We seek to identify factors that facilitate or inhibit transmission of drug abuse (DA) from high-risk parents to their children. In 44,250 offspring of these parents, ascertained from a Swedish national sample for having a mother and/or father with DA, we explored, using Cox models, how the prevalence of DA was predicted by potentially malleable risk factors in these high-risk parents, their spouses and the rearing environment they provided. Analyses of offspring of discordant high-risk siblings and offspring of discordant sibling-in-laws and step-parents aided causal inference. Risk for DA in the children was associated with high-risk and married-in parental externalizing psychopathology, a range of other features of these parents (e.g., low education and receipt of welfare), and aspects of the rearing environment (e.g., neighborhood deprivation and number of nearby drug dealers). Offspring of discordant high-risk siblings, siblings-in-laws and step-parents suggested that nearly all these associations were partly causal. A multivariate analysis utilizing offspring of discordant high-risk siblings identified the six most significant potentially malleable risk factors for offspring DA: (1) criminal behavior (CB) in married-in parent, (2) community peer deviance, (3) broken family, (4) DA in high-risk parent, (5) CB in high-risk parent and (6) number of family moves. Children in the lowest decile of risk had a 50% reduction in their DA prevalence, similar to that seen in the general population. We conclude that transmission of DA from high-risk parents to children partly results from a range of potentially malleable risk factors that could serve as foci for intervention.

中文翻译：

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促进与抑制药物滥用从高危父母向子女的传播：瑞典国家研究

我们寻求确定促进或抑制药物滥用 (DA) 从高危父母向其子女传播的因素。在这些父母的 44,250 名后代中，从瑞典国家样本中确定母亲和/或父亲患有 DA，我们使用 Cox 模型探索了这些高风险父母中潜在的可塑性风险因素如何预测 DA 的患病率，他们的配偶和他们提供的抚养环境。对不和谐的高风险兄弟姐妹的后代以及不和谐的兄弟姐妹和继父母的后代的分析有助于因果推理。儿童患 DA 的风险与高风险和已婚父母外化精神病理学、这些父母的一系列其他特征（例如，教育程度低和接受福利）以及抚养环境的各个方面（例如，邻里剥夺和附近毒贩的数量）。不和谐的高风险兄弟姐妹、姻亲兄弟和继父母的后代表明，几乎所有这些关联都是部分因果关系。利用不一致的高风险兄弟姐妹的后代进行的多变量分析确定了后代 DA 的六个最重要的潜在可塑性风险因素：（1）已婚父母的犯罪行为（CB），（2）社区同伴越轨行为，（3）破碎的家庭, (4) 高风险父母中的 DA，(5) 高风险父母中的 CB 和 (6) 家庭搬迁次数。处于风险最低十分位数的儿童的 DA 患病率降低了 50%，与普通人群相似。