European Child & Adolescent Psychiatry

, Volume 15, Issue 8, pp 460–466 | Cite as

Risk factors for the development of emotional and behavioural problems in children born to drug-dependent mothers

  • Hans-Christoph Steinhausen
  • Serena Dal Mas
  • Christoph Ledermann
  • Christa Winkler Metzke



The study of biological and psychosocial risk factors for the development of emotional and behavioural problems in children of drug-dependent mothers.


In a sample of 52 children and drug-dependent mothers participating in a residential intervention programme emotional and behavioural problems were studied in the children by use of the Child Behaviour Checklist (CBCL). The Symptom-Checklist Revised (SCL-90-R) served to assess mental problems in the mother. Drug exposure during pregnancy, various psychosocial risk factors due to the drug-career, and educational status of the mother were assessed by maternal interview. A brief assessment of intelligence of the mother was included.


Among the various biological and psychosocial risk factors, maternal mental health problems, maternal educational status, and a small number of close social relationships correlated significantly with child outcome variables. Multiple regression analyses identified maternal mental health factors as the main predictors of child behaviour.


Assisting drug-dependent mothers in overcoming the psychosocial sequelae of drug abuse implies also assistance to the children in terms of prevention of emotional and behavioural problems.


drug abuse mothers behaviour problems 



The author would like to thank all the participating mothers and children of the present study and the two teams of the supporting residential treatment centres, particularly Elisabeth Frei on behalf of “Die Alternative” and Verena Schäfer on behalf of “Sozialtherapeutische Gemeinschaft Ruedli”.


  1. 1.
    Accornero VH, Morrow CE, Bandstra ES, Johnson AL, Anthony JC (2002) Behavioral outcome of preschoolers exposed prenatally to cocaine: role of maternal behavioral health. J Pediatr Psychol 27:259–269PubMedCrossRefGoogle Scholar
  2. 2.
    Achenbach TM (1991) Manual for the child behavior checklist/4–18 and 1991 profile. University of Vermont Department of Psychiatry, Burlington, VermontGoogle Scholar
  3. 3.
    Achenbach TM (1992) Manual for the child behavior checklist/2–3 and 1992 profile. University of Vermont, Department of Psychiatrie, BurlingtonGoogle Scholar
  4. 4.
    Azuma SD, Chasnoff IJ (1993) Outcome of children prenatally exposed to cocaine and other drugs: a path analysis of three-year data. Pediatrics 92:396–402PubMedGoogle Scholar
  5. 5.
    Bennet DS, Bendersky M, Lewis M (2002) Children’s intellectual and emotional-behavioral adjustment at 4 years as a function of cocaine exposure, maternal characteristics and environmental risk. Dev Psychol 38:648–658CrossRefGoogle Scholar
  6. 6.
    Bennett DS, Bendersky M, Lewis M (2002) Children’s intellectual and emotional-behavioral adjustment at 4 years as a function of cocaine exposure, maternal characteristics and environmental risk. Dev Psychol 35:648–658CrossRefGoogle Scholar
  7. 7.
    Bennett FC, Brown RT, Craver J, Anderson D (1999) Stimulant medication for the child with attention-deficit/hyperactivity disorder. Pediatr Clin North Am 46:929PubMedCrossRefGoogle Scholar
  8. 8.
    Cicchetti D, Rogosch FA, Toth SL (1998) Maternal depressive disorder and contextual risk: contributions to the development of attachment insecurity and behavior problems in toddlerhood. Dev Psychopathol 10:283–300PubMedCrossRefGoogle Scholar
  9. 9.
    Cubas de M, Field TF (1993) Children of methadone-dependent women: develop-mental outcomes. Am J Orthopsychiatry 63:266–276Google Scholar
  10. 10.
    Delaney-Black V, Covington C, Templin T (2000) Teacher-assessed behavior of children prenatally exposed to cocaine. Pediatrics 106:627–634CrossRefGoogle Scholar
  11. 11.
    Derogatis LR (1977) SCL-90-R, administration, scoring and procedures manual-I for the R(evised) version. Johns Hopkins University School of Medicince, EigendruckGoogle Scholar
  12. 12.
    Griffith DR, Azuma SD, Chasnoff IJ (1994) Three year outcome of children ex-posed prenatally to drugs. J Am Acad Child Adolesc Psychiatry 33:20–27PubMedCrossRefGoogle Scholar
  13. 13.
    Hans SL, Bernstein VJ, Henson LG (1999) The role of psychopathology in the parenting of drug-dependent women. Dev Psychopathol 11:957–977PubMedCrossRefGoogle Scholar
  14. 14.
    Hawley TL, Halle TG, Drasin RE, Thomas NG (1995) Children of addicted mothers: effects of the “crack epidemic” on the caregiving environment and the development of preschoolers. Am J Orthopsychiatry 65:364–379PubMedGoogle Scholar
  15. 15.
    Lester BM, Freier K, LaGasse L (1995) Prenatal cocaine exposure and child outcome: what do we really know? In: Lewis M, Bendersky M (eds) Mothers, babies and cocaine. Lawrence Erlbaum Associates, Hilsdale, N.J., pp 19–40Google Scholar
  16. 16.
    Luthar SS, Cushing G (1999) Neighborhood influences and child development: a prospective study of substance abusers’ offspring. Dev Psychopathol 11:763–784PubMedCrossRefGoogle Scholar
  17. 17.
    Ornoy A, Michailevskaya V, Kukashov I, Bar-Hamburger R, Harel S (1996) The developmental outcome of children born to heroin-dependent mothers, raised at home or adopted. Child Abuse Negl 20:385–396PubMedCrossRefGoogle Scholar
  18. 18.
    Ornoy A, Segal J, Bar-Hamburger R, Greenbaum C (2001) Development outcome of school-age children born to mothers with heroin dependency: importance of environmental factors. Dev Med Child Neurol 43:668–675PubMedCrossRefGoogle Scholar
  19. 19.
    Oswald WD, Roth E (1978) Der Zahlen-Verbindungstest (ZVT. Ein sprachfreier Intelligenz-Schnell-Test. Hogrefe, GöttingenGoogle Scholar
  20. 20.
    Pilowsky DJ, Zybert PA, Hsieh P-W, Vlahov D, Susser E (2003) Children of HIV-positive drug-using parents. J Am Acad Child Adolesc Psychiatry 42:950–956PubMedCrossRefGoogle Scholar
  21. 21.
    Richardson GA (1998) A longitudinal study of development. In: Harvey JA, Kosofsky BE (eds) Cocaine: effects on the developing brain. The New York Academy of Sciences, New York, pp 144–152Google Scholar
  22. 22.
    Richardson GA, Conroy ML, Day NL (1996) Prenatal cocaine exposure: effects on the development of school-age children. Neurotoxicol Teratol 18:627–634PubMedCrossRefGoogle Scholar
  23. 23.
    Richters JE (1992) Depressed mothers as informants about their children: a review of evidence for distortion. Psychol Bull 112:485–499PubMedCrossRefGoogle Scholar
  24. 24.
    Slinning K (2004) Foster placed children prenatally exposed to poly-substances. Eur Child Adolesc Psychiatry 13:19–27PubMedCrossRefGoogle Scholar
  25. 25.
    Stanger C, Higgins ST, Bickel WK, Elk R, Grabowski J, Schmitz J, Amass L, Kirby KC, Seracini AM/ (1999) Behavioral and emotional problems among children of cocaine- and opiate-dependent parents. J Am Acad Child Adolesc Psychiatry 38:421–428PubMedCrossRefGoogle Scholar
  26. 26.
    Steinhausen HC, Blattmann B, Pfund F (in press) Developmental outcome in children with intrauterine exposure to substances. European Addiction ResearchGoogle Scholar
  27. 27.
    van Baar AL (1999) Children of drug-addictd parents. In: Steinhausen HC, Verhulst F (eds) Risks and outcomes in developmental psychopathology. University Press, Oxford, pp 64–84Google Scholar
  28. 28.
    Wilens TE, Biedermann J, Kiely K, Bredin E, Spencer TJ (1995) Pilot study of behavioral and emotional disturbances in the high-risk children of parents with Opioid dependence. J Am Acad Child Adolesc Psychiatry 34:779–785PubMedCrossRefGoogle Scholar

Copyright information

© Steinkopff Verlag Darmstadt 2006

Authors and Affiliations

  • Hans-Christoph Steinhausen
    • 1
  • Serena Dal Mas
    • 1
  • Christoph Ledermann
    • 1
  • Christa Winkler Metzke
    • 1
  1. 1.Department of Child and Adolescent PsychiatryUniversity of ZürichZürichSwitzerland

Personalised recommendations