Paternal Substance Use Characteristics and Children's Emotional-Behavioral Problems: The Moderating Role of Family System in Pakistani Families

Abstract

Paternal substance use disorder (SUD) has not been sufficiently studied from a family-level perspective on psychosocial adaptation of children in Pakistan where household organization can range from joint to nuclear. This study analyzes the connection between paternal substance use and emotional and behavioral issues of children and determines if the family system (joint vs. nuclear) is a factor in this association.Primary caregivers of 220 children (average age 10 years) from a sample of Pakistani fathers enrolled in treatment for substance use in rehabilitation centers, were recruited and completed the Strengths and Difficulties Questionnaire (SDQ) and a demographic and clinical form. Longer paternal substance use had a positive association with children’s difficulties, and the joint family system was associated with fewer difficulties than the nuclear family system. Moderation analysis using Hayes’ PROCESS Model 1, with control for child age and the primary substance of use, found a significant interaction between paternal substance use duration and family system. In joint family systems, the positive association with children’s difficulties was less pronounced compared to nuclear family systems. Although the findings were limited to association, the results supported a potential buffering hypothesis, as the presence of a joint family system in Pakistani households may lessen, but not fully remove, the psychosocial risks of prolonged paternal substance use. It has practical importance for family-centered addiction treatment and child mental health screening.