, developed by cumulating across psychosocial and clinical research domains. Despite advances in ACOA research, the lack of cross-disciplinary integration between psychosocial and clinical research has only served to undermine the scope and utility of research efforts. On the one hand, psychosocial researchers have access to resources required to develop and test sophisticated statistical models that afford greater precision in estimating alcohol effects. These findings, however, don't have the desired impact because the average ACOA in the population does not have access to this information. Clinicians, on the other hand, work extensively with ACOAs and have the power to make the most impact on outcomes but continue to emphasize pathology and risk in their treatments of ACOAs. This has resulted in the construction of two distinct bodies of knowledge that rarely overlap. The need of the hour is not to continue testing and re-testing established descriptions of ACOAs, but to work collaboratively on building effective intervention strategies developed by cumulating across complementary research domains.
As Jacob (as told to de Ribeaux, 1997) suggested, future research should move beyond dichotomous thinking and examine the conditions that shape complex behavioral patterns by adopting an overarching ‘developmental framework within which course and outcomes can be better understood’ (p. 264). Being identified as an ACOA, without considering the disruptive family processes that accompany parental drinking, contributes little, if any, to our understanding of the ACOA experience.
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FOOTNOTES |
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1 For more on suppression, please see Cohen et al. (2003
). 
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