Psychopathology Of Pregnant Women With Alcohol And Drug Dependencies Examined.

2001 AUG 23 - (NewsRx Network) -- The majority of alcohol research to date has focused primarily on men, or on combined samples of men and women. Even fewer psychopathological studies, which examine emotional, behavioral, and psychological problems, have focused exclusively on women with drug dependencies. Of those that have, the focus has been on single substances of abuse, such as cocaine.

A study in the July 2001 issue of Alcoholism: Clinical & Experimental Research examines the psychopathology of pregnant women with co-occurring alcohol and drug dependencies.

"Pregnant drug-dependent women present for treatment with a variety of medical, psychosocial and emotional problems," said Donna R. Miles, postdoctoral fellow in the Department of Pharmacology and Toxicology at Virginia Commonwealth University, and lead author of the study. "Rates of homelessness, poverty, unemployment, and prostitution are high in this patient population. Many of these women have histories of emotional, physical, and sexual abuse. Yet societal stigmatization typically prompts pregnant women to conceal substance use, which makes identification and intervention difficult. In fact, many alcohol- and drug-abusing women avoid prenatal care altogether. Furthermore, in many states, delivery of a drug-positive infant results in legal sanctions that include termination of parental rights and criminal prosecution.

"Taken together," Miles continued, "this myriad of problems and concerns make pregnant drug-dependent women a very vulnerable population in need of more intensive, user-friendly services that focus not only on their alcohol and drug problems, but their other needs and concerns as well."

"Pregnancy can have multiple effects on alcohol/drug-dependent women," added Roy W. Pickens, associate vice-president for research, and professor of psychiatry, at Virginia Commonwealth University. "On the one hand, concern about the effects of alcohol/drug use may cause a pregnant woman to be more willing to seek and complete treatment. On the other hand, pregnancy adds to the unfounded social stigma of being alcohol/drug dependent, which may keep a woman from entering treatment."

In the study, the psychopathology of 170 pregnant women in treatment for drug dependency was measured using the Minnesota Multiphasic Personality Inventory - Revised (MMPI-2). The MMPI-2 uses 567 self-report items to measure different aspects of psychopathology, including depression, anxiety, impulsivity, aggression, and suspiciousness. The majority of the women (79%) were drug-dependent only; less than one quarter (21%) were both alcohol and drug dependent.

"Our findings show that cocaine- and/or heroin-dependent pregnant women who also have problems with alcohol come into treatment with more psychological problems than those who don't also have alcohol problems," said Miles. "Specifically, they had more symptoms of depression and anxiety as well as problems controlling impulsivity and aggression. They were also more likely to misinterpret life experiences and react in atypical ways to their environment. These findings emphasize the need for universal screening for alcohol problems in drug-using pregnant women and, for those who screen positive, to make sure treatment is offered and tailored to meet their needs."