title: Parental alcohol use and adolescent school adjustment in the general population: results from the HUNT study.
abstract: BACKGROUND
  This study investigates the relationship between parental drinking and school adjustment in a total population sample of adolescents, with independent reports from mothers, fathers, and adolescents. As a group, children of alcohol abusers have previously been found to exhibit lowered academic achievement. However, few studies address which parts of school adjustment that may be impaired. Both a genetic approach and social strains predict elevated problem scores in these children. Previous research has had limitations such as only recruiting cases from clinics, relying on single responders for all measures, or incomplete control for comorbid psychopathology. The specific effects of maternal and paternal alcohol use are also understudied.
  
  
  METHODS
  In a Norwegian county, 88% of the population aged 13-19 years participated in a health survey (N = 8984). Among other variables, adolescents reported on four dimensions of school adjustment, while mothers and fathers reported their own drinking behaviour. Mental distress and other control variables were adjusted for. Multivariate analysis including generalized estimation equations was applied to investigate associations.
  
  
  RESULTS
  Compared to children of light drinkers, children of alcohol abusers had moderately elevated attention and conduct problem scores. Maternal alcohol abuse was particularly predictive of such problems. Children of abstainers did significantly better than children of light drinkers. Controlling for adolescent mental distress reduced the association between maternal abuse and attention problems. The associations between parental reported drinking and school adjustment were further reduced when controlling for the children's report of seeing their parents drunk, which itself predicted school adjustment. Controlling for parental mental distress did not reduce the associations.
  
  
  CONCLUSIONS
  Parental alcohol abuse is an independent risk factor for attention and conduct problems at school. Some of the risk associated with mothers' drinking is likely to be mediated by adolescent mental distress. Despite lowered adjustment on the externalizing dimensions, children of alcohol abusers report that they enjoy being at school as much as other children.
authors.affiliation: Division of Mental Health, Norwegian Institute of Public Health, 0403 Oslo, Norway. fartein.torvik@fhi.no
authors.forename: Fartein A
authors.initials: FA
authors.lastname: Torvik
authors.forename: Kamilla
authors.initials: K
authors.lastname: Rognmo
authors.forename: Helga
authors.initials: H
authors.lastname: Ask
authors.forename: Espen
authors.initials: E
authors.lastname: Røysamb
authors.forename: Kristian
authors.initials: K
authors.lastname: Tambs
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D016241:Child of Impaired Parents / Q000523:psychology*; D019955:Conduct Disorder / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D012574:Schools; D012917:Social Adjustment; D013315:Stress, Psychological; D055815:Young Adult