Analysis of risk factors associated with suicidality in children and adolescents with fetal alcohol spectrum disorder in Western Australia

BACKGROUND: Individuals with fetal alcohol spectrum disorder (FASD) are at an elevated suicide risk compared with those in the general population. This public health issue warrants further research attention to help inform the development of prevention and intervention efforts. Our study is the first to characterize suicidality (i.e., suicidal ideation/suicide attempt) and explore associated risk factors in young individuals with FASD within the Australian context.

METHODS: Retrospective file reviews from a diagnostic clinic in Western Australia obtained data on demographic variables and risk factors, including psychosocial stressors (i.e., child protection and justice system involvement, history of abuse/neglect) and comorbid diagnoses (i.e., attention-deficit-hyperactivity disorder (ADHD), attachment disorder, conduct disorder, anxiety disorder, depression, substance use disorder, and sleep disorder). Data on suicidality were collected via formal suicide risk assessments and source documentation.

RESULTS: One hundred and ninety-five participants diagnosed with FASD were included in the study (M age  = 11.75 years, range = 5-21 years). Of these, 40 (21%) reported suicidality, with the youngest being 5 years old. There was a significant positive correlation between suicidality and age. A greater proportion of individuals with FASD who had been involved with the justice system (n = 30, 35%) reported suicidality. Participants with attachment disorder (n = 19, 34%), conduct disorder (n = 10, 40%), substance use disorder (n = 14, 50%), and depression (n = 12, 60%) had significantly higher rates of suicidality than individuals without these comorbidities. The risk of suicidality increased in participants with comorbid depression (OR = 4.20) after controlling for age as a covariate.

CONCLUSION: These findings add to the growing body of evidence that highlights the vulnerability of individuals with FASD to suicidality compared with the general population, underscoring the need for targeted, culturally safe suicide intervention/prevention efforts.