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A Closer Look: Q&A with Esme Fuller-Thomson

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Esme Fuller-Thomson is a professor of social work at University of Toronto.  She discussed with us her recent study  findings that depression in adulthood is linked to parental addictions during childhood.

Can you tell us a little about the initial questions informing your study?

For the past several years, we have been examining the association between early childhood adversities and adult health outcomes.  Our original research focused on the long-term consequences of childhood physical abuse.  However, childhood abuse cannot be considered in a vacuum; early adversities often cluster together.   In a recent publication in Child: Care, Health and Development, we showed that adults whose parents struggled with addiction issues were more than five times more likely to report they had been victims of childhood physical abuse than those who grew up in homes without this problem.  Millions of children are living with parents who abuse drugs or alcohol, so it seemed important to examine the long-term mental health of adults who had grown up in these households.

What did you find?

Our study of a representative, community-dwelling Canadian sample of 6,000 adults showed that children whose parents were addicted to drugs or alcohol had twice the odds of developing adult depression.

We had incorrectly anticipated that the association between parental addictions and adult depression would have been explained by one or more of several plausible factors, such as dysfunctional ways of coping (including the adult child’s alcohol abuse or obesity), lower levels of education or adult income of individuals who grew up in these households, or other co-occurring early childhood traumas (such as childhood physical abuse or parental unemployment).  Even after taking into account all of these factors, individuals exposed to parental addictions still had  69% higher odds of depression in adulthood.

What are some possible explanations for the relationship between parental addiction and a diagnosis of depression?

The survey nature of this study does not allow us to determine the cause of the relationship between parental addictions and adult depression. We hypothesize that children who are faced with a chaotic home environment may become hypervigilant, constantly scanning their environment for potential threats. While this coping behavior may be protective when faced with an intoxicated parent, it may cause long term damage, permanently altering the way these children’s bodies react to stress.  Production of the key ‘fight or flight’ hormone, cortisol, may become impaired. Problems in cortisol production may influence the later development of depression.  Future research is needed to test this hypothesis.


You note in your study that the findings demonstrate the intergenerational consequences of drug and alcohol addiction, and reinforce the need to develop interventions that support healthy childhood development to prevent ongoing patterns of addiction and depression.  What interventions or further research do you recommend?

As an important first step, children who experience toxic stress at home can be greatly helped by the stable involvement of caring adults, including grandparents, teachers, coaches, neighbors and social workers. Although more research is needed to determine if access to a responsive and loving adult decreases the likelihood of adult depression among children exposed to parental addictions, we do know that these caring relationships promote healthy development and buffer stress.

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