Specificity and heterogeneity in children's responses to profound institutional privation

Rutter, Michael; Kreppner, Jana; O’Connor, Thomas G.

doi:10.1192/bjp.179.2.97

Cited by 335 publications

(290 citation statements)

References 24 publications

(31 reference statements)

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“…It proved surprising, however, that these institutional features did not predict ADHD symptoms, especially given results of related investigations [8,9]. We are not the first to fail to document such seemingly anticipated associations, however, thereby calling attention to methodological differences across inquiries that could account for variation in results.…”

Section: Discussionmentioning

confidence: 75%

“…We are not the first to fail to document such seemingly anticipated associations, however, thereby calling attention to methodological differences across inquiries that could account for variation in results. Recall that in our own and in Zeanah and colleagues' [6] work, the focus was on children still institutionalized, whereas other research focused on previously institutionalized children, living with their adoptive families [8,9]. Another factor to consider in entertaining reasons for divergent results across studies is that the absence of an effect of duration of deprivation on ADHD may be attributable to the fact that all children from the current study were institutionalized for no less than 6 months and this was by no means the case in other work.…”

Section: Discussionmentioning

confidence: 94%

“…In fact, recent work indicates that institution-reared children, relative to their family-raised peers, have a higher incidence of ADHD symptoms of inattention and hyperactivity [4][5][6], with problems persisting years after they have departed the institution, often due to adoption [7][8][9][10]. Such high prevalence and resistance to intervention led some to argue that these difficulties represent a persistent impairment and constitute a specific deprivation syndrome associated with institutional rearing [11,12].…”

Section: Introductionmentioning

confidence: 99%

“…Thus, not all children exposed to institutional care, even for 6 months or more, evince signs of attention problems and hyperactivity [8,9]. This certainly calls attention to the need to consider non-institutional factors as contributors to the development of attention problems and hyperactivity.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Serotonin transporter polymorphism moderates the effects of caregiver intrusiveness on ADHD symptoms among institutionalized preschoolers

Baptista

Belsky

Mesquita

et al. 2016

Eur Child Adolesc Psychiatry

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Serotonin transporter polymorphism moderates the effects of caregiver intrusiveness on ADHD symptoms among institutionalized preschoolers

Baptista

Belsky

Mesquita

et al. 2016

Eur Child Adolesc Psychiatry

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“…6 The corollary has also been studied and Rutter has written extensively on the detrimental effects of institutionalisation. 7,8 The report itself cites a number of studies to support the case for community living both from a quality of life and costeffectiveness point of view. [9][10][11][12] However a study by Kozma, Mansell and Beadle-Brown is also mentioned in the report.…”

Section: Deinstitutionalisation Is Generally a Good Thingmentioning

confidence: 99%

Deinstitutionalisation – time to move on to legislation?

Carrigan¹

2011

Ir. j. psychol. Med.

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The report represents a significant step forward in promoting the deinstitutionalisation agenda in Ireland, with its core recommendations being that all individuals with a disability living in 'congregated settings' (a residential setting where the person lives with 10 or more people) should be moved into the community and that the institutional settings in which they live should be closed.The General summary of the reportThe report has 31 recommendations. These describe a new model of support for people with disabilities in the community. The plan is to move individuals from institutional care to dispersed forms of housing in ordinary communities. The housing would be provided by local authorities and the individuals would access mainstream health and social services such as GP, home help and public health nursing. Other specialised services and hospital services would be provided based on individualised assessments.Ten of the recommendations directly refer to the financial resources required for the successful implementation of the report through funding support structures, purchasing and building accommodation and the provision of extra social welfare benefits for the group. It also notes that the disability budgets have been "reduced by a minimum of 5% in the period 2008-2010 and there is now less flexibility within budgets to fund further movement into the community within existing resources". 5 Deinstitutionalisation is generally a good thingCertainly the evidence internationally is that, in general, individuals with disabilities do better outside the institutional setting. One study by Young in 2006 of people with moderate to severe intellectual disability showed increased adaptive behaviour, choice-making and life quality in a group followed up after discharge from institutional living into a community setting. 6 The corollary has also been studied and Rutter has written extensively on the detrimental effects of institutionalisation. 7,8 The report itself cites a number of studies to support the case for community living both from a quality of life and costeffectiveness point of view. 9-12 However a study by Kozma, Mansell and Beadle-Brown is also mentioned in the report. In it 67 papers published between 1997 and 2007 were reviewed. In seven out of 10 areas (community presence and participation, social networks and friendships, family contact, self-determination and choice, quality of life, adaptive behaviour, user and family views and satisfaction) the majority of studies showed that community living was superior to institutional care.In three areas (challenging behaviour, psychotropic medication and health, risks and mortality) research reported mixed or worse results. 13 People with higher support needs -whether because of the nature of their intellectual and physical disabilities, their challenging behaviour or social impairment, often experience less good outcomes in the community than people who are more independent. 14 In the general context of deinstitutionalisation, they are also typically the...

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Alterations in Neural Processing and Psychopathology in Children Raised in Institutions

Slopen

McLaughlin

Zeanah

et al. 2012

Arch Gen Psychiatry

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Context Children raised in institutional settings often experience severe deprivation in social, emotional, and cognitive stimulation. Although this deprivation is likely to disrupt brain development in ways that increase risk for psychopathology, neurodevelopmental mechanisms linking adverse early environments to psychopathology remain poorly understood. Objective To examine whether abnormalities in the neural processing of facial and emotional stimuli are related to the high rates of psychopathology observed among institutionally reared children. Design, Setting, and Participants Data were drawn from the Bucharest Early Intervention Project, a cohort of children raised in institutions in Romania and an age-matched sample of community control subjects. At entry to the study (mean age=22 months), event-related potentials (ERPs) were used to measure neural processing in two tasks: familiar and unfamiliar faces (n=114), and facial displays of emotion (n=74). Main Outcome Measure Psychiatric symptoms were assessed using the Preschool Age Psychiatric Assessment (PAPA) at 54 months. Results As previously reported, institutionally-reared children had elevated symptoms of attention deficit/hyperactivity (ADHD), anxiety, depression, and disruptive behavior compared to control children and peak amplitudes of the P100 and P700 in response to facial stimuli were blunted among institutionalized children compared to community children in both tasks. Current analyses reveal that children with reduced P100 and P700 amplitudes in response to facial stimuli exhibited higher levels of ADHD and anxiety symptoms. Peak amplitude of the P700 in response to facial stimuli significantly mediated the association between institutional rearing and ADHD symptoms at 54 months. Conclusion Exposure to institutional rearing disrupts the P700, conferring risk for the onset of psychopathology. The high levels of ADHD symptoms among children exposed to early-life deprivation may be attributable, in part, to abnormal patterns of neurodevelopment generated by these adverse rearing environments.

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Specificity and heterogeneity in children's responses to profound institutional privation

Abstract: Attachment disorder behaviours, inattention/overactivity and quasi-autistic behaviour constitute institutional privation patterns.

Cited by 335 publications

References 24 publications

Serotonin transporter polymorphism moderates the effects of caregiver intrusiveness on ADHD symptoms among institutionalized preschoolers

Serotonin transporter polymorphism moderates the effects of caregiver intrusiveness on ADHD symptoms among institutionalized preschoolers

Deinstitutionalisation – time to move on to legislation?

Alterations in Neural Processing and Psychopathology in Children Raised in Institutions

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