Cumulative Risk and Mental Health Outcomes in Children Prenatally Exposed to Alcohol
Date
2019-08-20
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Abstract
Fetal alcohol spectrum disorder (FASD) is caused by exposure to alcohol in utero and is the leading cause of birth defects and developmental disabilities. The timing, frequency, and dosage of alcohol consumed during the prenatal period contribute to the heterogeneous presentation of FASD, which includes physical, adaptive, behavioural, and social-emotional difficulties. Difficulties are often solely attributed to the effects of alcohol, yet alcohol is rarely the only explanatory factor for outcomes. Specifically, prenatal alcohol exposure (PAE) often co-occurs with other substances, as well as other environmental factors such as lack of prenatal care or poverty/malnutrition. Children and youth with FASD often experience adverse experiences postnatally, such as abuse or neglect. These factors may cumulatively interact to alter individual trajectories of children with PAE. The purpose of this study is to examine the relationship between cumulative risk factors (both prenatally and postnatally) on mental health outcomes of children exposed to alcohol prenatally. Additionally, the study aims to investigate what/if clinical neurocognitive factors further explain the variance associated with mental health outcomes, given the high prevalence of neurocognitive difficulties in this population. Results demonstrate that although PAE frequently co-occurs with a variety of other prenatal factors, in our sample, PAE was the most significant predictor of mental health symptoms, as measured by the Kiddie Schedule for Affective Disorders and Schizophrenia – Present and Lifetime Version (KSADS-PL). Our findings also show that postnatal threat or deprivation occurring after two years of age significantly predicted executive dysfunction. A hierarchical multiple regression was run to determine if the addition of postnatal experiences and EF to PAE significantly predicted symptom count. It was found that postnatal risks and executive functioning abilities better explained total mental health symptom count than PAE alone. The research and practice implications of the present study findings are discussed, in addition to strengths, limitations, and for future research directions.
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Keywords
mental health, fetal alcohol spectrum disorder, prenatal alcohol, executive functioning, cumulative risk
Citation
Ritter, C. M. (2019). Cumulative Risk and Mental Health Outcomes in Children Prenatally Exposed to Alcohol (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.