Is Heavy 1st Trimester Prenatal Alcohol Exposure Associated with an Increased Incidence of One or More Subtypes of Offspring Conduct Disorder?

Children with prenatal alcohol exposure (PAE) tend to show higher rates of conduct disorder (CD), even after the effect of some potentially confounding factors, including parental alcoholism, parental drug abuse, and externalizing disorder, have been taken into account. It is clear that some subgroups of CD may show distinct developmental pathways; for instance, the use of construct of psychopath for subtyping CD children has grown and some research has highlighted a distinction between callous-unemotional traits and highly-impulsive traits. As more and more studies have examined the relationship between PAE and the occurrence of CD, some important questions have been raised. The objective of this study is to determine whether PAE is associated with a specific subtype of CD, or if it is equally associated with both highly impulsive and the callous-unemotional forms of diagnosis. The National Institute of Mental Health Diagnostic Interview Schedule for Children- 4th Edition (DISC-IV) was used to assess the psychiatric disorders and symptoms of 572 children with PAE. Among these 572 children, 67 met the criteria for lifetime diagnosis of CD. We collapsed these children into three groups based on the levels of PAE (unexposed, lightly exposed, heavy exposed). The analyses were conducted to examine the difference of each CD symptoms and clinical information of children. The results suggest that while most of the CD symptoms and clinical information were similar among three groups, the differences of both domains of social impairment and psychiatric treatment in the twelve months preceding the diagnostic interview were statistically significant. Based on the outcome of the analyses, 1ST trimester PAE is associated with an observable increase in the incidence of both callous-unemotional and highly-impulsive subtypes of children with CD, rather than being associated with one or the other of these two subtypes. We would conclude that the CD children with PAE or non-PAE show a similar range of clinical symptoms and subtypes. For public health significance, this might be helpful information for clinicians and public health officials when they discuss the diagnoses or issues about children with PAE. This information may also assist researchers to build an individual and comprehensive intervention for different subtypes of conduct disorder in children