Behavior Problems in Children Adopted from Psychosocially Depriving Institutions

ArticleinJournal of Abnormal Child Psychology 38(4):459-70 · May 2010with20 Reads
DOI: 10.1007/s10802-009-9383-4 · Source: PubMed
Abstract
Behavior problems were investigated in 342 6- to 18-year-old children adopted from psychosocially depriving Russian institutions that provided adequate physical resources but not consistent, responsive caregiving. Results indicated that attention and externalizing problems were the most prevalent types of behavior problems in the sample as a whole. Behavior problem rates increased with age at adoption, such that children adopted at 18 months or older had higher rates than never-institutionalized children but younger-adopted children did not. There was a stronger association between age at adoption and behavior problems during adolescence than at younger ages at assessment. Children adopted from psychosocially depriving institutions had lower behavior problem rates than children adopted from severely depriving Romanian institutions in the 1990s. The implications of these results are that early psychosocial deprivation is associated with behavior problems, children exposed to prolonged early deprivation may be especially vulnerable to the developmental stresses of adolescence, and severe institutional deprivation is associated with a higher percentage of behavior problems after a shorter duration of exposure.
    • "To date, the most compelling evidence for a predominantly social/ environmental pathway to ADHD comes from studies of children exposed to nonfamily-related adversity (as found, e.g., in institutional settings) and then placed with adoptive or foster families (van IJzendoorn et al., 2011). Elevated levels of inattention and hyperactivity/impulsivity have been reported in different institutionalised populations (Loman et al., 2013; McLaughlin et al., 2010 McLaughlin et al., , 2014 Roy, Rutter, & Pickles, 2004; Wiik et al., 2011), with effects growing stronger as a function of duration of institutional care and severity of deprivation experienced (Merz & McCall, 2010). Evidence from the English and Romanian Adoptees (ERA) study is especially compelling in this regard (). "
    [Show abstract] [Hide abstract] ABSTRACT: 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 extremely depriving Romanian orphanages. Methods: We estimated rates of ADHD at age 15 years and in young adulthood (ages 22-25 years) in individuals at low (LoDep; nondeprived UK adoptees and Romanian adoptees with less than 6-month institutional exposure) and high deprivation-related risk (HiDep; Romanian adoptees with more than 6-month exposure). Estimates were based on parent report using DSM-5 childhood symptom and impairment criteria. At age 15, data were available for 108 LoDep and 86 HiDep cases, while in young adulthood, the numbers were 83 and 60, respectively. Data on education and employment status, IQ, co-occurring symptoms of young adult disinhibited social engagement (DSE), autism spectrum disorder (ASD), cognitive impairment, conduct disorder (CD), callous-unemotional (CU) traits, anxiety, depression and quality of life (QoL) were also collected. Results: ADHD rates in the LoDep group were similar to the general population in adolescence (5.6%) and adulthood (3.8%). HiDep individuals were, respectively, nearly four (19%) and over seven (29.3%) times more likely to meet criteria, than LoDep. Nine 'onset' young adult cases emerged, but these had a prior childhood history of elevated ADHD behaviours at ages 6, 11 and 15 years. Young adult ADHD was equally common in males and females, was predominantly inattentive in presentation and co-occurred with high levels of ASD, DSE and CU features. ADHD was associated with high unemployment and low educational attainment. Conclusion: We provide the first evidence of a strong persistence into adulthood of a distinctively complex and impairing deprivation-related variant of ADHD. Our results confirm the powerful association of early experience with later development in a way that suggests a role for deep-seated alterations to brain structure and function.
    Article · Jun 2016 · Development and Psychopathology
    • "the literature on how these risk factors modulate the effects of institutionalization on children's outcomes is inconclusive. Thus, the relatively few studies that evaluated the contribution of pre-institutional risk factors, such as low birth weight and fetal alcohol exposure, showed mixed results (Beverly, McGuinness, & Blanton, 2008; Merz & McCall, 2010; Miller et al., 2007). A group of recent studies evaluated the contribution of pre-institutional risk factors and those of institutionalization to indiscriminate social behavior (Soares et al., 2014), social withdrawal ( ), and physical growth trajectories (Martins et al., 2013) in institutionalized children in Portugal. "
    [Show abstract] [Hide abstract] ABSTRACT: The present study sought to compare 4 groups of age- and gender-matched children-(a) those reared in institutions for children without parental care in Russia; (b) those raised by their biological parents in Russia; (c) those adopted to the United States from Russian institutions; and (d) those born in the United States and raised by their biological parents-on indicators of cognition, language, and early learning. In addition, we aimed to compare the effects of the length of time spent in an institution, the age of initial placement in an institution, the age at adoption, and pre-institutional risk factors (i.e., prenatal substance exposure and prematurity and low birth weight) on the above-mentioned outcomes in the 2 groups of children with institutionalization experiences. Our results confirm previous reports demonstrating negative consequences of institutionalization and substantial ameliorating effects of adoption. They also underscore the complexity of the effects of institutionalization and adoption, showing that they are intertwined with the effects of pre-institutional risk factors. (PsycINFO Database Record
    Article · Apr 2016
    • "Differences for age at placement into families were generally infrequent, despite a literature that shows such effects are fairly common in general (Julian, 2013 ) and for Russian children in particular (Hawk & McCall, 2011; Merz & McCall, 2010 Muhamedrahimov et al., 2014). An exception was that older-placed children had higher mean scores on all but one subscale of the CBCL than did children placed at younger ages, and they had an especially high percentage of extremely poor scores (46.7% vs. 21.1%) on the CBCL attention problems scale. "
    [Show abstract] [Hide abstract] ABSTRACT: A total of 149 children, who spent an average of 13.8 months in Russian institutions, were transferred to Russian families of relatives and nonrelatives at an average age of 24.7 months. After residing in these families for at least 1 year (average = 43.2 months), parents reported on their attachment, indiscriminately friendly behavior, social–emotional competencies, problem behaviors, and effortful control when they were 1.5–10.7 years of age. They were compared to a sample of 83 Russian parents of noninstitutionalized children, whom they had reared from birth. Generally, institutionalized children were rated similarly to parent-reared children on most measures, consistent with substantial catch-up growth typically displayed by children after transitioning to families. However, institutionalized children were rated more poorly than parent-reared children on certain competencies in early childhood and some attentional skills. There were relatively few systematic differences associated with age at family placement or whether the families were relatives or nonrelatives. Russian parent-reared children were rated as having more problem behaviors than the US standardization sample, which raises cautions about using standards cross-culturally.
    Full-text · Article · Feb 2016
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