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Adult disinhibited social engagement in adoptees exposed to extreme institutional deprivation: examination of its clinical status and functional impact

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      Abstract

      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 their impact on, functioning in adulthood.

      Aims

      We examine these issues in the young adult follow-up of the English and Romanian Adoptees study.

      Method

      A total of 122 of the original 165 Romanian adoptees who had spent up to 43 months as children in Ceauşescu's Romanian orphanages and 42 UK adoptees were assessed for DSE behaviours, neurodevelopmental and mental health problems, and impairment between ages 2 and 25 years.

      Results

      Young adult DSE behaviour was strongly associated with early childhood deprivation, with a sixfold increase for those who spent more than 6 months in institutions. However, although DSE overlapped with autism spectrum disorder and attention-deficit hyperactivity disorder symptoms it was not, in itself, related to broader patterns of mental health problems or impairments in daily functioning in young adulthood.

      Conclusions

      DSE behaviour remained a prominent, but largely clinically benign, young adult feature of some adoptees who experienced early deprivation.

      Related collections

      Most cited references 35

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      The inventory of parent and peer attachment: Individual differences and their relationship to psychological well-being in adolescence.

      The results of two studies are reported. Study I involved the development of the Inventory of Parent and Peer Attachment (IPPA), a self-report instrument for use with adolescents. Subject were 179 college students aged 16-20 years. Item content of the instrument was suggested by attachment theory's formulations concerning the nature of feelings toward attachment figures. In Study II, the convergent validity of the IPPA was examined. Also, a hierarchial regression model was employed to investigate the association between quality of attachment and self-esteem, life-satisfaction, and affective status. Respondents were 86 adolescents from the Study I sample. As hypothesized, perceived quality of both parent and peer attachments was significantly related to psychological well-being. Results of the development of a theoretically focused, exploratory classification scheme indicated that adolescents classified as highly securely attached reported greater satisfaction with themselves, a higher likelihood of seeking social support, and less symptomatic response to stressful life events.
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        Callous-unemotional traits in a community sample of adolescents.

        This study examined the structure, distribution, and correlates of a new measure of self-reported callous-unemotional (CU) traits in 1,443 adolescents (774 boys, 669 girls) between the ages of 13 to 18 years. The Inventory of Callous-Unemotional Traits was subjected to exploratory factor analysis and confirmatory factor analysis. Exploratory factor analysis produced three factors: callousness, uncaring, and unemotional. Fit indexes suggested that the three-factor model, with a single higher-order factor, represented a satisfactory solution for the data. This factor structure fits well for both boys and girls. CU traits correlated significantly with measures of conduct problems and psychosocial impairment. Furthermore, the traits showed predicted associations with sensation seeking and the Big Five personality dimensions, supporting the construct validity of the measure of CU traits.
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          Annual Research Review: Enduring neurobiological effects of childhood abuse and neglect.

          Childhood maltreatment is the most important preventable cause of psychopathology accounting for about 45% of the population attributable risk for childhood onset psychiatric disorders. A key breakthrough has been the discovery that maltreatment alters trajectories of brain development.
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            Author and article information

            Affiliations
            Mark Kennedy, PhD, Developmental Brain-Behaviour Laboratory, Department of Psychology, University of Southampton, Southampton and Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Jana Kreppner, PhD, Developmental Brain-Behaviour Laboratory, Department of Psychology, University of Southampton, Southampton, UK; Nicky Knights, PhD, The Amy winehouse Foundation, London, UK; Robert Kumsta, PhD, Department of Genetic Psychology, Faculty of Psychology, Ruhr-University Bochum, Germany; Barbara Maughan, PhD, MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Dennis Golm, PhD, Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Jonathan Hill, PhD, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK; Michael Rutter, MD, MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Wolff Schlotz, PhD, Max-Planck-Institute for Empirical Aesthetics, Frankfurt am Main, Germany; Edmund Sonuga-Barke, PhD, Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
            Author notes
            Correspondence: Edmund J. S. Sonuga-Barke, Department of Child and Adolescent Psychiatry, PO85, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London SE5 8AF, UK. Email: edmund.sonuga-barke@ 123456kcl.ac.uk
            Journal
            Br J Psychiatry
            Br J Psychiatry
            bjprcpsych
            The British Journal of Psychiatry
            Royal College of Psychiatrists
            0007-1250
            1472-1465
            November 2017
            November 2017
            : 211
            : 5
            : 289-295
            28935662 5663971 10.1192/bjp.bp.117.200618
            © The Royal College of Psychiatrists 2017.

            This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence.

            Product
            Funding
            Funded by: UK Economic Social Research Council
            Award ID: ESRC; RES-062-23-3300
            Categories
            Papers

            Clinical Psychology & Psychiatry

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