重度产前酒精暴露青少年的适应功能与智商的关系。
Relation between adaptive function and IQ among youth with histories of heavy prenatal alcohol exposure.
机构信息
Center for Behavioral Teratology and Department of Psychology, San Diego State University, San Diego, California.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
出版信息
Birth Defects Res. 2019 Jul 15;111(12):812-821. doi: 10.1002/bdr2.1463. Epub 2019 Feb 4.
BACKGROUND
Adaptive function and general intellectual function are two important and often correlated domains. While youth with prenatal alcohol exposure frequently demonstrate impairments in both domains, it is not clear whether the relation between these domains is consistent across levels of ability or whether, for example, adaptive function is less affected by intellectual function at higher ability levels. The aim of the current study was to test this relation in youth with and without prenatal alcohol exposure.
METHODS
As part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, Phase II, subjects with heavy prenatal alcohol exposure (AE) and nonexposed subjects with and without other clinical conditions or concerns (CON) completed a comprehensive neurobehavioral battery. Multiple regression analyses tested the relation between full scale IQ (FSIQ) and overall adaptive function. Interaction terms between Group and each variable were created to formally test for group differences. Three subsequent regression analyses tested which adaptive function domains (Communication, Daily Living Skills, Socialization) significantly contributed to results. Follow-up analyses examined correlations based on IQ range (low IQ <85; high IQ ≥85).
RESULTS
The interaction between FSIQ and Group on overall adaptive function was significant; the relationship between FSIQ and adaptive function was weaker in the AE group than in the CON group. Regarding specific adaptive function domains, the interaction between FSIQ and Group was significant only in the Communication domain. Follow-up analyses showed, within the low IQ range, the correlation between FSIQ and Communication was stronger in the CON group than the AE group. Within the high IQ range, the correlation between FSIQ and Communication was significant only in the CON group.
CONCLUSIONS
Although higher intellectual functioning was associated with better adaptive function ability among controls, this was not found among the alcohol-exposed youth where a general dampening of adaptive ability was noted. Further, the differential relationship between IQ and adaptive function between groups appears to be driven by communication abilities. These findings suggest that level of intellectual functioning of children with prenatal alcohol exposure does not fully account for caregiver-reported communication and overall adaptive function deficits particularly at higher levels of functioning.
背景
适应功能和一般智力功能是两个重要且经常相关的领域。虽然有产前酒精暴露的年轻人在这两个领域经常表现出损伤，但尚不清楚这两个领域之间的关系是否在不同的能力水平上保持一致，或者例如，在更高的能力水平上，适应功能受智力功能的影响较小。本研究的目的是在有和没有产前酒精暴露的年轻人中测试这种关系。
方法
作为胎儿酒精谱系障碍合作倡议（Collaborative Initiative on Fetal Alcohol Spectrum Disorders，Phase II）的一部分，有大量产前酒精暴露（AE）的受试者和没有暴露的有和没有其他临床情况或关注点的受试者（CON）完成了全面的神经行为测试。多元回归分析测试了全量表智商（FSIQ）和整体适应功能之间的关系。创建了组间和每个变量的交互项，以正式测试组间差异。随后进行了三项回归分析，以测试哪些适应功能领域（沟通、日常生活技能、社交）对结果有显著贡献。后续分析根据智商范围（低智商<85；高智商≥85）检查相关性。
结果
FSIQ 和组之间的整体适应功能交互作用显著；FSIQ 和适应功能之间的关系在 AE 组比 CON 组弱。关于特定的适应功能领域，FSIQ 和组之间的交互作用仅在沟通领域显著。后续分析表明，在低智商范围内，CON 组中 FSIQ 与沟通之间的相关性强于 AE 组。在高智商范围内，仅在 CON 组中 FSIQ 与沟通之间的相关性显著。
结论
尽管较高的智力表现与对照组的适应功能能力相关，但在酒精暴露的年轻人中并未发现这种情况，他们的适应功能能力普遍减弱。此外，两组之间 IQ 和适应功能之间的差异关系似乎是由沟通能力驱动的。这些发现表明，有产前酒精暴露的儿童的智力水平并不能完全解释照顾者报告的沟通和整体适应功能缺陷，尤其是在较高的功能水平上。
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