
Jana KreppnerUniversity of Southampton · Department of Psychology
Jana Kreppner
PhD Developmental Psychology
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Publications (99)
Research examining the effects of severe, prolonged early deprivation has shown elevated rates of neurodevelopmental symptoms, which frequently persist into adulthood and are associated with functional and social relationship difficulties, as well as elevated rates of mental health problems. The behavioural manifestations of these symptoms closely...
Severe, prolonged early deprivation is associated with later neurodevelopmental difficulties. Despite elevated levels of contact with service providers, these problems often persist into adult life and are associated with impairment in adulthood (e.g., unemployment, higher rates of depression and anxiety symptoms and poorer subjective wellbeing). H...
It has been reported that adult adoptees with histories of maltreatment face particular challenges when they become parents. Here we explore this issue using a qualitative analysis of the views of 14 adoptee mothers, who suffered severe institutional deprivation in the Romanian orphanages of the late 1980s before being adopted into the UK, and thei...
Trauma-informed (T-I) approaches to working with vulnerable people have gained popularity in practice but are rarely used in academic research and little is known about the challenges of conducting a T-I approach to participatory research. This paper reflects on our experiences of a participatory peer research project involving unaccompanied young...
Inclusive education for children with attention deficit hyperactivity disorder (ADHD) presents challenges for school staff and professional development is lacking. Training is not always available when needed, strategies suggested by external experts can be impractical and staff lack autonomy in choosing the best way of being resourced. Additionall...
BACKGROUND
The Structured E-Parenting Support (STEPS) app provides support for parents of children with elevated levels of hyperactivity/impulsivity, inattention, and conduct problems, awaiting clinical assessment by child health services. STEPS will be evaluated in a randomised controlled trial (RCT), as part of the OPTIMA research programme in th...
Background
The Structured E-Parenting Support (STEPS) app provides support for parents of children with elevated hyperactivity, impulsivity, inattention, and conduct problems who are awaiting clinical assessment. STEPS will be evaluated in a randomized controlled trial (RCT) within the Online Parent Training for the Initial Management of ADHD Refer...
Background
Rutter and colleagues' seminal observation that extended early life exposure to extreme institutional deprivation can result in what he termed quasi‐autism (QA), informed both our understanding of the effects of adversity on development and the nature of autism. Here we provide the first detailed analysis of the adult outcomes of the gro...
Background
Children referred for attention-deficit/hyperactivity disorder (ADHD) often present with a broader pattern of conduct problems including oppositionality and defiance. This combination can be extremely stressful to parents, lower parents’ self-esteem and negatively impact family life. The National Institute for Health and Care Excellence...
Background
Children referred for attention-deficit hyperactivity disorder (ADHD) often present with a broader pattern of conduct problems including oppositionality and defiance. This combination can be extremely stressful to parents, lower parents’ self-esteem, and negatively impact family life. The National Institute for Health and Care Excellence...
Studies suggest that children who have experienced neglect are at risk for bullying which in turn increases the risk for poor mental health. Here we extend this research by examining whether this risk extends to the neglect associated with severe institutional deprivation and then testing the extent to which these effects are mediated by prior depr...
Background:
Perfectionism is an important feature of adult psychopathology. In the absence of a prior review of the role of perfectionism in perinatal psychopathology, we aimed to ascertain whether perfectionism was associated with symptoms of maternal perinatal depression and anxiety.
Method:
We followed PRISMA guidance (PROSPERO: 42019143369),...
Background: perfectionism is an important feature of adult psychopathology. In the absence of a prior review of the role of perfectionism in perinatal psychopathology, we aimed to ascertain whether perfectionism was associated with symptoms of maternal perinatal depression and anxiety.
Method: we followed PRISMA guidance (PROSPERO: 42019143369 ),...
Nurture Groups (NGs) have been widely implemented with vulnerable young people in mainstream primary schools to support the development of secure relationships and so promote a sense of wellbeing and readiness for learning. Success of the intervention within the primary school environment has led to increasing interest in the applicability of NGs t...
The educational outcomes and attainment of children and young people in care (CYPIC) are lower than those of individuals not in care and is a source of international concern (Sebba and Luke, 2019, McNamara et al., 2019). Despite positive shifts in the legislative landscape to increase focus and support for the educational progress of CYPIC, the att...
Background
Childhood institutional deprivation is associated with growth stunting in childhood but long-term effects in adulthood remain uncertain.
Objective
To examine the impact of global institutional deprivation experienced in early childhood on subsequent growth with a special focus on final adult height and puberty timing.
Participants & se...
Background: n the UK, children with high levels of hyperactivity, impulsivity and
inattention referred to clinical services with possible attention-deficit/hyperactivity disorder (ADHD) often wait a long time for specialist diagnostic assessment. Parent training (PT) has the potential to support parents during this difficult period, especially rega...
Teachers report feeling ill-equipped to meet the needs of ADHD children. Previous studies on ADHD teacher training have been largely quantitative, focused on measured gains in ADHD knowledge and use of behavioural strategies. Traditional training shows initial improvements which deteriorate over time necessitating a new approach. Staff perspectives...
Background: In the UK, children with high levels of hyperactivity, impulsivity and inattention referred to clinical services with possible attention-deficit/hyperactivity disorder (ADHD) often wait a long time for specialist diagnostic assessment. Parent training (PT) has the potential to support parents during this difficult period, especially reg...
Background: Perfectionism is an important feature of adult psychopathology. In the absence of a prior review of the role of perfectionism in perinatal psychopathology, we aimed to ascertain whether perfectionism was associated with symptoms of maternal perinatal depression and anxiety. Method: We followed PRISMA guidance (PROSPERO: 42019143369 ), e...
Objective
To synthesize the evidence on the efficacy of ADHD teacher training interventions for teachers’ ADHD knowledge and reducing pupils’ ADHD-type behaviors.
Method
Six electronic databases were systematically searched up to 14/04/20. Meta-analyses were performed to pool standardized mean differences (SMD).
Results
29 studies were included i...
Empirical evidence shows that asylum seekers experience a range of stressors in a post migration context that can contribute to poor mental health. Few studies have considered how post migration stressors affect the family unit, specifically with a focus on parenting and child outcomes. In 2018 and 2019, interviews were conducted with asylum seekin...
Objective: Characteristic symptoms of age-inappropriate inattention and/or hyperactivity-impulsivity in ADHD often lead to school problems. Our systematic review and meta-analysis assessed the effectiveness of ADHD teacher training to increase teacher ADHD knowledge and reduce severity of impairing student ADHD-type behaviours.
Methods: Six elect...
KEY CONCEPTS • Childhood maltreatment can be defined as ‘any acts of commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child’ (Child Maltreatment Surveillance, 2008). • These acts do not have to be intentional in order to be classed as maltreatment. Acts of commission include vari...
Background:
Using data from the English & Romanian Adoptees (ERA) study, we recently reported that early time-limited exposure to severe institutional deprivation is associated with early-onset and persistent neurodevelopmental problems and later-onset emotional problems. Here, we examine possible reasons for the late emergence of emotional proble...
Deaf and Hard of Hearing adolescents (DHH) experience more peer problems and lower levels of friendships than their hearing peers. This study used a qualitative approach to identify their experiences of peer problems and factors influencing them. A sample of 30, 13-19, year-old DHH adolescents with a moderate to profound hearing loss, drawn from a...
Both preterm birth and early institutional deprivation are associated with neurodevelopmental impairment – with both shared and distinctive features. To explore shared underlying mechanisms, this study directly compared effects of these putative risk factors on temperament profiles in six-year-olds: Children born very preterm (<32 weeks gestation)...
Objective/Background: children with Down syndrome (DS) commonly experience difficulties with executive function (EF). They are also vulnerable to obstructive sleep apnoea (OSA). OSA is associated with EF deficits in typically developing children. A recent study reported an association between OSA and cognitive deficits in 38 school-aged children wi...
Nurture Groups (NGs) are a short term, psychotherapeutic intervention aiming to provide reparative attachment experiences for children within an educational setting. The social skills of 16 children (aged between 6.0 and 9.75 years) were assessed through teacher ratings and children’s self-report to hypothetical and challenging social situations. T...
Background: Institutionally deprived young children often display distinctive patterns of attachment - classified as insecure/other (INS/OTH) - with their adoptive parents. The associations between INS/OTH and developmental trajectories of mental health and neuro-developmental symptoms were examined.Methods: Age four attachment status was determine...
Hypothalamic-pituitary-adrenal (HPA) axis function is disrupted in institutionally-deprived children - reduced morning cortisol, flattened diurnal slope and blunted reactivity persist even after successful adoption into positive family environments. Here we test whether such effects persist into adulthood. Cortisol release across the day (sampled a...
Background: Permanent childhood hearing loss (PCHL) is associated with an elevated level of emotional and behaviour difficulties (EBD). In children and adolescents with PCHL, EBD has been found to be linked to language ability in children with PCHL. The present study was designed to test whether childhood language and/or reading comprehension abili...
Objectives: it is known that during the middle childhood years those with permanent childhood hearing loss (PCHL) are at increased risk of showing emotional and behaviour difficulties (EBD). It has yet to be established whether this risk continues into the late teenage years. There is a paucity of longitudinal studies on the association between PCH...
Background: early life institutional deprivation produces disinhibited social engagement (DSE). Portrayed as a childhood condition, little is known about the persistence of DSE-type behaviours into, presentation during, and impact on, functioning in adulthood.
Aims: we examine these issues in the young adult follow-up of the English and Romanian...
Objectives:
This study aimed to examine whether (a) exposure to universal newborn hearing screening (UNHS) and b) early confirmation of hearing loss were associated with benefits to expressive and receptive language outcomes in the teenage years for a cohort of spoken language users. It also aimed to determine whether either of these two variables...
Background:
Time-limited, early-life exposures to institutional deprivation are associated with disorders in childhood, but it is unknown whether effects persist into adulthood. We used data from the English and Romanian Adoptees study to assess whether deprivation-associated adverse neurodevelopmental and mental health outcomes persist into young...
Background
Early‐life institutional deprivation is associated with attention‐deficit/hyperactivity disorder (ADHD) later in childhood and adolescence. In this article, we examine, for the first time, the persistence of deprivation‐related ADHD into young adulthood in a sample of individuals adopted as young children by UK families after periods in...
The English & Romanian Adoptees (ERA) study follows children who spent their first years of life in extremely depriving Romanian institutions before they were adopted by families in the UK. The ERA study constitutes a "natural experiment" that allows the examination of the effects of radical environmental change from a profoundly depriving institut...
The aim of this study is to estimate the extent to which children and adolescents with hearing impairment (HI)show higher rates of emotional and behavioural difficulties compared to normally hearing children. Studies of emotional
and behavioural difficulties in children and adolescents were traced from computerized systematic searches supplemented,...
The English & Romanian Adoptees (ERA) study follows children who spent their first years of life in extremely depriving Romanian institutions before they were adopted by families in the UK. The ERA study constitutes a “natural experiment” that allows the examination of the effects of radical environmental change from a profoundly depriving institut...
Objective To determine whether the benefits of universal newborn hearing screening (UNHS) seen at age 8 years persist through the second decade.
Design Prospective cohort study of a population sample of children with permanent childhood hearing impairment (PCHI) followed up for 17 years since birth in periods with (or without) UNHS.
Setting Birth...
This article briefly summarizes the literature on elements of research, practice, and policy pertaining to the development and care of children raised in institutions. It covers such childrens development while they reside in institutions and after their transition to adoptive or foster families. Of special interest are attachment and indiscriminat...
This chapter reviews sensitive periods in human brain development based on the literature on children raised in institutions. Sensitive experiences occur when experiences are uniquely influential for the development of neural circuitry. Because in humans, we make inferences about sensitive periods from evaluations of complex behaviors, we underesti...
A common polymorphism in the serotonin transporter gene (SLC6A4, 5HTT) has been repeatedly shown to moderate the influence of childhood adversity and stressful life events on the development of psychopathology. Using data from the English and Romanian Adoptee Study, a prospective-longitudinal study of individuals (n = 125) exposed to severe early i...
We set out to explore the meaning of the attachment categories in the Cassidy/Marvin strange situation procedure, as employed in the home, using data from a longitudinal study of children adopted into UK families up to the age of 42 months from Romanian institutions, and of adopted children without the experience of institutional care––both groups...
Parents of 165 children adopted from Romania and 52 children adopted from within the United Kingdom rated the success of the adoptions when the children were 11 years old. As was the case at two earlier study waves, satisfaction was found to be extremely high. Both positive and negative assessments were generally stable between ages 6 and 11, altho...
Early institutional deprivation is a risk factor for Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms. However not all individuals are affected. We tested the hypothesis that this heterogeneity is influenced by gene x environment (GxE) interaction and that genetic polymorphisms involved in dopamine neurotransmission moderate the effects of...
Despite the evidence on anomalous attachment patterns, there has been a tendency to interpret most of these as reflecting differences in security/insecurity.
Empirical research findings are reviewed in relation to attachment/insecurity as evident in both infancy and later childhood, disorganised attachment, inhibited attachment disorder, and disinh...
The English Romanian Adoptees (ERA) study is a remarkable exploration of the experiences of children whose early lives in Romanian institutions were unimaginably poor and who were then adopted into English families with all the material, emotional and social advantages that this brings. This publication focuses on the policy and practice implicatio...
Institutional deprivation is multifaceted and includes adverse psychosocial and nutrition-related components. In this study we partitioned these risks in relation to cognitive impairment and mental ill health, and explored the mediating role of reduced head/brain size. There were 138 participants (61 males, 77 females) in the study. Participants we...
This article by Celia Beckett, Amanda Hawkins, Michael Rutter, Jenny Castle, Emma Colvert, Christine Groothues, Jana Kreppner, Suzanne Stevens and Edmund Sonuga-Barke examines attitudes regarding cultural and national identity in a group of 165 young people adopted from Romania. The attitudes of their adoptive parents are also explored. The adoptiv...
Theory of Mind (ToM) and Executive Function (EF) have been associated with autism and with attention-deficit hyperactivity disorder (ADHD), and hence might play a role in similar syndromes found following profound early institutional deprivation. In order to examine this possibility the current study included a group of 165 Romanian adoptees, of wh...
The current study examined the persistence and phenotypic presentation of inattention/overactivity (I/O) into early adolescence, in a sample of institution reared (IR) children adopted from Romania before the age of 43 months. Total sample comprised 144 IR and 21 non-IR Romanian adoptees, and a comparison group of 52 within-UK adoptees, assessed at...
A study of the views of two groups of 11-year-old adopted children (one adopted as babies within the UK, n = 47, the other adopted from Romania, aged between two and 43 months, n = 133) indicates that parents underestimate the difficulty that their children have in talking about adoption. Children who found this harder experienced lower self-esteem...
The study assessed conduct and emotional difficulties in a group of Romanian adoptees at age 11, and serves as a follow-up to assessments made when the children were 6 years old. It was found that there was a significant increase in emotional difficulties, but not conduct problems, for the Romanian sample since age 6. It was also found that emotion...
Some young children reared in profoundly depriving institutions have been found to show autistic-like patterns, but the developmental significance of these features is unknown.
A randomly selected, age-stratified, sample of 144 children who had experienced an institutional upbringing in Romania and who were adopted by UK families was studied at 4,...
The relationship between severe early institutional deprivation and scholastic attainment at age 11 in 127 children (68 girls and 59 boys) adopted from institutions in Romania was compared to the attainment of 49 children (17 girls and 32 boys) adopted within the UK from a non-institutional background. Overall, children adopted from Romania had sig...
Amanda Hawkins, Celia Beckett, Jenny Castle, Christine Groothues, Edmund Sonuga-Barke, Emma Colvert, Jana Kreppner, Suzanne Stevens and Michael Rutter compared views about adoption for two groups of 11-year-old children (n = 180). The team's analyses compared the views of children according to their pre-adoption background: UK domestic adoptees pla...
Adolescent intercountry (n = 122) and domestic (n = 40) adoptees and their adoptive parents were asked about their views on communicative openness. The adoptees were also asked for their thoughts on birth parents and contact. A modest association between communicative openness and feelings about adoptive status and self-esteem was found. Girls were...
A randomly selected sample of 165 children from Romania (of whom 144 had been reared in institutions) who were adopted by UK families, with placement before the age of 42 months, was studied at 4, 6, and 11 years of age. Comparisons were made with a sample of 52 non-institutionalized UK children adopted before the age of 6 months, who were studied...
Longitudinal analyses on normal versus impaired functioning across 7 domains were conducted in children who had experienced profound institutional deprivation up to the age of 42 months and were adopted from Romania into U.K. families. Comparisons were made with noninstitutionalized children adopted from Romania and with nondeprived within-U.K. ado...
Longitudinal analyses on normal versus impaired functioning across 7 domains were conducted in children who had experienced profound institutional deprivation up to the age of 42 months and were adopted from Romania into U.K. families. Comparisons were made with noninstitutionalized children adopted from Romania and with nondeprived within-U.K. ado...
Longitudinal analyses on normal versus impaired functioning across 7 domains were conducted in children who had experienced profound institutional deprivation up to the age of 42 months and were adopted from Romania into U.K. families. Comparisons were made with noninstitutionalized children adopted from Romania and with nondeprived within-U.K. ado...
There are many postulates of a relation between quality of attachment with theory of mind and language functions (e.g., de Rosnay & Hughes, 2006). The current study examined in longitudinal design how different patterns of attachment are associated with usage of internal state language at ages 17, 23, 30 and 36 months. Transcripts of mother—child p...
Disinhibited attachment is an important sequel of an institutional rearing, but questions remain regarding its measurement, its persistence, the specificity of the association with institutional rearing and on whether or not it constitutes a meaningful disorder.
Children initially reared in profoundly depriving institutions in Romania and subsequen...
There is uncertainty about the extent to which language skills are part of general intelligence and even more uncertainty on whether deprivation has differential effects on language and non-language skills.
Language and cognitive outcomes at 6 and 11 years of age were compared between a sample of 132 institution-reared Romanian children adopted int...