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Adoptees’ responses to separation from, and reunion with, their adoptive parent at age 4 years is associated with long-term persistence of autism symptoms following early severe institutional deprivation

Published online by Cambridge University Press:  13 June 2019

Edmund Sonuga-Barke ,
Mark Kennedy ,
Dennis Golm ,
Nicky Knights ,
Hanna Kovshoff ,
Jana Kreppner ,
Robert Kumsta ,
Barbara Maughan ,
Thomas G. O'Connor  and
Wolff Schlotz
Edmund Sonuga-Barke*
Affiliation:
Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
Mark Kennedy
Affiliation:
Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
Dennis Golm
Affiliation:
Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
Nicky Knights
Affiliation:
Amy Winehouse Foundation, London, UK
Hanna Kovshoff
Affiliation:
Department of Psychology, University of Southampton, Southampton, UK
Jana Kreppner
Affiliation:
Department of Psychology, University of Southampton, Southampton, UK
Robert Kumsta
Affiliation:
Department of Genetic Psychology, Faculty of Psychology, Ruhr-University Bochum, Bochum, Germany
Barbara Maughan
Affiliation:
Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Thomas G. O'Connor
Affiliation:
Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
Wolff Schlotz
Affiliation:
Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany.
*
Author for Correspondence: Edmund J. S. Sonuga-Barke, Department of Child & Adolescent Psychiatry, Institute of Psychology, Psychiatry & Neuroscience, 16 DeCrespigny Park LondonSE5 8AF, United Kingdom; E-mail: edmund.sonuga-barke@kcl.ac.uk.
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Abstract

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 neurodevelopmental symptoms were examined. Age 4 attachment status was determined for 97 Romanian adoptees exposed to up to 24 months of deprivation in Romanian orphanages and 49 nondeprived UK adoptees. Autism, inattention/overactivity and disinhibited-social-engagement symptoms, emotional problems, and IQ were measured at 4, 6, 11, and 15 years and in young adulthood. Romanian adoptees with over 6 months deprivation (Rom>6) were more often classified as INS/OTH than UK and Romanian adoptees with less than 6 months deprivation combined. INS/OTH was associated with cognitive impairment at age 4 years. The interaction between deprivation, attachment status, and age for autism spectrum disorder assessment was significant, with greater symptom persistence in Rom>6 INS/OTH(+) than other groups. This effect was reduced when IQ at age 4 was controlled for. Age 4 INS/OTH in Rom>6 was associated with worse autism spectrum disorder outcomes up to two decades later. Its association with cognitive impairment at age 4 is consistent with INS/OTH being an early marker of this negative developmental trajectory, rather than its cause.

Keywords

adversityinsecure otherinstitutional deprivationlongitudinalRomanian adoptees
Type
Regular Articles
Information
Development and Psychopathology , Volume 32 , Issue 2 , May 2020 , pp. 631 - 640
Copyright
Copyright © Cambridge University Press 2019

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