Exploring perceptions of genetic risk and the transmission of substance use disorders

• Published in: Addiction science & clinical practice Vol. 19; no. 1; pp. 57 - 15
• Main Authors: Keller, Amanda, Bosk, Emily A, Mendez, Alicia, Greenfield, Brett, Flynn, Carolynn, Everett DelJones, Gina, Julien, Fabrys, Michael, MacKenzie
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 02-08-2024; BioMed Central; BMC
• Subjects: Addictions; Addictive behaviors; Adult; Blame; Brain diseases; Brain research; Care and treatment; Child; Children; Children of substance users; Continuity of Substance Use Disorder; intergenerational transmission of Substance Use Disorder; Drug use; Families & family life; Female; Genetic Predisposition to Disease; Genetic research; Genetic risk; Genetic susceptibility; Genetics; Health aspects; Health risk assessment; Heritability; Humans; Influence; Inpatient care; Intergenerational transmission; Internal working models; Interviews; Male; Mental disorders; Mental health; Mental models; Middle Aged; Mother-Child Relations - psychology; Mothers; Mothers - psychology; Neurobiology; Neurosciences; New Genetics; Lay Genetics; Parent-child relations; Parents & parenting; Perceptions; Psychoeducational treatment; Qualitative Research; Risk Factors; Risk perception; Selfblame; Stigma; Substance abuse; Substance abuse treatment; Substance Use Disorder; Substance-Related Disorders - genetics; Substance-Related Disorders - psychology; Twins; Working Model of the child interview; Working models; Working parents; Brain Disease Model of Addiction; Substance Use Disorder Treatment; Substance Use Disorder; Continuity of Substance Use Disorder; intergenerational transmission of Substance Use Disorder; Genetic risk; New Genetics; Lay Genetics; Children of substance users; Working Model of the child interview
• ISSN: 1940-0640; 1940-0632; 1940-0640
• DOI: 10.1186/s13722-024-00470-w

Substance use disorders (SUDs) have been consistently shown to exhibit moderate intergenerational continuity (1-3). While much research has examined genetic and social influences on addiction, less attention has been paid to clients' and lay persons' perceptions of genetic influences on the heritability of SUD (4) and implications for treatment.
For this qualitative study, twenty-six structured Working Model of the Child Interviews (WMCI) were conducted with mothers receiving inpatient SUD treatment. These interviews were thematically analyzed for themes related to maternal perceptions around intergenerational transmission of substance use behaviours.
Findings show that over half of the mothers in this sample were preoccupied with their children's risk factors for addictions. Among this group, 29% spontaneously expressed concerns about their children's genetic risk for addiction, 54% shared worries about their children's propensity for addiction without mentioning the word gene or genetic. Additionally, 37% had challenges in even discussing their children's future when prompted. These concerns mapped onto internal working models of attachment in unexpected ways, with parents who were coded with balanced working models being more likely to discuss intergenerational risk factors and parents with disengaged working models displaying difficulties in discussing their child's future.
This research suggests that the dominant discourse around the brain-disease model of addictions, in its effort to reduce stigma and self-blame, may have unintended downstream consequences for parents' mental models about their children's risks for future addiction. Parents receiving SUD treatment, and the staff who deliver it, may benefit from psychoeducation about the intergenerational transmission of SUD as part of treatment.