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The impact of childhood deprivation on adult neuropsychological functioning is associated with ADHD symptom persistence

Published online by Cambridge University Press:  18 May 2020

Dennis Golm Open the ORCID record for Dennis Golm [Opens in a new window] ,
Sagari Sarkar ,
Nuria K. Mackes ,
Graeme Fairchild ,
Mitul A. Mehta ,
Michael Rutter ,
Edmund J. Sonuga-Barke  and
ERA Young Adult Follow Up study team
Dennis Golm
Affiliation:
Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK
Sagari Sarkar
Affiliation:
Cognitive Neuroscience & Neuropsychiatry Section, University College London, London, UK
Nuria K. Mackes
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
Graeme Fairchild
Affiliation:
Department of Psychology, University of Bath, Bath, UK
Mitul A. Mehta
Affiliation:
Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Michael Rutter
Affiliation:
MRC Social Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
Edmund J. Sonuga-Barke*
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark
*
Author for correspondence: Edmund J. Sonuga-Barke, E-mail: edmund.sonuga-barke@kcl.ac.uk
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Abstract

Background

Institutional deprivation in early childhood is associated with neuropsychological deficits in adolescence. Using 20-year follow-up data from a unique natural experiment – the large-scale adoption of children exposed to extreme deprivation in Romanian institutions in the 1980s –we examined, for the first time, whether such deficits are still present in adulthood and whether they are associated with deprivation-related symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).

Methods

Adult neuropsychological functioning was assessed across five domains (inhibitory control, emotion recognition, decision-making, prospective memory and IQ) in 70 previously institutionalized adoptees (mean age = 25.3, 50% female) and 22 non-deprived UK adoptees (comparison group, mean age = 24.6, 41% female). ADHD and ASD symptoms were assessed using parent-completed questionnaires.

Results

Early institutionalization was associated with impaired performance on all tasks in adulthood. Prospective memory deficits persisted after controlling for IQ. ADHD and ASD symptoms were positively correlated. After controlling for ASD symptoms, ADHD symptoms remained associated with deficits in IQ, prospective memory, proactive inhibition, decision-making quality and emotion recognition. ASD symptoms were not independently associated with neuropsychological deficits when accounting for their overlap with ADHD symptoms. Multiple regression analysis revealed that the link between childhood deprivation and adult ADHD symptoms was statistically explained by deprivation-related differences in adult IQ and prospective memory.

Conclusions

These results represent some of the most compelling evidence to date of the enduring power of early, time-limited childhood adversity to impair long-term neuropsychological functioning across the lifespan – effects that are linked specifically to deprivation-related adult ADHD symptoms.

Keywords

ADHDchildhood neglectinstitutional deprivationmaltreatmentprospective memory
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 15 , November 2021 , pp. 2675 - 2684
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

*

The ERA young adult follow-up team is Edmund Sonuga-Barke, Mark Kennedy, Jana Kreppner, Nicky Knights, Robert Kumsta, Barbara Maughan and Wolff Schlotz.

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