Article Summary #10: Recent advances in FASD for mental health professionals

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This Article Summary is part of our CanFASD Connect Top Articles Summary Series. Over the next several months, we will be bringing you summaries of all the recent research papers from our list of the Top FASD Articles of 2019. This is an overview of a research article called Recent advances in fetal alcohol spectrum disorder for mental health professionals.

Background:
Fetal alcohol spectrum disorder (FASD) refers to the array of disorders that may occur from prenatal alcohol exposure (PAE). Individuals with FASD are likely to experience comorbid mental health disorders. Approximately 22-28% of a mental health professional’s patients may be diagnosed with a neurodevelopmental disorder associated with PAE. Therefore, adequate training, knowledge, and support are required for mental health professionals in order to make an informed response and to support their clients. Despite a need for FASD-informed diagnosis and intervention within the mental health system, there are currently no guidelines available to support mental health professionals in identifying PAE in their patient populations. The authors of this review highlight recent evidence in FASD within the mental health field to facilitate positive outcomes for people with FASD. 
Main Findings:
  • Standardizing FASD diagnosis internationally and improving mental health professionals’ knowledge and understanding of FASD can improve care for individuals with FASD who experience mental health challenges.
  • Mental health professionals should be aware of the stigma, medical treatment, and manifestations of PAE.
  • Biopsychosocial interventions can be effective strategies to support individuals with FASD/ND-PAE. Strategies that are individualized and integrated and that target specific neurocognitive impairments are most effective.
  • Identifying, understanding, and supporting an individual’s specific neurocognitive deficits is key to successfully preventing negative outcomes in those with mental disorders associated with PAE.
  • Combining neuroanatomic, dysmorphologic, neuroimaging, epigenetic, and neurocognitive research findings will help the development of accurate diagnostic biomarkers.
Recommendations:
  • Mental health professionals should apply stigma reduction strategies (e.g., personal contact with individuals with lived experience, shift language use, focusing on strengths rather than deficits) to reduce the stigma and discrimination experienced by individuals with FASD.
  • Mental health professionals should be able to recognize PAE and the broader system effects as a whole-body disorder in the individual.
  • Mental health professionals should use biopsychosocial interventions for individuals with ND-PAE/FASD.
  • Future research on epigenetics, comorbid conditions, and interventions is needed to better understand how to support individuals with FASD and mental health challenges.
  • Improving knowledge of assessment and treatment of patients with ND-PAE/FASD and comorbid conditions is needed to help mental health professionals to provide quality care for patients with PAE.
Take-home message: Individuals with FASD or PAE experience high rates of comorbid mental health issues, but there are currently no standard guidelines to help mental health professionals identify and support individuals with FASD in their practice. Increasing knowledge of FASD amongst mental health professionals is important to support individuals with FASD in mental health settings. 

Authors: Mansfield Mela, Kelly D. Coons-Harding, and Tara Anderson Journal: Current Opinion in Psychiatry Date: July 2019 Read the full article (not available open access)

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