Biopsychosocial Predictors of Conduct Problems in Adolescents with Fetal Alcohol Spectrum Disorder

Research has consistently found an association between prenatal alcohol exposure (PAE) and the development of conduct problems (CP); however, there are numerous biopsychosocial risk factors that often co-occur with PAE and may be important predictors of CP in this high-risk population. The current study applies a biopsychosocial model in order to identify which biological, neuropsychological, family, and social risk factors are most closely associated with the development of CP in adolescents with FASD. This study is part of a larger prospective follow-up study of a cohort of children diagnosed with FASD in the Motherisk Clinic at The Hospital for Sick Children, between 2003 and 2012. Data for predictors were obtained from standardized behavioural questionnaires and life history data gathered during the initial diagnostic assessment. Standardized questionnaires and a semi-structured interview were conducted with caregivers and youth 2 to 7 years post-diagnosis, in order to gather outcome data on the prevalence of various types of CP in adolescence. Multiple linear and logistic regression models were used to identify significant biopsychosocial predictors of CP. After accounting for the effects of a number of key biopsychosocial risk factors, emotional/behavioural regulation ability was found to be a significant and unique predictor of various measures of CP in youth with FASD. Remarkably, this is the first study to investigate the role of these executive processes in the development of CP in individuals with FASD, despite numerous reports of executive functioning deficits in this population. Future intervention efforts aimed at preventing or mitigating CP in individuals with FASD should focus on improving self-regulation skills.