Subst Use. 2026 Aug 31;20:29768357261462391. doi: 10.1177/29768357261462391. eCollection 2026 Jan-Dec.
ABSTRACT
BACKGROUND: Adolescents with co-occurring alcohol use and mental health disorders have better treatment outcomes when caregivers are involved in their treatment. Currently, little is known about why caregiver involvement improves outcomes.
OBJECTIVES: To facilitate caregiver-involved treatment process research, this study preliminarily examined within- and between-person variability in ecological momentary assessment (EMA) items assessing caregiver-child communication (eg, warmth, conflict), general (eg, monitoring, praise), and substance-specific parenting practices (eg, alcohol reactions and communication), and their correlations with momentary treatment targets (eg, craving, affect, motivation).
DESIGN: Fifteen adolescent (Mage = 15.8, range = 13-18, 73.3% male, 73.3% White, 13.3% American Indian or Alaskan Native) and caregiver (Mage = 49.9, 86.7% biological/adoptive mothers) dyads were recruited from an adolescent co-occurring disorders intensive outpatient program. Dyads completed 7 consecutive weeks of EMA, which consisted of morning and random (4x/day) assessments.
METHODS: Intraclass correlation coefficients (ICCs) examined the magnitude of between- and within-person variability for each item, which were administered to adolescents and caregivers. Within-person correlations examined how parenting practices related to alcohol and cannabis use and intentions, treatment motivation and engagement, and mental health symptoms (morning reports) and alcohol and cannabis craving and positive and negative affect (random assessments).
RESULTS: Within-person variability exceeded 20% for all parenting items other than parental reactions to alcohol use. Whereas some items demonstrated patterns consistent with study hypotheses (eg, caregiver warmth was associated with lower alcohol craving and negative affect), others had correlations in the opposite direction of study hypotheses (eg, adolescent disclosure and parental solicitation were positively associated with cannabis intentions).
CONCLUSION: Findings indicate that parenting practices vary across days and moments and are cross-sectionally associated with momentary indicators of treatment outcomes. Future work continuing to develop and test the psychometric properties of daily and momentary parenting practices will be essential for examining caregiver behaviors during treatment that facilitate improved treatment outcomes.
PMID:42683011 | PMC:PMC13530506 | DOI:10.1177/29768357261462391
