Stakeholder perspectives on the stigma of fetal alcohol spectrum disorder

Corrigan, Patrick W.; Shah, Binoy Biren; Lara, Juana Lorena; Mitchell, Kathleen T.; Combs-Way, Peggy; Simmes, Diana R.; Jones, Kenneth Lyons

doi:10.1080/16066359.2018.1478413

Cited by 39 publications

(31 citation statements)

References 24 publications

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“…These include the relatively “hidden” nature of the disorder, with a large proportion of those with FASD presenting with no overt outward physical signs (~90%), as well as underreporting of alcohol use during pregnancy due to substantial stigma and fear of repercussions (Astley, 2010; Corrigan et al, 2019). Additional barriers include a continued lack of system‐level resources, complex and variable clinical presentations, and limited FASD knowledge and awareness among professionals needed to effectively recognize, assess, and provide support to individuals with FASD and their families (Astley Hemingway et al, 2019; Corrigan et al, 2019; McLachlan et al, 2020; Wedding et al, 2007). Guidelines for diagnosing FASD also range considerably across countries with respect to criteria and diagnostic nosology, which continue to change over time (see Coles et al, 2016, for a review).…”

Section: Introductionmentioning

confidence: 99%

Screening approaches for identifying fetal alcohol spectrum disorder in children, adolescents, and adults: A systematic review

Grubb

Golden

Withers

et al. 2021

Alcoholism Clin & Exp Res

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Background Fetal alcohol spectrum disorder (FASD) is a prevalent neurodevelopmental disorder that is caused by prenatal alcohol exposure (PAE) and associated with a range of cognitive, affective, and health concerns. Although the identification of FASD can facilitate the provision of interventions and support, and plays a protective role against adverse outcomes, there are high rates of missed detection. The identification of FASD via screening may improve its recognition across settings. The current systematic review examined the available evidence on FASD screening tools and approaches across age groups and settings. Methods A systematic search was carried out for both peer‐reviewed studies and gray literature sources published between January 1990 and May 2020 and was preregistered with PROSPERO (#CRD42019122077). Studies included in the review focused on human applications of FASD screening in children, adolescents, and adults. The quality of the studies was assessed using the QUADAS‐2 and GRADE frameworks. Results The search yielded 20 screening tools and approaches across 45 studies, broadly characterized in 2 groups. The first group included approaches currently in use that aim to identify individuals at risk of FASD using a range of markers (n = 19) or associated sentinel dysmorphic facial features (n = 6). Another group of studies, characterized as emerging, focused on identifying promising biomarkers of PAE/FASD (n = 20). Overall, we identified limited research supporting the psychometric properties of most screening approaches. The quality review provided evidence of bias due to the common use of case–control designs and lack of adequate reference standards. Conclusions Although several FASD screening tools and approaches are available for use across a range of age groups and settings, the overall evidence base supporting their psychometric properties is weak, with most studies demonstrating significant risk of bias. Service providers should exercise caution in selecting and implementing FASD screening tools given these limitations. It is critically important to accurately identify individuals with FASD across ages and settings to support healthy outcomes. Thus, there is a pressing need for additional research in this area, particularly validation studies in large and representative samples using robust methodological approaches.

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Section: Introductionmentioning

confidence: 99%

Screening approaches for identifying fetal alcohol spectrum disorder in children, adolescents, and adults: A systematic review

Grubb

Golden

Withers

et al. 2021

Alcoholism Clin & Exp Res

View full text Add to dashboard Cite

show abstract

“…The first strength of the present study was that multiple perspectives and types of mental health conditions and substance misuse that were included, creating a comprehensive and realistic view on the topic. 29 , 34 , 35 Additionally, the sample included participants with an addiction, even though this is a sensitive topic within the military. Results showed that the fear of losing one's job was especially present for substance misuse, making the inclusion of participants with addiction valuable.…”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators for treatment-seeking for mental health conditions and substance misuse: multi-perspective focus group study within the military

et al. 2020

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Background Globally, millions are exposed to stressors at work that increase their vulnerability to develop mental health conditions and substance misuse (such as soldiers, policemen, doctors). However, these types of professionals especially are expected to be strong and healthy, and this contrast may worsen their treatment gap. Although the treatment gap in the military has been studied before, perspectives of different stakeholders involved have largely been ignored, even though they play an important role. Aims To study the barriers and facilitators for treatment-seeking in the military, from three different perspectives. Method In total, 46 people participated, divided into eight homogeneous focus groups, including three perspectives: soldiers with mental health conditions and substance misuse (n = 20), soldiers without mental health conditions and substance misuse (n = 10) and mental health professionals (n = 16). Sessions were audio-taped and transcribed verbatim. Content analysis was done by applying a general inductive approach using ATLAS.ti-8.4.4 software. Results Five barriers for treatment-seeking were identified: fear of negative career consequences, fear of social rejection, confidentiality concerns, the ‘strong worker’ workplace culture and practical barriers. Three facilitators were identified: social support, accessibility and knowledge, and healthcare within the military. The views of the different stakeholder groups were highly congruent. Conclusions Barriers for treatment-seeking were mostly stigma related (fear of career consequences, fear of social rejection and the ‘strong worker’ workplace culture) and this was widely recognised by all groups. Social support from family, peers, supervisors and professionals were identified as important facilitators. A decrease in the treatment gap for mental health conditions and substance misuse is needed and these findings provide direction for future research and destigmatising interventions.

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“…Recent research by Corrigan et al (2017) has demonstrated that mothers of children with FASD are highly stigmatized by the public. Further, stigma towards biological mothers of children with FASD was positively associated with FASD literacya finding that conflicts with mental illness and substance use disorders research (Corrigan et al, 2019). Results from this qualitative study found that workers self-reported understanding of FASD varied with some participants noting they felt FASD informed, and others describing their understanding as limited.…”

Section: Discussionmentioning

confidence: 81%

‘We do what we can as soon as we can’ Alcohol and Other Drug workforce perspectives on preventing and responding to prenatal alcohol exposure

Pedruzzi

Hamilton

Hodgson

et al. 2020

Drugs: Education, Prevention and Policy

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Stakeholder perspectives on the stigma of fetal alcohol spectrum disorder

Cited by 39 publications

References 24 publications

Screening approaches for identifying fetal alcohol spectrum disorder in children, adolescents, and adults: A systematic review

Screening approaches for identifying fetal alcohol spectrum disorder in children, adolescents, and adults: A systematic review

Barriers and facilitators for treatment-seeking for mental health conditions and substance misuse: multi-perspective focus group study within the military

‘We do what we can as soon as we can’ Alcohol and Other Drug workforce perspectives on preventing and responding to prenatal alcohol exposure

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