PERSPECTIVE article

Front. Psychol., 04 October 2021
Sec. Developmental Psychology
https://doi.org/10.3389/fpsyg.2021.703948

The Value of Mechanistic Experiments to Target the Shared Neural Circuitry of Parenting and Addiction: The Potential for Video Feedback Interventions

  • Department of Psychology, University of Oregon, Eugene, OR, United States

Certain neural processes that underlie addiction are also central to parenting, notably stress and reward. Parenting interventions that incorporate the unique context of caregivers with addiction have demonstrated some success: However, real-world implementation of evidence-based interventions can be difficult with this population. Video feedback interventions are an especially promising approach to reach parents who experience barriers to participation, particularly caregivers with addiction. A translational neuroscientific approach to elucidating the mechanisms of change in these interventions will aid the delivery and success of this method and advance theory surrounding parenting in the context of addiction. Along these lines, we provide an example of one video feedback intervention, Filming Interactions to Nurture Development, that will serve as such a mechanistic experiment.

Introduction

Caregivers of young children constitute a notable proportion of the population of individuals with substance use disorders. Increasing rates of substance use, particularly opioid use, in this subgroup reflect an already-emergent public health concern (Terplan, 2020; Goetz et al., 2021; National Institute on Drug Abuse, 2021) that has been amplified by the impact of the COVID-19 pandemic (Mota, 2020; Ornell et al., 2020; Rogers et al., 2020; Sun et al., 2020). The negative intergenerational consequences of substance use problems are well documented, reflected by an increased vulnerability to addiction and psychopathology (Merikangas et al., 1998; Clark et al., 2004; Knight et al., 2014). Concomitant consequences for offspring of caregivers with substance use disorders are evident throughout development; during childhood, this may include difficulties with temperament, attachment, aggression, cognition, and speech and language (Shulman et al., 2000; Barnard and McKeganey, 2004).

The significance of these consequences has fueled research examining the intersectionality of substance use and parenting (Niccols et al., 2012; Moreland and McRae-Clark, 2018). Parental involvement is hypothesized to be the primary route through which addiction impacts parenting and subsequent parent and child wellbeing (Suchman and Luthar, 2000). Intrusive or disengaged parenting styles often co-occur with substance use problems (Burns et al., 1997; Hans et al., 1999; Jacques et al., 2020), and the extremes of these styles result in child maltreatment which is associated with caregiver substance use (Freisthler and Kepple, 2019). Recently, a greater focus on how parenting might impact addiction suggests that parenting itself confers a unique form of stress that may increase risk of substance use (Rutherford and Mayes, 2019).

Understanding the mechanisms underlying the interaction between parenting and addiction provides useful knowledge for identifying intervention targets that promote healthy parent and child outcomes. Although those mechanisms can be studied at multiple levels (e.g., cognitive or behavioral), investigating the neurobiological correlates of parenting processes that mediate responsive caregiving in the context of addiction draws upon the wealth of knowledge provided in these separate literatures (i.e., neurobiology of parenting and neurobiology of addiction; Rutherford et al., 2020). Notably, and with some important exceptions that we describe below, there is limited extant research in this area.

In this paper, we provide rationale for applying a translational neuroscientific approach to intervention research aimed at helping parents struggling with addiction. Translational neuroscience necessitates a conceptual model of disorder that identifies specific processes supported by neurobiological systems with respect to any relevant moderators (Fisher and Berkman, 2015). Interventions can engage these systems to promote desired outcomes. This approach has the potential to increase the specificity or direction of proposed intervention targets, elucidate individual differences in intervention response at the neurobiological level, and lead to the application of precision interventions based on biobehavioral markers. Parents with addiction remain a particularly difficult population to engage in parenting interventions. Our goal is to draw upon the growing knowledge of the shared neural circuitry of parenting and addiction to advance these efforts. To explicate our perspective, we discuss a neurobiological mechanistic experiment with the potential to address barriers to engagement with opioid-using mothers.

Neural Intersection of Parenting and Addiction

Certain cognitive and affective processes, such as those related to stress and reward, are central in both addiction and parenting. For example, in the context of addiction, non-medically used psychoactive substances (hereafter referred to as drugs) elicit reward responses, and stress often precedes subsequent use (Sinha et al., 2005). In the context of parenting, children elicit reward responses in caregivers (Ferrey et al., 2016), and parenting stress influences family interactions and function (Deater-Deckard, 1998).

Activation of stress and reward neural circuitry across these contexts plausibly induces a mutually informed interaction wherein system responses in one context impact the response in another (Rutherford et al., 2011). Although the overlapping neurobiology of these two contexts has not yet been widely studied, researchers have investigated neural changes in these contexts separately. During the development of drug dependence, neural reward systems are highly activated in response to drug use, and this positive reinforcement maintains drug-seeking behavior (Koob and Volkow, 2010). As addiction becomes reinforced primarily through withdrawal and anticipation, stress-related neural systems generate negative reinforcement when a substance provides relief.

The dysregulation of these stress and reward systems associated with addiction must be considered alongside the neuroendocrine changes elicited by the onset of parenthood. Research on the maternal brain suggests that rising levels of hormones (e.g., oxytocin and cortisol) correspond with stress and reward circuit activation central to sensitive caregiving (Atzil et al., 2011; Swain et al., 2019). This circuitry, which includes subcortical (amygdala, insula, and ventral striatum) and cortical (anterior cingulate cortex, prefrontal cortex, and precuneus) regions, supports emotion regulation and executive function (Swain and Ho, 2017). Many of these regions overlap with those impaired in addiction, indicating that regional disruption can echo throughout connected circuits (Rutherford et al., 2011).

In addition to the impact of general addiction processes, the type of drug used can impart unique physiological changes. While there is little research on the effect of extended opioid use on parental brain circuitry, the role of endogenous opioids in maternal stress and emotion regulation and reward processing highlights the importance of investigating that effect (Benarroch, 2012; Swain et al., 2019).

As shown in Figure 1 (adapted from Rutherford et al., 2011), we highlight a “reciprocal influence model” characterizing the bidirectional effects of parenting and addiction. Reward system dysregulation may decrease saliency of social or relational rewards that are pervasive in parenting and underlie secure parent-infant attachment. Additionally, stress and emotion dysregulation in caregiving roles could intensify craving and drug-seeking behaviors. Parents with addiction might find caring for infants less rewarding and more stressful than parents without addiction, creating a cycle that maintains substance use.

FIGURE 1
www.frontiersin.org

Figure 1. Role of brain changes in the relationship between drug use and parenting (adapted from Rutherford et al., 2011). Drug use causes many brain changes (gray), which can influence each other (black) by amplifying/diminishing alterations depending on context.

A reward-stress dysregulation model of addiction and parenting proposed by Rutherford and Mayes (2017) incorporates these dynamic neural interactions. Implicated brain regions include the prefrontal cortex, ventral tegmental area, and nucleus accumbens within reward circuitry and the hypothalamic-pituitary-adrenal axis and extended amygdala within stress circuitry (Rutherford et al., 2011). Studies examining parental reactions to infant cues provide evidence for this model. Altered neural activity in response to infant stimuli suggests that positively valenced infant cues may be less salient and negatively valenced cues may be more stressful for parents with addiction, corroborating observations of parental disengagement (Landi et al., 2011; Kim et al., 2017; Rutherford et al., 2017, 2020).

Interventions at the Intersection of Responsive Caregiving and Addiction Treatment

Instances of household instability and child neglect along with co-occurring mental health difficulties underscore the need for effective interventions for parents with addiction (Barnard and McKeganey, 2004; Barlow et al., 2019). Despite the significant social costs of this problem, complications to intervening within this population persist (Daley, 2013). These stem from additional comorbidities and social problems including time constraints, affordability, transportation difficulties, mistrust in clinicians, fear of losing children, and shame (Acevedo et al., 2012; Guerrero et al., 2015; Matsuzaka and Knapp, 2020).

Although dual treatment for substance use and parenting results in improvements in both domains (Neger and Prinz, 2015), directing substance-using caregivers to optimal interventions remains difficult. Different interventions target multiple and varying mechanisms of change, and effectiveness may depend on parenting stage or the substance of abuse (Neger and Prinz, 2015; Cioffi et al., 2019). Rigorous randomized clinical trials can help determine the influence of specific hypothesized mechanisms on outcomes, thereby establishing causal evidence which allows the identification of effective strategies to improve outcomes and advances theory.

Many interventions for parents with substance use disorders are based on attachment and relational theories, integrating varying aspects of caregiver responsivity, mentalization, emotion and stress regulation, and mindfulness to improve parent and child outcomes. Examples include Relational Psychotherapy Mothers’ Group (Luthar and Suchman, 2000), Practicing Safety Mindfulness Project for Mothers in Drug Treatment (Short et al., 2017), Mothers and Toddler Program (MTP; Suchman et al., 2010), Parenting under Pressure (PuP; Barlow et al., 2013), Attachment and Biobehavioral Catch-Up (ABC; Berlin et al., 2014), and a modified ABC (mABC) specifically for mothers using opioids (Labella et al., 2021). One promising component of many of these interventions is the inclusion of video feedback, where clinicians or instructors provide mothers feedback about their interactions with their child, based on recorded interactions.

Video Feedback Design

Video feedback has been employed in parenting interventions where caregiver-child interactions are filmed. Videos are useful for capturing the reciprocal influence parents and children exert on each other. Trained therapists use recordings to replay and personalize feedback to parents. This method allows researchers to highlight parenting skills in a naturalistic environment, often in participants’ homes. Although the specificity of this intervention approach varies, many video feedback interventions aim to encourage supportive interactions between parents and their children. A review of 29 experimental studies revealed that video feedback interventions successfully resulted in a change of maternal sensitivity and more positive parent and child behaviors (Balldin et al., 2018).

Given the disruption of maternal sensitivity in many parents with addiction, this style of intervention might be especially well suited for substance-using parents. However, the true measure of intervention effectiveness does not end within a research context but extends to the feasibility of disseminating and evaluating that intervention in community settings for those who could benefit most. Barriers to accessing treatment are a primary concern for parents with addiction and often have roots in systemic inequalities and racism prevalent in society (Acevedo et al., 2012; Guerrero et al., 2015; Matsuzaka and Knapp, 2020). The natural environment context of these parenting interventions provides an avenue to partially address inequity by increasing availability to caregivers. Furthermore, the salient personalized stimuli present in video feedback could both increase participant interest and facilitate the transition from in-session learning to home integration. Still, the relative utility of video feedback in comparison with other interventions in real-world settings remains an open subject that necessitates the scrutiny of future research.

Research on video feedback interventions containing proposed mechanisms of change helps discern employable components to further explore and integrate into interventions for caregivers with substance use disorders. Although there is overlap among hypothesized mechanisms, distinct interventions have not targeted mechanisms uniformly. A cursory comparison of different video feedback interventions illustrates this. PuP uses psychoeducation and mindfulness skill building to target the proposed mechanisms of change: parental emotion regulation, representation quality, and mentalization about own and child’s emotions (Dawe and Harnett, 2007; Barlow et al., 2019). Similarly, MTP hypothesizes that changes in maternal mentalization, representations of one’s child, and the therapeutic alliance lead to positive outcomes (Suchman et al., 2010, 2011, 2012). Mechanisms in ABC and mABC include changing nurturing behaviors during child distress, improving synchronous interactions, and reducing frightening behavior (Dozier and Bernard, 2017).

These video interventions have yielded improvements in parenting and substance use behaviors (Dawe and Harnett, 2007; Suchman et al., 2011, 2012; Barlow et al., 2013, 2019; Dozier and Bernard, 2017). However, targeting multiple mechanisms makes it difficult to identify which are most effective and for whom. Furthermore, these interventions have been predominantly tested among pregnant and postnatal mothers, limiting generalizability across other caregivers. There may be a significant benefit to interventions founded on a specific process of change and inclusive of a range of caregivers. To illustrate these considerations, we describe the Filming Interactions to Nurture Development (FIND) intervention.

Filming Interactions to Nurture Development

Filming Interactions to Nurture Development is a strength-based video feedback intervention with a clearly proposed conceptual model, protocol, and potential to achieve notable impact at scale. FIND was designed to primarily target responsive caregiving and consequently improve caregiver and child outcomes. This design is informed by research on serve and return interactions that are critical to healthy development, a process where caregivers provide contingent, supportive responses to child-initiated cues (Dozier et al., 2002; Fisher et al., 2006; Shonkoff and Bales, 2011). Almost all parents—even those at highest risk—engage in responsive caregiving to some extent. Thus, the goal of FIND is not to teach responsive caregiving but to highlight the occurrence of caregivers’ own responsiveness with video clips.

Across 10 sessions with a family (five filming sessions and five coaching sessions), coaches share video compilations of positive micro-social interactions between parent and child to encourage parents to identify and increase the frequency of specific serve and return components (e.g., Sharing the Child’s Focus, Supporting and Encouraging, Naming, Back and Forth, and Ending and Beginnings). Further details of the program can be found in Fisher et al. (2016).

Emerging evidence suggests that FIND is particularly effective for high-adversity families. A preliminary study with low-income fathers provides support for FIND’s conceptual model that caregiver and child improvements occur through increases in responsive parenting (Schindler et al., 2017). Fathers with high levels of childhood adversity also experienced an increase in parental self-concept and a decrease in their child’s behavioral problems. Another preliminary study suggests that FIND participation alters brain functioning in regions related to inhibitory control for low-income mothers, which is noteworthy given the relatively small intervention dose (Giuliani et al., 2019).

Current Perspective

Parents with opioid addiction tend to experience difficulty understanding and reacting to child cues, exhibiting greater irritability and decreased responsiveness compared to other parents (Romanowicz et al., 2019). Gaps in the literature highlight the need to identify whether parenting interventions engage the neural circuitry that is implicated in such parenting difficulties and influenced by addiction. The conceptual model of FIND (see Figure 2) proposes a testable mechanism through which FIND might serve mothers recovering from opioid misuse. In recognition of this shared neural circuitry, future research on FIND will test mediating roles of brain changes related to parental self-concept, executive function, and reward. Following principles of translational neuroscience, this model targets the drug-induced brain changes that impact maternal responsivity and wellbeing identified by Rutherford et al. (2011). This line of research not only identifies process-level mechanisms, but also may elucidate why intervention effects might persist in some caregivers but not others.

FIGURE 2
www.frontiersin.org

Figure 2. FIND conceptual model.

Currently, a randomized clinical trial of FIND is being conducted with 200 mothers in opioid use treatment or recovery with children aged 0–36 months. Half the parents are assigned to a control condition, which includes alternating child development information sessions and supportive observations of caregiver-child interaction. This study will both evaluate the effect of FIND on responsive caregiving and test whether observed changes in parenting and addiction circuitry, which have considerable overlap (Rutherford et al., 2011), accompany behavioral improvements. Regions that underlie parental self-concept (e.g., medial prefrontal cortex) and inhibitory control (e.g., insula and inferior frontal gyrus) will be examined before and after intervention. Tasks will also be employed that allow for the disaggregation and assessment of motivation and reward, known to be affected by drug addiction (Kelley and Berridge, 2002), at behavioral and neural levels. This will illuminate whether specific phenotypes exist in mothers with opioid use issues (e.g., low motivation-high reward; high motivation-low reward), whether these phenotypes respond differently to the intervention, and how sensitive these processes are to change in this context. We expect that, across all neurocognitive functions under investigation, intervention effects may be moderated by intervention delivery variables (e.g., fidelity and dosage) and infant opioid exposure/withdrawal.

Investigating the neurocognitive mediators of responsive caregiving improvements and subsequent outcomes allows for more informed intervention alteration and adaptation in real-world contexts. Many evidence-based interventions fail to achieve impact when delivered at scale, and others only yield modest effects and fail to support families at highest risk (Shonkoff, 2010). For substance-using parents of young children, the effectiveness of the intervention in real-world community settings is of heightened concern.

The design process employed in developing FIND was intended to proactively tackle large-scale dissemination concerns of both scalability and real-world efficacy for high-risk populations. FIND’s descriptive, as opposed to analytical, coaching delivery permits more people (rather than only those with specialty knowledge or degrees) to implement the program, enhancing scalability. Parents of addiction may respond particularly well to the specific, strength-based nature of the program which directly addresses non-drug reward hypo-responsivity by increasing the inherent rewards of parenting without imposing feelings of shame or guilt that might accompany skill-learning present in other interventions. Previous research suggests that participation increases responsive caregiving at lower doses than many existing interventions (Schindler et al., 2017), possibly due to the exclusive practice of showing caregivers positive instances of their own responsive caregiving. This avoids the trap of including too many untested components within a single intervention, enhancing efficacy. Given these implementation considerations and preliminary findings, evidence suggests that FIND may be especially effective for caregivers who are traditionally difficult to reach.

Discussion

The need for effective resources and interventions for caregivers with addiction necessitates carefully planned research that acknowledges their shared and unique contexts. The reciprocal influence model posits that drug-induced brain changes are implicated in a cluster of cognitive, behavioral, and affective caregiver changes that directly impact child interactions and consequently create a high-stress parenting environment that increases risk for further drug use. Such models, informed by the neurobiology of shared processes, have potential to be more efficient and scalable than those without a clearly proposed and tested mechanism.

Building, testing, and disseminating effective interventions for this population are complicated by ongoing challenges. Individuals come in with varying skills and may be experiencing concurrent and related stress or adversity. One intervention cannot be made to suit all caregivers and some caregivers may need more or less support. Continued research that connects the growing knowledge of neurobiology related to caregiving and substance use with mechanistic intervention evaluation will allow scientists to investigate what works, why, and for whom.

Data Availability Statement

The original contributions presented in the study are included in the article/supplementary material, and further inquiries can be directed to the corresponding author.

Author Contributions

PF and A-MB conceived the idea. A-MB and KM wrote the manuscript. All authors contributed to the final version of the manuscript.

Funding

The authors gratefully acknowledge grant P50 DA048756 from the National Institute on Drug Abuse to PF.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

References

Acevedo, A., Garnick, D. W., Lee, M. T., Horgan, C. M., Ritter, G., Panas, L., et al. (2012). Racial/ethnic differences in substance abuse treatment initiation and engagement. J. Ethn. Subst. Abus. 11, 1–21. doi: 10.1080/15332640.2012.652516

PubMed Abstract | CrossRef Full Text | Google Scholar

Atzil, S., Hendler, T., and Feldman, R. (2011). Specifying the neurobiological basis of human attachment: brain, hormones, and behavior in synchronous and intrusive mothers. Neuropsychopharmacology 36, 2603–2615. doi: 10.1038/npp.2011.172

PubMed Abstract | CrossRef Full Text | Google Scholar

Balldin, S., Fisher, P. A., and Wirtberg, I. (2018). Video feedback intervention with children: a systematic review. Res. Soc. Work. Pract. 28, 682–695. doi: 10.1177/1049731516671809

CrossRef Full Text | Google Scholar

Barlow, J., Sembi, S., Gardner, F., Macdonald, G., Petrou, S., Parsons, H., et al. (2013). An evaluation of the parents under pressure programme: a study protocol for an RCT into its clinical and cost effectiveness. Trials 14:210. doi: 10.1186/1745-6215-14-210

PubMed Abstract | CrossRef Full Text | Google Scholar

Barlow, J., Sembi, S., Parsons, H., Kim, S., Petrou, S., Harnett, P., et al. (2019). A randomized controlled trial and economic evaluation of the parents under pressure program for parents in substance abuse treatment. Drug Alcohol Depend. 194, 184–194. doi: 10.1016/j.drugalcdep.2018.08.044

PubMed Abstract | CrossRef Full Text | Google Scholar

Barnard, M., and McKeganey, N. (2004). The impact of parental problem drug use on children: what is the problem and what can be done to help? Addiction 99, 552–559. doi: 10.1111/j.1360-0443.2003.00664.x

PubMed Abstract | CrossRef Full Text | Google Scholar

Benarroch, E. E. (2012). Endogenous opioid systems: current concepts and clinical correlations. Neurology 79, 807–814. doi: 10.1212/WNL.0b013e3182662098

PubMed Abstract | CrossRef Full Text | Google Scholar

Berlin, L. J., Shanahan, M., and Appleyard Carmody, K. (2014). Promoting supportive parenting in new mothers with substance-use problems: a pilot randomized trial of residential treatment plus an attachment-based parenting program. Infant Ment. Health J. 35, 81–85. doi: 10.1002/imhj.21427

PubMed Abstract | CrossRef Full Text | Google Scholar

Burns, K. A., Chethik, L., Burns, W. J., and Clark, R. (1997). The early relationship of drug abusing mothers and their infants: an assessment at eight to twelve months of age. J. Clin. Psychol. 53, 279–287. doi: 10.1002/(SICI)1097-4679(199704)53:3<279::AID-JCLP11>3.0.CO;2-F

PubMed Abstract | CrossRef Full Text | Google Scholar

Cioffi, C. C., Leve, L. D., and Seeley, J. R. (2019). Accelerating the pace of science: improving parenting practices in parents with opioid use disorder. Parenting 19, 244–266. doi: 10.1080/15295192.2019.1615801

PubMed Abstract | CrossRef Full Text | Google Scholar

Clark, D. B., Cornelius, J., Wood, D. S., and Vanyukov, M. (2004). Psychopathology risk transmission in children of parents with substance use disorders. Am. J. Psychiatry 161, 685–691. doi: 10.1176/appi.ajp.161.4.685

PubMed Abstract | CrossRef Full Text | Google Scholar

Daley, D. C. (2013). Family and social aspects of substance use disorders and treatment. J. Food Drug Anal. 21, S73–S76. doi: 10.1016/j.jfda.2013.09.038

PubMed Abstract | CrossRef Full Text | Google Scholar

Dawe, S., and Harnett, P. (2007). Reducing potential for child abuse among methadone-maintained parents: results from a randomized controlled trial. J. Subst. Abus. Treat. 32, 381–390. doi: 10.1016/j.jsat.2006.10.003

PubMed Abstract | CrossRef Full Text | Google Scholar

Deater-Deckard, K. (1998). Parenting stress and child adjustment: some old hypotheses and new questions. Clin. Psychol. Sci. Pract. 5, 314–332. doi: 10.1111/j.1468-2850.1998.tb00152.x

CrossRef Full Text | Google Scholar

Dozier, M., Albus, K., Fisher, P. A., and Sepulveda, S. (2002). Interventions for foster parents: implications for developmental theory. Dev. Psychopathol. 14, 843–860. doi: 10.1017/S0954579402004091

PubMed Abstract | CrossRef Full Text | Google Scholar

Dozier, M., and Bernard, K. (2017). Attachment and biobehavioral catch-up: addressing the needs of infants and toddlers exposed to inadequate or problematic caregiving. Curr. Opin. Psychol. 15, 111–117. doi: 10.1016/j.copsyc.2017.03.003

PubMed Abstract | CrossRef Full Text | Google Scholar

Ferrey, A. E., Santascoy, N., McCrory, E. J., Thompson-Booth, C., Mayes, L. C., and Rutherford, H. J. V. (2016). Motivated attention and reward in parenting. Parenting 16, 284–301. doi: 10.1080/15295192.2016.1184928

CrossRef Full Text | Google Scholar

Fisher, P. A., and Berkman, E. T. (2015). Designing interventions informed by scientific knowledge about effects of early adversity: a translational neuroscience agenda for next-generation addictions research. Curr. Addict. Rep. 2, 347–353. doi: 10.1007/s40429-015-0071-x

PubMed Abstract | CrossRef Full Text | Google Scholar

Fisher, P. A., Frenkel, T. I., Noll, L. K., Berry, M., and Yockelson, M. (2016). Promoting healthy child development via a two-generation translational neuroscience framework: the filming interactions to nurture development video coaching program. Child Dev. Perspect. 10, 251–256. doi: 10.1111/cdep.12195

PubMed Abstract | CrossRef Full Text | Google Scholar

Fisher, P. A., Gunnar, M. R., Dozier, M., Bruce, J., and Pears, K. C. (2006). Effects of therapeutic interventions for foster children on behavioral problems, caregiver attachment, and stress regulatory neural systems. Ann. N. Y. Acad. Sci. 1094, 215–225. doi: 10.1196/annals.1376.023

PubMed Abstract | CrossRef Full Text | Google Scholar

Freisthler, B., and Kepple, N. J. (2019). Types of substance use and punitive parenting: a preliminary exploration. J. Soc. Work. Pract. Addict. 19, 262–283. doi: 10.1080/1533256X.2019.1640019

PubMed Abstract | CrossRef Full Text | Google Scholar

Giuliani, N. R., Beauchamp, K. G., Noll, L. K., and Fisher, P. A. (2019). A preliminary study investigating maternal neurocognitive mechanisms underlying a child-supportive parenting intervention. Front. Behav. Neurosci. 13:16. doi: 10.3389/fnbeh.2019.00016

PubMed Abstract | CrossRef Full Text | Google Scholar

Goetz, T. G., Becker, J. B., and Mazure, C. M. (2021). Women, opioid use and addiction. FASEB J. 35:e21303. doi: 10.1096/fj.202002125R

PubMed Abstract | CrossRef Full Text | Google Scholar

Guerrero, E. G., Fenwick, K., Kong, Y., Grella, C., and D’Aunno, T. (2015). Paths to improving engagement among racial and ethnic minorities in addiction health services. Subst. Abuse Treat. Prev. Policy 10:40. doi: 10.1186/s13011-015-0036-z

PubMed Abstract | CrossRef Full Text | Google Scholar

Hans, S. L., Bernstein, V. J., and Henson, L. G. (1999). The role of psychopathology in the parenting of drug-dependent women. Dev. Psychopathol. 11, 957–977. doi: 10.1017/S0954579499002400

PubMed Abstract | CrossRef Full Text | Google Scholar

Jacques, D. T., Sturge-Apple, M., Davies, P., and Cicchetti, D. (2020). Maternal alcohol dependence and harsh caregiving across parenting contexts: The moderating role of child negative emotionality. Dev. Psychopathol. 32, 1509–1523. doi: 10.1017/S0954579419001445

PubMed Abstract | CrossRef Full Text | Google Scholar

Kelley, A. E., and Berridge, K. C. (2002). The neuroscience of natural rewards: relevance to addictive drugs. J. Neurosci. 22, 3306–3311. doi: 10.1523/JNEUROSCI.22-09-03306.2002

PubMed Abstract | CrossRef Full Text | Google Scholar

Kim, S., Iyengar, U., Mayes, L. C., Potenza, M. N., Rutherford, H. J. V., and Strathearn, L. (2017). Mothers with substance addictions show reduced reward responses when viewing their own infant’s face. Hum. Brain Mapp. 38, 5421–5439. doi: 10.1002/hbm.23731

PubMed Abstract | CrossRef Full Text | Google Scholar

Knight, K. E., Menard, S., and Simmons, S. B. (2014). Intergenerational continuity of substance use. Subst. Use Misuse 49, 221–233. doi: 10.3109/10826084.2013.824478

PubMed Abstract | CrossRef Full Text | Google Scholar

Koob, G. F., and Volkow, N. D. (2010). Neurocircuitry of addiction. Neuropsychopharmacology 35, 217–238. doi: 10.1038/npp.2009.110

PubMed Abstract | CrossRef Full Text | Google Scholar

Labella, M. H., Eiden, R. D., Roben, C. K. P., and Dozier, M. (2021). Adapting an evidence-based home visiting intervention for mothers with opioid dependence: modified attachment and biobehavioral catch-up. Front. Psychol. 12:675866. doi: 10.3389/fpsyg.2021.675866

PubMed Abstract | CrossRef Full Text | Google Scholar

Landi, N., Montoya, J., Kober, H., Rutherford, H. J. V., Mencl, W. E., Worhunsky, P. D., et al. (2011). Maternal neural responses to infant cries and faces: relationships with substance use. Front. Psych. 2:32. doi: 10.3389/fpsyt.2011.00032

PubMed Abstract | CrossRef Full Text | Google Scholar

Luthar, S., and Suchman, N. (2000). Relational Psychotherapy Mothers’ Group: a developmentally informed intervention for at-risk mothers. Dev. Psychopathol. 12, 235–253. doi: 10.1017/S0954579400002078

PubMed Abstract | CrossRef Full Text | Google Scholar

Matsuzaka, S., and Knapp, M. (2020). Anti-racism and substance use treatment: Addiction does not discriminate, but do we? J. Ethn. Subst. Abus. 19, 567–593. doi: 10.1080/15332640.2018.1548323

PubMed Abstract | CrossRef Full Text | Google Scholar

Merikangas, K. R., Dierker, L. C., and Szatmari, P. (1998). Psychopathology among offspring of parents with substance abuse and/or anxiety disorders: a high–risk study. J. Child Psychol. Psychiatry 39, 711–720. doi: 10.1111/1469-7610.00370

PubMed Abstract | CrossRef Full Text | Google Scholar

Moreland, A. D., and McRae-Clark, A. (2018). Parenting outcomes of parenting interventions in integrated substance-use treatment programs: A systematic review. J. Subst. Abus. Treat. 89, 52–59. doi: 10.1016/j.jsat.2018.03.005

PubMed Abstract | CrossRef Full Text | Google Scholar

Mota, P. (2020). Avoiding a new epidemic during a pandemic: The importance of assessing the risk of substance use disorders in the COVID-19 era. Psychiatry Res. 290:113142. doi: 10.1016/j.psychres.2020.113142

PubMed Abstract | CrossRef Full Text | Google Scholar

National Institute on Drug Abuse (2021). Opioid overdose crisis. National Institute on Drug Abuse. Available at: https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis (Accessed March 27, 2021).

Google Scholar

Neger, E. N., and Prinz, R. J. (2015). Interventions to address parenting and parental substance abuse: conceptual and methodological considerations. Clin. Psychol. Rev. 39, 71–82. doi: 10.1016/j.cpr.2015.04.004

PubMed Abstract | CrossRef Full Text | Google Scholar

Niccols, A., Milligan, K., Sword, W., Thabane, L., Henderson, J., and Smith, A. (2012). Integrated programs for mothers with substance abuse issues: A systematic review of studies reporting on parenting outcomes. Harm Reduct. J. 9:14. doi: 10.1186/1477-7517-9-14

PubMed Abstract | CrossRef Full Text | Google Scholar

Ornell, F., Moura, H. F., Scherer, J. N., Pechansky, F., Kessler, F. H. P., and von Diemen, L. (2020). The COVID-19 pandemic and its impact on substance use: Implications for prevention and treatment. Psychiatry Res. 289:113096. doi: 10.1016/j.psychres.2020.113096

PubMed Abstract | CrossRef Full Text | Google Scholar

Rogers, A. H., Shepherd, J. M., Garey, L., and Zvolensky, M. J. (2020). Psychological factors associated with substance use initiation during the COVID-19 pandemic. Psychiatry Res. 293:113407. doi: 10.1016/j.psychres.2020.113407

PubMed Abstract | CrossRef Full Text | Google Scholar

Romanowicz, M., Vande Voort, J. L., Shekunov, J., Oesterle, T. S., Thusius, N. J., Rummans, T. A., et al. (2019). The effects of parental opioid use on the parent–child relationship and children’s developmental and behavioral outcomes: a systematic review of published reports. Child Adolesc. Psychiatry Ment. Health 13:5. doi: 10.1186/s13034-019-0266-3

PubMed Abstract | CrossRef Full Text | Google Scholar

Rutherford, H. J. V., Maupin, A. N., Landi, N., Potenza, M. N., and Mayes, L. C. (2017). Current tobacco-smoking and neural responses to infant cues in mothers. Parenting 17, 1–10. doi: 10.1080/15295192.2017.1262176

CrossRef Full Text | Google Scholar

Rutherford, H. J., and Mayes, L. C. (2017). Parenting and addiction: neurobiological insights. Curr. Opin. Psychol. 15, 55–60. doi: 10.1016/j.copsyc.2017.02.014

PubMed Abstract | CrossRef Full Text | Google Scholar

Rutherford, H. J. V., and Mayes, L. C. (2019). Parenting stress: A novel mechanism of addiction vulnerability. Neurobiol. Stress 11:100172. doi: 10.1016/j.ynstr.2019.100172

PubMed Abstract | CrossRef Full Text | Google Scholar

Rutherford, H. J. V., Williams, S. K., Moy, S., Mayes, L. C., and Johns, J. M. (2011). Disruption of maternal parenting circuitry by addictive process: rewiring of reward and stress systems. Front. Psych. 2:37. doi: 10.3389/fpsyt.2011.00037

PubMed Abstract | CrossRef Full Text | Google Scholar

Rutherford, H. J. V., Yip, S. W., Worhunsky, P. D., Kim, S., Strathearn, L., Potenza, M. N., et al. (2020). Differential responses to infant faces in relation to maternal substance use: An exploratory study. Drug Alcohol Depend. 207:107805. doi: 10.1016/j.drugalcdep.2019.107805

PubMed Abstract | CrossRef Full Text | Google Scholar

Schindler, H. S., Fisher, P. A., and Shonkoff, J. P. (2017). From innovation to impact at scale: lessons learned from a cluster of research–community partnerships. Child Dev. 88, 1435–1446. doi: 10.1111/cdev.12904

PubMed Abstract | CrossRef Full Text | Google Scholar

Shonkoff, J. P. (2010). Building a new biodevelopmental framework to guide the future of early childhood policy. Child Dev. 81, 357–367. doi: 10.1111/j.1467-8624.2009.01399.x

PubMed Abstract | CrossRef Full Text | Google Scholar

Shonkoff, J. P., and Bales, S. N. (2011). Science does not speak for itself: translating child development research for the public and its policymakers. Child Dev. 82, 17–32. doi: 10.1111/j.1467-8624.2010.01538.x

PubMed Abstract | CrossRef Full Text | Google Scholar

Short, V. L., Gannon, M., Weingarten, W., Kaltenbach, K., LaNoue, M., and Abatemarco, D. J. (2017). Reducing stress among mothers in drug treatment: a description of a mindfulness based parenting intervention. Matern. Child Health J. 21, 1377–1386. doi: 10.1007/s10995-016-2244-1

PubMed Abstract | CrossRef Full Text | Google Scholar

Shulman, L. H., Shapira, S. R., and Hirshfield, S. (2000). Outreach developmental services to children of patients in treatment for substance abuse. Am. J. Public Health 90, 1930–1933. doi: 10.2105/ajph.90.12.1930

PubMed Abstract | CrossRef Full Text | Google Scholar

Sinha, R., Lacadie, C., Skudlarski, P., Fulbright, R. K., Rounsaville, B. J., Kosten, T. R., et al. (2005). Neural activity associated with stress-induced cocaine craving: a functional magnetic resonance imaging study. Psychopharmacology 183, 171–180. doi: 10.1007/s00213-005-0147-8

PubMed Abstract | CrossRef Full Text | Google Scholar

Suchman, N. E., DeCoste, C., Leigh, D., and Borelli, J. (2010). Reflective functioning in mothers with drug use disorders: implications for dyadic interactions with infants and toddlers. Attach Hum. Dev. 12, 567–585. doi: 10.1080/14616734.2010.501988

PubMed Abstract | CrossRef Full Text | Google Scholar

Suchman, N. E., Decoste, C., Mcmahon, T. J., Rounsaville, B., and Mayes, L. (2011). The mothers and toddlers program, an attachment-based parenting intervention for substance-using women: results at 6-week follow-up in a randomized clinical pilot. Infant Ment. Health J. 32, 427–449. doi: 10.1002/imhj.20303

PubMed Abstract | CrossRef Full Text | Google Scholar

Suchman, N. E., Decoste, C., Rosenberger, P., and McMahon, T. J. (2012). Attachment-based intervention for substance-using mothers: a preliminary test of the proposed mechanisms of change. Infant Ment. Health J. 33, 360–371. doi: 10.1002/imhj.21311

PubMed Abstract | CrossRef Full Text | Google Scholar

Suchman, N. E., and Luthar, S. S. (2000). Maternal addiction, child maladjustment and socio-demographic risks: implications for parenting behaviors. Addiction 95, 1417–1428. doi: 10.1046/j.1360-0443.2000.959141711.x

PubMed Abstract | CrossRef Full Text | Google Scholar

Sun, Y., Li, Y., Bao, Y., Meng, S., Sun, Y., Schumann, G., et al. (2020). Brief report: increased addictive internet and substance use behavior during the COVID-19 pandemic in China. Am. J. Addict. 29, 268–270. doi: 10.1111/ajad.13066

PubMed Abstract | CrossRef Full Text | Google Scholar

Swain, J. E., and Ho, S.-H. S. (2017). Neuroendocrine mechanisms for parental sensitivity: overview, recent advances and future directions. Curr. Opin. Psychol. 15, 105–110. doi: 10.1016/j.copsyc.2017.02.027

PubMed Abstract | CrossRef Full Text | Google Scholar

Swain, J. E., Ho, S. S., Fox, H., Garry, D., and Brummelte, S. (2019). Effects of opioids on the parental brain in health and disease. Front. Neuroendocrinol. 54:100766. doi: 10.1016/j.yfrne.2019.100766

PubMed Abstract | CrossRef Full Text | Google Scholar

Terplan, M. (2020). “Opioid use, misuse, and addiction in pregnancy and postpartum,” in Protocols for High-Risk Pregnancies. eds. J. T. Queenan, C. Y. Spong, and C. J. Lockwood (Hoboken, USA: John Wiley & Sons Ltd), 15–20.

Google Scholar

Keywords: parenting, addiction, translational neuroscience, intervention, mechanisms of change

Citation: Barrett A-MY, Mudiam KR and Fisher PA (2021) The Value of Mechanistic Experiments to Target the Shared Neural Circuitry of Parenting and Addiction: The Potential for Video Feedback Interventions. Front. Psychol. 12:703948. doi: 10.3389/fpsyg.2021.703948

Received: 01 May 2021; Accepted: 13 September 2021;
Published: 04 October 2021.

Edited by:

Hui Li, Macquarie University, Australia

Reviewed by:

Jana Pruett Covington, Georgia State University, United States
Madelyn Labella, University of Delaware, United States

Copyright © 2021 Barrett, Mudiam and Fisher. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Ann-Marie Y. Barrett, ayb@uoregon.edu

Download