PHP 1540: Alcohol Use & Misuse April 9, 2012 Effects on Children & Youth: FASD Children of Alcoholics Cognitive Effects Emerging Adulthood & Substance Use

Fetal Alcohol Syndrome (FAS) a group of irreversible birth defects that include physical, mental and behavioral problems FAS affects between 0.5 and 7.0 out of every 1,000 live births in the US; 1% have FASD Alcohol is leading cause of preventable birth defects a fetus metabolizes alcohol more slowly than an adult does, its BACs are higher than those of the mother presence of alcohol impairs nutrition for the fetus’ developing organs and brain cells

Specific defects depend on when in pregnancy the fetus was exposed to alcohol . . .

Babies born with FAS usually suffer from: Small head and brain size (microcephaly) Facial malformations Deformities of joints, limbs and fingers Heart defects Vision difficulties (e.g., nearsightedness) Slow physical growth before / after birth

From Wattendorf & Muenke (2005) Figure 2. Characteristic facial features in children of different ethnicities with fetal alcohol spectrum disorders. (A) Child of Northern European descent. (B) Native American child. (C) Black child. (D) Biracial child (white, black).

FAS also causes: Mental retardation and delayed development Abnormal behavior such as short attention span, hyperactivity and poor impulse control Mental health, social, school, and legal problems throughout life FAS is the leading cause of MR and DD in the US These are entirely preventable

Bottom Line: ≥ 1 drink/day increases risk of fetal impairment and/or spontaneous abortion Negative effects appear to be related to binge drinking, especially high BACs Recommendation: Women who wish to become pregnant should not drink alcohol

Adolescent Increases in social behavior, sensation seeking and risk taking ==> evolutionary purpose Prepares the adolescent to explore new environments, establish new social networks, and become independent of parents Human adolescents are inclined to seek out reinforcement from new experiences and extreme experiences (Spear, 2002)

+ Adolescent Adolescents appear to be less sensitive to alcohol’s depressant effects (compared to adults) sedation motor impairment hangover effects Adolescents may be more sensitive to positive rewarding effects (enhanced sensitivities of mesocorticolimbic reward system incr. DA release) social facilitation effects alcohol-related cognitive impairment: alcohol dependent teens show deficits in attention and working memory Note: adolescent GABA receptors are less sensitive to ethanol-induced potentiation of GABA-mediated inhibition

prefrontal cortex: important for cognitive control Casey & Jones (2010): these data suggest that, although adolescents as a group are considered risk-takers, some adolescents will be more prone than others to engage in risky behaviors, putting them at potentially greater risk for negative outcomes. However, risk-taking can be quite adaptive in the right environments. So rather than trying to eliminate adolescent risk-taking behavior that has not been a successful enterprise to date, a more constructive strategy may be to provide access to risky and exciting activities (e.g., after school programs with in-door wall climbing) under controlled settings and limit harmful risk taking opportunities. prefrontal cortex: important for cognitive control the striatum: critical in detecting and learning about novel and rewarding cues in the environment (consists of nucleus accumbens and the olfactory tubercle; assoc. with limbic structures, such as the amygdala, hippocampus) According to the model, the adolescent is biased by functionally mature subcortical relative to less mature cortical circuitry during adolescence (i.e., imbalance in reliance of systems) (Casey & Jones, 2010)

Concerns. . . Average age of first alcohol use is declining The earlier the age of starting alcohol/drugs, the greater the risk of later problems High amounts of alcohol exposure during adolescence may disrupt brain maturation – in structure and function

Fetal Alcohol Spectrum Disorders Resources CDC info on FASD: http://www.cdc.gov/ncbddd/fasd/index.html Alcohol Research & Health, Vol 34, Issue 1: http://pubs.niaaa.nih.gov/publications/arh341/toc34_1.htm FASD video