This paper explores the parenting of drug-dependent women and the contributions of comorbid psychopathology to their parenting. A sample of 32 children whose mothers were dependent on opioid drugs during pregnancy and 37 children whose mothers were not drug users were followed from birth to middle childhood. Multivariate regression analyses were conducted contrasting whether maternal substance abuse or psychopathology was more closely linked to parenting behaviors and continuity in parenting over time. Maternal drug dependence was related to whether mothers were able to remain primary caregivers for their children over time, even after controlling for psychopathology. Maternal drug use was related to unresponsive and negative parenting behavior during mother–infant interaction, but this relation was largely accounted for by the effects of comorbid maternal psychopathology on parenting, particularly symptoms of antisocial and related personality disorders. For those children whose mothers continued to care for them into middle childhood, perceptions of their mothers as rejecting were related to maternal antisocial personality and maternal depression. Substance-abuse treatment for women should be integrated with interventions addressing their mental health and parenting needs.

Associations between mothers' psychological distress, experiences of verbal and violent relational conflict, representations of the relationships with their infants, and parenting behavior were examined in 100 African American mothers of 17- to 20-month-old infants. Maternal representations of infants were assessed via the Working Model of the Child Interview (WMCI; Zeanah, Benoit, Hirshberg, & Barton, 1986). Results showed that mothers who experienced more conflict with their own mothers had increased odds of having disengaged representations of the relationship with their infants. Mothers who experienced more conflict with their infants' fathers had increased odds of having distorted views of their infants. Mothers who reported more hostile psychological symptomalogy had greater odds of not having a balanced representation of their infants (distorted or disengaged). Additionally, mothers with disengaged representations were less sensitive, more passive, and used less encouragement and guidance with their children. Maternal hostility and conflict were directly related to parenting and were not mediated by representations. Results show that representations and parenting behavior are linked and multiply determined.

Doulas, whose traditional role is to support women during labor and delivery, are being increasingly utilized within community-based programs where a primary goal is supporting mother-infant relationships. The present study investigated the effect of doula services on parenting among young, low-income mothers. A total of 248 pregnant women were randomly assigned to receive either doula services or routine medical and social services. The doulas provided prenatal home visitation, support during labor and delivery, and 3 months of postpartum home visitation. Parenting was assessed through video recordings of mother-infant interaction at 4, 12, and 24 months of child age and maternal report of parenting attitudes and stress. Intent-to-treat analyses showed that mothers who had received doula services endorsed more child-centered parenting values, showed more positive engagement with their infants, and were more likely to respond to infant distress at 4 months. Their infants were less likely to show visible upset during observed interactions. Most effects of the program on parent and child behavior faded over time. Community doula intervention is a promising practice for supporting parenting and parent-infant interaction. Integration of doulas into longer term home-visiting models might sustain the early impact of doula services and enhance parenting services offered by traditional home-visiting programs.

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