The Effects of Prenatal Alcohol Exposure and Attention-Deficit/Hyperactivity Disorder on Psychopathology and Behavior

Authors

  • Ashley L. Ware,

    1. Center for Behavioral Teratology , San Diego State University, San Diego, California
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  • Jessica W. O'Brien,

    1. Center for Behavioral Teratology , San Diego State University, San Diego, California
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  • Nicole Crocker,

    1. Center for Behavioral Teratology , San Diego State University, San Diego, California
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  • Benjamin N. Deweese,

    1. Center for Behavioral Teratology , San Diego State University, San Diego, California
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  • Scott C. Roesch,

    1. Department of Psychology , San Diego State University, San Diego, California
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  • Claire D. Coles,

    1. Department of Psychiatry and Behavior Sciences and Pediatrics , Emory University School of Medicine, Atlanta, Georgia
    2. Department of Pediatrics , Emory University School of Medicine, Atlanta, Georgia
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  • Julie A. Kable,

    1. Department of Pediatrics , Emory University School of Medicine, Atlanta, Georgia
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  • Philip A. May,

    1. Department of Nutrition , Gillings School of Global Public Health, University of North Carolina Nutrition Research Institute, Kannapolis, North Carolina
    2. Center on Alcoholism , Substance Abuse and Addictions, The University of New Mexico, Albuquerque, New Mexico
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  • Wendy O. Kalberg,

    1. Center on Alcoholism , Substance Abuse and Addictions, The University of New Mexico, Albuquerque, New Mexico
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  • Elizabeth R. Sowell,

    1. Developmental Cognitive Neuroimaging Laboratory , Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
    2. Division of Research on Children, Youth, and Families , Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California
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  • Kenneth Lyons Jones,

    1. Department of Pediatrics , School of Medicine, University of California, San Diego, California
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  • Edward P. Riley,

    1. Center for Behavioral Teratology , San Diego State University, San Diego, California
    2. Department of Psychology , San Diego State University, San Diego, California
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  • Sarah N. Mattson,

    Corresponding author
    1. Department of Psychology , San Diego State University, San Diego, California
    • Center for Behavioral Teratology , San Diego State University, San Diego, California
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  • CIFASD

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    • The Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD; E. Riley, San Diego State University, Principal Investigator) includes 16 different centers where data collection and analysis take place. The data collection sites and associated investigators described in this paper are: San Diego State University (S.N. Mattson), the University of New Mexico and Northern Plains (P.A. May, W.O. Kalberg), University of California, Los Angeles (E.R. Sowell), and Emory University (C.D. Coles and J.A. Kable).


Reprint requests: Sarah N. Mattson, PhD, 6330 Alvarado Court, Suite 100, San Diego, CA 92120; Tel.: 619-594-7228; Fax: 619-594-1895; E-mail: sarah.mattson@sdsu.edu

Abstract

Background

This study examined prevalence of psychiatric disorders and behavioral problems in children with and without prenatal alcohol exposure (AE) and attention-deficit/hyperactivity disorder (ADHD).

Methods

Primary caregivers of 344 children (8 to 16 years, M = 12.28) completed the Computerized Diagnostic Interview Schedule for Children-IV (C-DISC-4.0) and the Child Behavior Checklist (CBCL). Subjects comprised 4 groups: AE with ADHD (AE+, = 85) and without ADHD (AE−, = 52), and nonexposed with ADHD (ADHD,= 74) and without ADHD (CON,= 133). The frequency of specific psychiatric disorders, number of psychiatric disorders (comorbidity), and CBCL behavioral scores were examined using chi-square and analysis of covariance techniques.

Results

Clinical groups had greater frequency of all psychiatric disorders, except for anxiety, where the AE- and CON groups did not differ. There was a combined effect of AE and ADHD on conduct disorder. For comorbidity, children with ADHD had increased psychiatric disorders regardless of AE, which did not have an independent effect on comorbidity. For CBCL scores, there were significant main effects of AE and ADHD on all scores and significant AE × ADHD interactions for Withdrawn/Depressed, Somatic Complaints, Attention, and all Summary scores. There was a combined effect of AE and ADHD on Externalizing, Total Problems, and Attention Problems.

Conclusions

Findings indicate that ADHD diagnosis elevates children's risk of psychiatric diagnoses, regardless of AE, but suggest an exacerbated relation between AE and ADHD on conduct disorder and externalizing behavioral problems in children. Findings affirm a poorer behavioral prognosis for alcohol-exposed children with ADHD and suggest that more than 1 neurobehavioral profile may exist for individuals with AE.

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