Parental Problematic Alcohol Use (PPAU): A Burden for Life?-Exposure to PPAU and Anxiety and Depression in Adulthood: A Systematic Review and Meta-Analysis.
TL;DR
Childhood exposure to PPAU is associated with an increased risk of anxiety and depression in adulthood, and the available evidence suggests that these associations may be partly explained by co-occurring childhood adversities and broader family dysfunction.
Abstract
BackgroundExposure to parental problematic alcohol use (PPAU) during childhood represents a common form of early adversity with potential long-term consequences for mental health. While childhood adversity is well established as a risk factor for later psychological difficulties, the specific association between childhood exposure to PPAU and anxiety and depression in adulthood remains insufficiently understood.AimsThis study aimed to systematically review and quantitatively synthesize existing evidence on the association between childhood exposure to PPAU and anxiety and depression outcomes in adulthood.MethodA systematic search was conducted in Medline, PsycINFO, Web of Science, and the Cochrane Library. Studies were screened using predefined inclusion criteria. Thirty-two studies met eligibility criteria, of which twenty-nine were included in the meta-analyses. Random-effects models were used to calculate pooled standardized mean differences (SMDs) and odds ratios (ORs) for anxiety and depression outcomes.ResultsThe findings indicated a significant association between childhood exposure to PPAU and increased risk of anxiety and depression in adulthood. For anxiety, the pooled SMD was 0.37, and pooled ORs indicated a 73% higher likelihood of anxiety among individuals exposed to PPAU. For depression, the pooled SMD was 0.29, with pooled ORs suggesting a 65% increased likelihood of depressive symptoms. Although effect sizes were attenuated in studies adjusting for confounding variables, associations remained statistically significant.ConclusionsChildhood exposure to PPAU is associated with an increased risk of anxiety and depression in adulthood. However, the available evidence suggests that these associations may be partly explained by co-occurring childhood adversities and broader family dysfunction. Consequently, PPAU may represent one component of a broader constellation of childhood risk factors associated with adverse adult mental health outcomes. Taken together, these findings underscore the importance of early identification and family-focused preventive interventions for children exposed to parental alcohol problems.