Date of Award

Fall 2019

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Daniel Whitaker

Second Advisor

Wendy Guastaferro


Background: Since 1991, the number of children with incarcerated mothers has increased by 98% and those with incarcerated fathers has increased by 58%. Estimates from the National Survey of Children’s Health suggest that more than 5.1 million children have had a parent incarcerated at some point. Parental incarceration and parental substance abuse can have broad negative impacts on children. Both are considered “adverse childhood experiences” that cause high levels of toxic stress and can lead to lasting harms, both psychologically and physically.

Objective: This research analyzes the relationship between two ACES – parental criminal history and parental substance use – on children’s mental health outcomes, specifically, internalizing, externalizing, and adaptive behaviors among a sample of individuals who were in treatment at drug courts.

Methods: That study was conducted at four drug courts in the Atlanta region from 2013-2016, and used a quasi-experimental design involving four drug courts (two adult drug courts and two family treatment courts). As part of that study, families (i.e., a drug court client, their child, and a co-parents) were interviewed at baseline and up to three years following baseline. This analysis uses data from this study; only baseline data from the drug court clients were used.

Results: Parent criminal history was positively related to externalizing behavior indicating that parents with greater levels of criminal history reported children with more externalizing behaviors. Parental substance use did not predict externalizing behavior, internalizing behavior, or adaptive behaviors.

Discussion: This study indicates that the relationship between traumas experienced can be impacted by the child’s age and gender. There are many social and contextual factors which are also at play when analyzing children’s mental health symptoms. Nevertheless, parental incarceration, parental substance use, and other adverse childhood experiences should be considered when reviewing children’s behaviors over time.

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Available for download on Tuesday, November 24, 2020