Coles Grant Kable 2022.pdf

“We report on 292 individuals who responded to a health survey between January 2017 and May 2021. Of these, 283 had responses that included all data necessary to carry out causal modeling. Participants were recruited from two existing cohorts in Atlanta and Seattle. Individuals defined as alcohol-exposed in these cohorts were known to have been diagnosed with an FASD or to have been exposed to alcohol prenatally according to maternal self-report during the prenatal period.”

This study analyzes data collected from a survey of participants in two different cities, Atlanta and Seattle, both of which have been exposed to alcohol prenatally and have self-reported as being prenatally exposed or diagnosed with Fetal Alcohol Syndrome Disorder. This is a longitudinal design with surveys, and the exposed groups’ data collected from their survey were compared to that of the non-exposed control group.

“While the primary focus of research has been on the physical birth defects (Jones, Smith, Ulleland, & Streissguth, 1973), growth (Day et al., 1989) and neurocognitive development (Doyle & Mattson, 2015) that define fetal alcohol syndrome (FAS), an association between PAE and mental health disorders has been observed as well (O’Connor & Paley, 2009; Spohr, Willms, & Steinhausen, 2007; Weyrauch, Schwartz, Hart, Klug, & Burd, 2017) but remains much less thoroughly examined than other outcomes. This is particularly true for adults with PAE and FASD. There is relatively little information available about the impact of PAE on emotional status in adulthood and, in the clinically referred groups who are often the subjects of study, it can be difficult to discriminate the effects of prenatal exposure against the backdrop of social and environmental stressors that often accompany PAE.”

The overwhelming focus of prenatal alcohol exposure (PAE) has been on the changes in typical physical and cognitive development of those affected by PAE. There has been a gap in research focusing on the impact that PAE has on individuals’ mental health, especially at an adult age and not within the primary stages of development in childhood.

“PAE did not directly predict depression but did so indirectly (β = .114, p < .008) via its impact on SES (β = .066, p < .023) and ACEs (β = .082, p < .001). Gender also had an indirect effect on depression (β = .057, p < .002) associated with its effect on ACEs (β = .056, p < .002). In addition, Site (β= −.216, p < .005), ACEs (β = .288, p < .003) and SES (β = −.141, p < .028) also directly predicted depression with the Seattle site, higher ACEs and lower SES being associated with a greater likelihood of depression diagnosis. Dysmorphology had neither a direct nor indirect relationship with depression.”

Prenatal alcohol exposure was not directly linked to depression, but was indirectly linked because it was associated with a lower socioeconomic status and more adverse childhood experiences. Both of these factors increased the likelihood of the PAE individual having depression.

“As this was a survey, information about mental health is based on participant self-report and not confirmed by professional diagnosis. Participants were recruited from longitudinal cohorts, both of which previously had reported mental health issues in alcohol – groups. Thus, it may be most conservative to say that this study demonstrates that such effects are persistent over many years.”

Due to this study’s reliance on self-reports in surveys for data collection, the information, such as answers about diagnoses or mental health symptoms, is not being confirmed by professionals, which can affect the results. With the recorded effects persisting over time, it is difficult to identify when, why or how the effects developed or changed over this time and only that they are simply still present at the time of data collection.

Future research could include professional diagnoses or reports of symptoms, so bias in self-reports is minimized. It seems that prenatal alcohol exposure (PAE) does indirectly affect mental health in different ways, such as low socioeconomic status. It would be beneficial to research the data on how support programs or prevention can positively impact the mental health of PAE individuals. This may also allow for PAE to be examined more directly if support plans put in place for low SES do not change PAE’s effect on mental health.

This paper has a complex research design as it tracks people over decades, and the positively correlated factors that affect individuals’ mental health are not directly related to prenatal alcohol exposure, so the varying life factors recorded in the results do not clearly focus on the effects of prenatal alcohol exposure on mental health in adulthood.