Mental Health Co-morbidity in Children and Adolescents with Fetal Alcohol Spectrum Disorder

• Author / Creator

  Tamana, Sukhpreet K

• Children and adolescents with Fetal Alcohol Spectrum Disorder (FASD) present with a range of physical, mental, behavioral, and cognitive challenges which can result in poor long-term outcomes. Mental health issues affect over 90% of individuals with FASD and is the most common and pressing secondary problem affecting children and adolescents with FASD or prenatal alcohol exposure (PAE). I examined the pattern and rates of mental health disorders diagnosed, the role of risk and protective factors on these outcomes, and the impact of having a mental health co-morbidity upon neurobehavioral functioning in children and adolescents with FASD/PAE. In Study 1, I retrospectively examined the prenatal and postnatal risk factors associated with internalizing and externalizing mental health disorders diagnosed in a large sample of children and adolescents (n = 209) aged 3 to 17 years assessed for an FASD. Findings revealed that 54.8% of our sample were diagnosed with a mental health disorder, and up to 33.3% were at-risk for a mental health diagnosis. The most common co-morbidities reported in our sample included ADHD (46.9%, n = 98), Anxiety (10.5%, n = 22), Attachment Disorder (9.6%, n = 20), ODD or Conduct Disorder (7.7%, n = 16), PTSD (7.7%, n = 16), and Depression (6.2%, n = 13). Children with a history of 4 or more Adverse Childhood Experiences (ACEs) were at 4 times increased risk for having an internalizing mental health diagnosis. Age at assessment and exposure to abuse or neglect emerged as significant risk factors for an internalizing disorder, while sleep issues, gestational weight, drug use during pregnancy, and number of pregnancies emerged as significant risk factors for an externalizing disorder. Living in a two-parent home emerged as a protective factor associated with an externalizing disorder, whereas living in a non-fostercare placement at the time of FASD assessment, biological parent history of behavioral issues or legal issues, and lower intellectual ability, were identified as protective factors associated with an internalizing disorder. Protective factors identified in this study as being associated with positive mental health outcomes are most likely due to receiving increased supports and services. In Study 2, I compared the neurobehavioral profile of 24 children and adolescents with FASD/PAE, aged 9 to 19 years, with and without a mental health co-morbidity. Children and adolescents with a mental health co-morbidity showed trends towards greater difficulty on measures of executive function, memory and learning, attention, and behavior. Parent reported executive behavior difficulties correlated with increased behavioral problems measured on two mental health rating-scales. Results from this research have important implications for improving mental health screening and care among children and adolescents with FASD. Future directions and implications regarding mental health outcomes among children and adolescents with FASD are discussed.

• Subjects / Keywords

  • FASD
  • Mental Health
  • Prenatal Alcohol Exposure

• Graduation date

  Spring 2016

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/R3TH8BW09

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.