A Comparison of Psychopathology in Children with and without Prenatal Alcohol Exposure
Walthall, Johanna C., O'Connor, Mary J., Paley, Blair, Mental Health Aspects of Developmental Disabilities
Research suggests that psychiatric problems may be common in children with prenatal alcohol exposure. The purpose of the current study was to examine psychiatric diagnoses in a non-clinic referred sample of 130 children ages 6 to 12 years old, with and without prenatal alcohol exposure. A standardized diagnostic interview procedure was employed, comparing children with prenatal alcohol exposure and social skills deficits to children without prenatal alcohol exposure and social skills deficits. Findings suggest that children with prenatal alcohol exposure exhibit significantly more psychopathology, including symptoms of anxiety, disruptive behaviors, and mood disorders, when compared to children without alcohol exposure.
Keywords: intellectual disability, prenatal alcohol exposure, child psychopathology, fetal alcohol spectrum disorders, fetal alcohol syndrome, psychiatric disorder
Over the past 30 years, mounting evidence about the impact of maternal alcohol consumption during pregnancy has prompted increased attention to the link between prenatal alcohol exposure and a constellation of developmental disabilities that are characterized by physical, cognitive, and behavioral impairments. These disabilities include a continuum of disorders known as Fetal Alcohol Spectrum Disorders (FASDs). Fetal Alcohol Syndrome (FAS) (47) is considered the most severe condition resulting from in utero alcohol exposure and involves characteristic facial malformations, growth deficiencies, and neurodevelopmental deficits. (14) Although prevalence rates for FAS vary widely depending on the epidemiological and clinical methods used to collect information, as well as the populations being studied, one recent report estimated a national rate of 0.5 to 2 cases of FAS per 1,000 live births, with the prevalence of the entire continuum of FASDs estimated to be 1 in 100 in the United States. (20)
Relatively recent research on structural brain changes in individuals with prenatal alcohol exposure has documented overall reductions in brain size and greater than expected reductions in the sizes of the basal ganglia, corpus callosum, and anterior cerebellar vermis. (39) Although changes in 39 brain structure are particularly compelling evidence of alcohol's teratogenicity, changes in behavior caused by prenatal alcohol exposure can be equally devastating. Most behavioral research has particularly focused on impairment in overall intellectual functioning and deficits in general cognitive abilities, which have been reported in both children with FAS and those with heavy prenatal alcohol exposure who do not meet full criteria to warrant a diagnosis of FAS. In (34) addition to intellectual deficits, children with prenatal alcohol exposure also present with other significant neurocognitive deficits. These deficits include problems with executive functioning, learning and memory, language, attention, and information processing speed. (16,31,32,33,34,46)
Given the significant neurocognitive deficits seen in this population, it is not surprising that psychosocial dysfunction among children with FASDs has also been consistently noted in the literature. Children with prenatal alcohol exposure have difficulty understanding social cues, exhibit indiscriminant social behavior, and have difficulty communicating in social contexts. (21,43) Caregiver and teacher ratings of social functioning suggest that children with prenatal exposure to alcohol have poorer social skills than unexposed children, even after controlling for differences in cognitive functioning. Furthermore, studies of (35,47,48) adolescents and adults with FASDs indicate that these social skills deficits continue into adulthood. Behavioral difficulties are also (27,46) prevalent in alcohol-exposed children, with externalizing behaviors being particularly problematic in the classroom and at home. Moreover, as alcohol-exposed (3,6,16,25,26,29,30) individuals approach adolescence, behavioral difficulties often increase and may include problems with alcohol and substance use, school failure, delinquency, and trouble with the law. …