In the United States, suicide is one of the leading causes of death for adolescents between the ages of 13 and 18. Patients with symptoms falling on the FASD spectrum make up approximately 5% of youth in the United States, and as a result, they too experience suicidal thoughts and ideations. This is exacerbated by the fact that 94% of adolescents and adults with pre-natal alcohol exposure (PAE) have some form of a mental health problem. These problems are underscored by the degree of suicide risk in adulthood, with 43% of patients reporting suicide ideation and 23% reporting a history of suicide attempts.
Although many studies have been done on FASD adolescents with a lower IQ, and how that relates to their risk of suicide, nothing of the sort has been done for higher functioning FASD patients. This study, done by O’Connor et al., examined the prevalence of suicidal ideations and serious suicide attempts in adolescents with high functioning FASD.
This study involved 54 adolescents between 13 and 18, with 15.69 being the mean age in years. The mean IQ was 91.11. Each participant was tested for classic FASD symptoms and criteria, which includes growth retardation, FAS facial deformities (such as a flat lip and wide set eyes), neurodevelopmental dysfunction and exposure to alcohol in utero. The three main classifications of FASD found in the participants were Fetal Alcohol Spectrum Disorder, partial Fetal Alcohol Spectrum Disorder and Alcohol Related Neurodevelopmental DIsorder.
The suicide risk for the participants was recorded using the Children’s Interview for Psychiatric Syndromes (ChIPS). This was used to identify adolescents who experienced suicidal ideations and or who had made a previous suicide attempt. For this study, ideation was classified as a participant having any thoughts about killing themselves or verbalizing a suicidal intention. A suicide attempt was classed as an instance of deliberate harmful behaviour with a conscious or clear intent of a wish to die, with medical attention following an attempt.
The results of this study revealed that 35.2% of the adolescents had suicidal ideations and 13.0% had made at least one suicide attempt in the past twelve months. There was no significant difference between males and females who expressed ideations of suicide, but there was a significant difference in the suicide attempts between the sexes. 29.2% of males attempted suicide while 0% of females had a suicide attempt. Analyzing the IQ’s, it was found that male’s who attempted suicide had a significantly lower IQ compared to non-attempters. 36.8% of adolescents who reported suicide ideation also met the criteria for depressive disorders. Among the male sample, 42.9% reported a serious suicide attempt.
Comparing the results of this study to the national average, it is found that adolescents with FASD have a 5.5 times greater chance of making a serious suicide attempt compared to other adolescents of their age range. The results of the sex difference was even more drastic; nationally, typically-developing males have a suicide attempt rate of 1.5%. The rate of suicide attempts for males with FASD was 19.5 times higher at 29.2%.
The results of this study highlight a need for more monitoring and interventions for individuals with FASD. It gives support for the fact that FASD is not just a developmental disorder, there are serious social and behavioural issues associated, which can lead to extreme consequences for the adolescents impacted. It also poses the question of why females are less impacted, and what protective factors do they possess that males do not?
Teens and adolescents with FASD are at a much greater risk of developing life-threatening ideations compared to the rest of the population, with males being a significantly higher risk. The results of this study should provide motivation to implement some type of suicide screening for adolescents in general, and not just adolescents with FASD.
Article Reference
O’Connor, M.J., L.C. Portnoff, M. Lebsack-Coleman & K.M. Dipple (2019). Suicide risk in adolescents with fetal alcohol spectrum disorders. Birth Defects Research. Doi: https://doi.org/10.1002/bdr2.1465
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