Dissertation: Maternal substance use shapes early childhood attachment and development
- Nordic Alcohol and Drug Policy Network
- Sep 29
- 2 min read
29.09.2025 - Maternal substance use is a major social problem that affects the wellbeing of mothers, children, and families. In her doctoral dissertation, psychologist Noora Hyysalo examined how a mother’s substance use shapes a child’s attachment, maternal caregiving behavior, and the child’s ability to adapt to challenging circumstances. The results underline the importance of supporting parenting early and using strength-based approaches when helping vulnerable mothers and children.
Hyysalo’s research explored the connections between maternal substance use, mother-child relationships, caregiving behavior, and child development. She used a multi-method approach, focusing on preschool-aged children and their mothers who used substances. The substance use varied: many mothers used medication during pregnancy, and polysubstance use involving alcohol, tobacco, and medicines was common. Some mothers were in opioid substitution treatment. Pregnancy and childbirth motivated some to stop using substances altogether.
Early interaction is critical for child development, and maternal substance use is often linked to difficulties in interaction. Based on literature, Hyysalo found that substance use during pregnancy and after birth is associated with insecure attachment in young children. “Maternal substance use often creates an insecure environment where the child does not receive the support and comfort they need in moments of distress. This may affect later social and emotional development. However, this does not mean a simple cause-and-effect relationship, as many underlying factors are still not well understood,” Hyysalo explains.
The study also used a novel video-assisted method to assess maternal caregiving behavior at the micro level, focusing on the predictability of auditory, visual, and tactile stimuli. Hyysalo applied this approach for the first time to mothers using substances. While no differences were found between substance-using and non-using mothers in predictability, unpredictable caregiving was linked to weaker neurocognitive development in children. “It appears that the predictability of maternal sensory cues may provide a foundation for favorable cognitive development in children,” Hyysalo says.
Children’s perspectives were explored through play stories describing coping strategies. Children of mothers who used substances depicted both positive and negative experiences of support in stressful situations, but a key finding was their ways of coping independently without adult help. “Children adapt to many environments and develop various strategies to cope with very challenging conditions. It is important to recognize these strengths when designing support services for vulnerable families,” Hyysalo concludes.
Hyysalo’s dissertation Substance Use in Motherhood: Unraveling its role in the mother-child relationship, maternal caregiving behavior, and child adaptation will be publicly examined at the Faculty of Social Sciences, Tampere University, on Friday 3 October 2025 at 13:00 in the Väinö Linna auditorium, Linna building (Kalevantie 5, Tampere). The opponent will be Associate Professor Karen Milligan from Toronto Metropolitan University, and the custos will be Senior Lecturer Minna Sorsa from Tampere University.
Find more: https://trepo.tuni.fi/handle/10024/229996
