Dr. Linda Mayes, from the Yale Child Study Center and Yale School of Medicine, looks at the key brain systems involved with reward seeking and stress regulation that are central to the capacities required to care for another (e.g., there is a neural circuitry for parental care and attachment). Substance abuse and addiction, often preceded by early adversity, lead to enduring neural changes in sensitivity to rewards and to stress. This affects the capacities and neural circuits involved in parental care and attachment such that infant signals such as cries or other markers of distress elicit heightened stress in parents and disrupt, rather than elicit, parental care. Substance abuse and addiction also impact the ability to think about and reflect on the emotional needs of one’s self and of the infant, especially under times of stress. How this impacts parenting also informs the understanding of the intergenerational transmission of early adversity and addiction, and intervention approaches. This presentation was delivered as part of the Recovery from Addiction (RFA) symposium, held in October 2012.