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Attach Hum Dev. 2018 Apr;20(2):181-207. doi: 10.1080/14616734.2017.1398764. Epub 2017 Nov 6.

Parental reflective functioning and executive functioning in mothers with substance use disorder.

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a The Research Centre for Child and Youth Competence and Development , Innland Norway University of Applied Sciences , Lillehammer , Norway.
b Division Mental Health Care , Innlandet Hospital Trust , Lillehammer , Norway.
c Norwegian School of Sport Science , University of Oslo , Oslo , Norway.
d Department of Psychology , University of Oslo , Oslo , Norway.
e Research Division , Innlandet Hospital Trust , Lillehammer , Norway.


Having a substance use disorder (SUD) may adversely affect caregiving capacities. Reflective functioning (RF) and executive functioning (EF) are both important capacities for sensitive parenting, and are often impaired in a SUD. Only a few studies have explored the possible association between the two phenomena. In this study, we used a neuropsychological test battery to assess EF, and the Parent Development Interview to assess RF in a sample of mothers with a SUD (N = 43). Although parental RF (PRF) was associated with EF, when controlled for intelligence (IQ) and mental health, there was no significant association between EF and PRF. Mental health, however, showed a significant negative association with PRF. Splitting the group in two based on PRF level, mothers with a negative to low PRF exhibited more severe difficulties in SUD-related aspects, as well as in several EF components, compared to mothers with an adequate to high PRF, highlighting the association between EF and PRF. The results from this study contribute to enhance our understanding of the dynamics underlying vulnerability in PRF that mothers with small children may experience. We suggest EF to be a prerequisite for adequate PRF, and for interventions to be customized accordingly regarding parents with a SUD.


Parental reflective functioning; executive functioning; infant; maternal; substance use disorder

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