Signs of attachment disorders and social functioning among early adolescents with a history of institutional care

Abstract

Background: Institutional rearing is associated with increased risk for reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED). Disorders of attachment involve disturbances in children's primary caregiving relationships, and are likely to disturb multiple domains of social functioning. Objective: To examine associations between signs of RAD and DSED and social functioning in early adolescence. Participants and setting: Our participants were 110 children with a history of institutional rearing and 50 community comparison adolescents from the Bucharest Early Intervention Project, based in Bucharest, Romania. Participants were assessed at age 12 years (M age in years=12.80, SD=0.71). Method: Signs of RAD and DSED were obtained through caregiver report. Reports of social functioning were provided by caregivers and teachers. General and specific domains of social functioning were identified using bi-factor modeling. A general social functioning factor and four specific factors were revealed: peer conflict, caregiver views as victim, teacher views as victim, and social competence. Results: Signs of RAD predicted poorer general social functioning (β=−.36, p<.01, 95% confidence interval [CI] [−.33, −.09]) and poorer social competence (β=−.38, p<.01, 95% CI[−.05, −.01]) above and beyond time spent in institutional care and placement disruptions. Signs of DSED (β=−.38, p<.001, 95% CI[−.49, −.16]) along with placement disruptions (β=−.22, p<.05, 95% CI[−.29, −.01]) predicted poorer general social functioning above and beyond time spent in institutional care. Signs of DSED predicted higher scores on caregiver views as victim (β=.29, p<.

Social communication deficits following early‐life deprivation and relation to psychopathology: a randomized clinical trial of foster care

“…However, unlike noninstitutionalized youth who tend to become withdrawn or socially avoidant following victimization, postinstitutionalized youth demonstrate significantly more disinhibited behavior (Pitula et al, 2014). This is consistent with recent work from our group that shows higher levels of disinhibited social engagement disorder among institutionally-reared children which is, in turn, related to lower social competence (Guyon-Harris, Humphreys, Fox, Nelson, & Zeanah, 2018, 2019. While not a primary goal of the current study, supplementary analysis showed that more SC difficulties at age 8 (and to a lesser extent at age 16) are related to multiple behavioral problems at age 16, including signs of disinhibited social engagement disorder, reactive attachment disorder, and ADHD, even after controlling for general psychopathology risk (Table S8).…”

Friendship and social functioning following early institutional rearing: The role of ADHD symptoms

“…Other forms of psychopathology that are known to be associated with the absence of adequate caregiving, specifically reactive attachment disorder and disinhibited social engagement disorder (DSED; American Psychiatric Association, 2013), have been examined as potential correlates or predictors of social functioning in children with institutional care exposure (Guyon-Harris, Humphreys, Fox, Nelson, & Zeanah, 2018b; Sonuga-Barke et al, 2010). However, symptoms of these disorders are relatively rare in later childhood and early adolescence (Gleason et al, 2011; Guyon-Harris et al, 2018; Guyon-Harris, Humphreys, Fox, Nelson, & Zeanah, 2018a).…”

Reactive Attachment Disorder Symptoms and Prosocial Behavior in Middle Childhood: The Role of Secure Base Script Knowledge&nbsp;

“…The rst item explained 51.83% (factor loading = 0.76), the second explained 28.80% (factor loading = .80) and the third item explained 19.37% (factor loading = .51) of the variance in this pictorial Secure Base Script knowledge test. All three items thus reach factor loadings above 40,. which is argued as acceptable for measures with such a small number of items [58].…”