Suicide risk in adolescents with fetal alcohol spectrum disorders

O’Connor, Mary J.; Portnoff, Larissa C.; Lebsack‐Coleman, Michael; Dipple, Katrina M.

doi:10.1002/bdr2.1465

Cited by 32 publications

(21 citation statements)

References 19 publications

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“…Inclusion criteria for the ADHD + PAE group were as follows: ADHD by DSM-5 criteria for ADHD (any subtype) according to the clinician-administered computerized Schedule for Affective Disorders and Schizophrenia for School Aged Children, Parent Version (K-SADS) ( Kaufman et al, 1997 ; Townsend et al, 2020 ) and the Conners-3 Parent Form ( Conners, 2008 ); and diagnostic features of fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), or alcohol-related neurodevelopmental disorder (ARND) according to the Institute of Medicine (IOM) criteria proposed in updated guidelines ( Hoyme et al, 2016 ; O’Connor et al, 2019 ). Four key diagnostic features of FAS were evaluated: 1) growth retardation; 2) the FAS facial phenotype, including short palpebral fissures, flat philtrum, and flat upper vermillion border (see details below); 3) neurodevelopmental dysfunction; and 4) gestational alcohol exposure.…”

Section: Methodsmentioning

confidence: 99%

Cortical gyrification in children with attention deficit-hyperactivity disorder and prenatal alcohol exposure

Kilpatrick

Joshi

O’Neill

et al. 2021

Drug and Alcohol Dependence

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Background: An improved understanding of the neurodevelopmental differences between attention deficit hyperactivity disorder with and without prenatal alcohol exposure (ADHD + PAE and ADHD−PAE, respectively) is needed. Herein, we evaluated gyrification (cortical folding) in children with ADHD + PAE compared to that in children with familial ADHD−PAE and typically developing (TD) children. Methods: ADHD + PAE (n = 37), ADHD−PAE (n = 25), and TD children (n = 27), aged 8–13 years, were compared on facial morphological, neurobehavioral, and neuroimaging assessments. Local gyrification index (LGI) maps were compared between groups using general linear modelling. Relationships between LGI and clincobehavioral parameters in children with ADHD ± PAE were evaluated using multivariate partial least squares. Results: ADHD + PAE and ADHD−PAE groups showed significantly lower LGI (relative to TD) in numerous regions, overlapping in medial prefrontal, parietal, and temporo-occipital cortices (p < 0.001). However, LGI in left mid-dorsolateral prefrontal cortex was uniquely lower in the ADHD + PAE group (p < 0.001). Partial least squares analysis identified one significant latent variable (accounting for 59.3 % of the crossblock correlation, p < 0.001), reflecting a significant relationship between a profile of lower LGI in prefrontal (including left mid-dorsolateral), insular, cingulate, temporal, and parietal cortices and a clinicobehavioral profile of PAE, including a flat philtrum and upper vermillion border, lower IQ, poorer behavioral regulation scores, and greater hyperactivity/impulsivity. Conclusions: Children with ADHD + PAE uniquely demonstrate lower mid-dorsolateral LGI, with widespread lower LGI related to more severe facial dysmorphia and neurobehavioral impairments. These findings add insight into the brain bases of PAE symptoms, potentially informing more targeted ADHD treatments based on an objective differential diagnosis of ADHD + PAE vs. ADHD−PAE.

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Section: Methodsmentioning

confidence: 99%

Cortical gyrification in children with attention deficit-hyperactivity disorder and prenatal alcohol exposure

Kilpatrick

Joshi

O’Neill

et al. 2021

Drug and Alcohol Dependence

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“…Elevated rates of both internalizing and externalizing problems have been reported among people with FASD (Khoury et al, 2018), and common comorbid diagnoses include attention-deficit/hyperactivity disorder, conduct disorder, oppositional defiant disorder, and psychotic disorders (Fryer et al, 2007;Lange et al, 2018;Pagnin et al, 2019;Patel et al, 2020;Popova et al, 2016;Rasmussen et al, 2010;Weyrauch et al, 2017). Individuals with FASD also experience high rates of suicidality (Landgren et al, 2019;O'Connor et al 2019;Streissguth et al, 1996), which has been linked to comorbid mental health and substance use problems, impaired emotion regulation, history of trauma, financial stress, and a lack of stable social support (Dirks et al, 2019;Huggins et al, 2008;Temple et al, 2019). PAE is also associated with the development and high rates of substance use problems later in life (Dodge et al, 2019;Goldschmidt et al, 2019;McLachlan et al, 2020;Streissguth et al, 1996Streissguth et al, , 2004Yates et al, 1998).…”

Section: Mental Health and Substance Use In Fasdmentioning

confidence: 99%

A Systematic Review of Interventions to Improve Mental Health and Substance Use Outcomes for Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder

Flannigan

Harding

Anderson

et al. 2020

Alcoholism Clin & Exp Res

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Individuals with fetal alcohol spectrum disorder (FASD) experience remarkably high rates of mental health and substance use challenges, beginning early in life and extending throughout adulthood. Proactive intervention can help to mitigate some of these negative experiences. Although the literature on FASD intervention is growing, there is currently a lack of consolidated evidence on interventions that may improve mental health and substance use outcomes in this population. Informed by a life course perspective, we undertook a systematic review of the literature to identify interventions that improve mental wellness through all developmental stages for people with prenatal alcohol exposure (PAE) and FASD. A total of 33 articles were identified, most of which were focused on building skills or strategies that underlie the well-being of children with PAE and FASD and their families. Other interventions were geared toward supporting child and family wellness and responding to risk or reducing harm. There was a notable lack of interventions that directly targeted mental health and substance use challenges, and a major gap was also noted in terms of interventions for adolescents and adults. Combined, these studies provide preliminary and emerging evidence for a range of intervention approaches that may support positive outcomes for individuals with FASD across the life course.

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“…Finally, the risk of suicidal ideation, suicide attempts and completions for children and youth with FASD has emerged as an area of concern. Suicide is a leading cause of premature death specifically among individuals with FASD (Thanh & Jonsson, 2016), with high estimations of suicidal ideation and attempts across studies (O'Connor, Portnoff, Lebsack‐Coleman, & Dipple, 2019; Streissguth, Barr, Kogan, & Bookstein, 1996). Approximately 13%–26% of individuals with FASD have reported a history of suicide attempts (Dirks et al, 2019; Streissguth et al, 1996), with adolescents with FASD being 5.5 times more likely to make a serious attempt compared with their age‐matched peers (O'Connor et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Comparing outcomes of children and youth with fetal alcohol spectrum disorder (FASD) in the child welfare system to those in other living situations in Canada: Results from the Canadian National FASD Database

Burns

Badry

Harding

et al. 2020

Child

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Aims: The current study aimed to explore differences in adverse outcomes between youth and adolescents with fetal alcohol spectrum disorder (FASD) living in child welfare care (i.e., foster care or group home) with those living with their biological parent(s) or with adoptive or other family member(s) in Canada. Methods: Data gathered from the Canadian National FASD Database were used for analysis. A total of 665 youth and adolescents with a clinical diagnosis of FASD under the age of 18 living in child welfare care, with biological, adoptive or other family members, were included in the sample. Key areas examined included living situation, legal problems, experience of sexual or physical abuse, mental health (anxiety, conduct disorder, mood disorder and post-traumatic stress disorder) and suicidal ideation. Descriptive statistics and chi-square comparisons were utilized to explore these differences. Results: Results revealed a significantly higher rate of reported sexual and physical abuse among individuals in child welfare care compared with those living with biological parents or with adoptive or other family member(s). Rates of difficulty with the law were also higher among those in child welfare care compared with adoptive/ other family members. Conversely, the rate of mood disorders was significantly higher among those living with adoptive/other family members compared with child welfare care. Results highlight similar rates of reported suicidal ideation/attempts across all living situations, as well as mental health concerns.

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Suicide risk in adolescents with fetal alcohol spectrum disorders

Cited by 32 publications

References 19 publications

Cortical gyrification in children with attention deficit-hyperactivity disorder and prenatal alcohol exposure

Cortical gyrification in children with attention deficit-hyperactivity disorder and prenatal alcohol exposure

A Systematic Review of Interventions to Improve Mental Health and Substance Use Outcomes for Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder

Comparing outcomes of children and youth with fetal alcohol spectrum disorder (FASD) in the child welfare system to those in other living situations in Canada: Results from the Canadian National FASD Database

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