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Pasalich DS, Aquilina B, Hassall A, Goulter N, Xyrakis N, Khoo A. Childhood Experiences of Alternative Care and Callousness/Unemotionality: A Conceptual Model, Scoping Review, and Research Agenda. Clin Child Fam Psychol Rev 2023; 26:789-804. [PMID: 37436541 PMCID: PMC10465668 DOI: 10.1007/s10567-023-00445-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2023] [Indexed: 07/13/2023]
Abstract
Individuals with experiences of alternative care (AC; i.e., out-of-home care and institutional care) are at high risk for various mental health and relational problems stemming from exposure to serious attachment disruptions, loss, and complex trauma. Yet, despite the interpersonal context of their significant adversities, surprisingly there is scant research explicitly focusing on callousness/unemotionality (e.g., lack of guilt, callous disregard for others) in this population. This paper provides the first conceptual model for, and systematic scoping review of, callousness/unemotionality in children and young people with experiences of AC. In a comprehensive search of nine databases, 22 articles involving samples of participants in AC or with histories of AC, were identified for inclusion. The pattern of findings revealed that callous-unemotional and psychopathic traits are elevated in children and young people with AC experiences, and positively associated with AC. Moreover, results showed associations between these traits and various psychosocial correlates, most consistently with externalizing and internalizing problems and attachment-related problems. Only two intervention studies were located, one of which found benefits of training and supporting foster caregivers for reducing callous-unemotional traits. These findings are discussed with respect to gaps in the literature, future research directions, and trauma-informed practice to assess and treat callousness/unemotionality in children and young people with experiences of AC.
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Affiliation(s)
- Dave S Pasalich
- School of Medicine and Psychology, Australian National University, Building 39, Science Rd, ACT 2601, Canberra, Australia.
| | - Benjamin Aquilina
- School of Medicine and Psychology, Australian National University, Building 39, Science Rd, ACT 2601, Canberra, Australia
| | - Alison Hassall
- School of Medicine and Psychology, Australian National University, Building 39, Science Rd, ACT 2601, Canberra, Australia
| | - Natalie Goulter
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
| | - Nakiya Xyrakis
- School of Medicine and Psychology, Australian National University, Building 39, Science Rd, ACT 2601, Canberra, Australia
| | - Anderson Khoo
- School of Medicine and Psychology, Australian National University, Building 39, Science Rd, ACT 2601, Canberra, Australia
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2
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Todorov JJ, Devine RT, De Brito SA. Association between childhood maltreatment and callous-unemotional traits in youth: A meta-analysis. Neurosci Biobehav Rev 2023; 146:105049. [PMID: 36681371 DOI: 10.1016/j.neubiorev.2023.105049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/15/2022] [Accepted: 01/14/2023] [Indexed: 01/21/2023]
Abstract
Callous-unemotional (CU) traits (i.e., lack of remorse or guilt, callous lack of empathy, deficient concern for the feelings of others) in youth with conduct problems confer risk for a particularly severe and persistent form of antisocial behaviour. Previous research has linked childhood maltreatment as a potential risk factor for CU traits, both primary (i.e., genetically underpinned) and secondary (i.e., environmentally influenced) variants, but findings have been inconsistent, and the association has not yet been tested in a meta-analysis. To address this gap, we conducted a meta-analysis to assess the nature and strength of the associations between childhood maltreatment and its subtypes with CU traits and potential variants (i.e., primary and secondary CU traits). A systematic search identified 29 eligible studies including 9,894 participants (42% female) between the ages of 3 and 18 years (Mage=14.22 years, SD = 1.07). Results revealed a significant moderate positive association between childhood maltreatment and CU traits. All subtypes of maltreatment bar sexual abuse were significantly associated with CU traits. However, it was not possible to compare primary and secondary CU traits directly due to inconsistencies in how they are defined. The limitations posed by current research signal the need for clinical and operational guidelines on how to define primary and secondary CU traits. Additionally, prospective longitudinal, genetically informed research is needed to clarify if maltreatment is a causal risk factor for CU traits.
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Affiliation(s)
- Jessica J Todorov
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK.
| | - Rory T Devine
- Centre for Developmental Science, School of Psychology, University of Birmingham, UK
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK.
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3
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Petrican R, Paine AL, Escott-Price V, Shelton KH. Overlapping brain correlates of superior cognition among children at genetic risk for Alzheimer's disease and/or major depressive disorder. Sci Rep 2023; 13:984. [PMID: 36653486 PMCID: PMC9849214 DOI: 10.1038/s41598-023-28057-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Early life adversity (ELA) tends to accelerate neurobiological ageing, which, in turn, is thought to heighten vulnerability to both major depressive disorder (MDD) and Alzheimer's disease (AD). The two conditions are putatively related, with MDD representing either a risk factor or early symptom of AD. Given the substantial environmental susceptibility of both disorders, timely identification of their neurocognitive markers could facilitate interventions to prevent clinical onset. To this end, we analysed multimodal data from the Adolescent Brain and Cognitive Development study (ages 9-10 years). To disentangle genetic from correlated genetic-environmental influences, while also probing gene-adversity interactions, we compared adoptees, a group generally exposed to substantial ELA, with children raised by their biological families via genetic risk scores (GRS) from genome-wide association studies. AD and MDD GRSs predicted overlapping and widespread neurodevelopmental alterations associated with superior fluid cognition. Specifically, among adoptees only, greater AD GRS were related to accelerated structural maturation (i.e., cortical thinning) and higher MDD GRS were linked to delayed functional neurodevelopment, as reflected in compensatory brain activation on an inhibitory control task. Our study identifies compensatory mechanisms linked to MDD risk and highlights the potential cognitive benefits of accelerated maturation linked to AD vulnerability in late childhood.
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Affiliation(s)
- Raluca Petrican
- Institute of Population Health, Department of Psychology, University of Liverpool, Bedford Street South, Liverpool, L69 7ZA, UK.
| | - Amy L Paine
- School of Psychology, Cardiff University, 70 Park Place, Cardiff, CF10 3AT, UK
| | - Valentina Escott-Price
- Division of Neuroscience and Mental Health, School of Medicine, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Katherine H Shelton
- School of Psychology, Cardiff University, 70 Park Place, Cardiff, CF10 3AT, UK
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Turner F, Kainth G, MacDonald S, O'Connor R, Crawford K, Minnis H. "I will commit to this child as much as I can for the time that they are with me:" A qualitative examination of how foster carer commitment relates to short-term foster care for young children following abuse and neglect. CHILD ABUSE & NEGLECT 2023; 135:105983. [PMID: 36525826 DOI: 10.1016/j.chiabu.2022.105983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 09/27/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Foster carer commitment to the child has been shown to be of paramount importance in young children's recovery and development following abuse and neglect. In Dozier's definition of commitment in the US, there is a focus on both emotional investment in the child and committing to an enduring relationship with the child. How this relates to the routine practice of short-term, temporary, foster care has not been studied. OBJECTIVE This is the first qualitative study to explore the drivers of, and barriers to, commitment in short-term foster care within the broader aim of examining whether short-term care is meeting the needs of maltreated young children. PARTICIPANTS & SETTING Fourteen foster carers took part in research interviews and five focus groups were conducted with infant mental health professionals. METHODS Interviews and focus group data were subject to qualitative thematic analysis in order to identify patterns of commonality in relation to our research questions. RESULTS Three broad themes pertain to commitment and the meeting of young children's needs in short-term foster care: Influence, Timescales and Choice in the fostering role. These themes were found to house both drivers of, and barriers to, commitment in short-term care, which are influenced by systemic normalisations of fostering practices. CONCLUSIONS The emotional investment facet of commitment is more alive in the 'psyche' of short-term foster care than commitment to an enduring relationship. A long-term outlook for the child may be an undefined facet of commitment that is more akin with short-term placements.
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Affiliation(s)
- Fiona Turner
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK.
| | - Gary Kainth
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK.
| | - Sara MacDonald
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK.
| | - Rory O'Connor
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK.
| | - Karen Crawford
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK.
| | - Helen Minnis
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK.
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Northam JC, Fisher CA, Burman C, Hawes DJ, Dadds MR. No hard feelings: maternal emotion socialization and callous-unemotional traits in children. Eur Child Adolesc Psychiatry 2022; 31:1983-1993. [PMID: 34184116 DOI: 10.1007/s00787-021-01835-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 06/23/2021] [Indexed: 01/26/2023]
Abstract
Parents' identification and discussion of their own and their children's emotions are important emotion socialization behaviors (ESBs) that may mitigate child conduct problems (CPs). However, if parents perceive their child to be relatively unemotional, which may be the case for children with conduct problems and high callous-unemotional traits (CP + CU), these parents may be limited in their capacity to use ESBs effectively. This study tested these questions by looking at ESBs in mothers (N = 145) of children aged 2-8 years with CP + CU (n = 24), CPs and low CU traits (CP-CU; n = 94) and a non-clinical community sample (n = 27). After watching an emotional movie excerpt, mothers were asked to (1) provide ratings of their child's emotional experience and then (2) engage in a debriefing task with their child about the content. Children's expressed emotion during the excerpt and transcriptions of the debriefing task were coded by masked raters. Unexpectedly, mothers' perceptions of their children's emotion did not vary by group. Emotional ratings provided by mothers of children in the CP + CU group most closely aligned with ratings from independent observers. ESBs did not differ by group in the debriefing task. Mothers of children with CP + CU traits were shown in this study to be reliable reporters of their children's expressed emotion and showed similar rates of parental ESBs as mothers of children in the other groups. Results are discussed in reference to various models of parenting and CU traits that might account for these unexpected findings.
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Affiliation(s)
- Jaimie C Northam
- School of Psychology, The University of Sydney, Sydney, Australia.
| | - Carri A Fisher
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Charlotte Burman
- School of Psychology, The University of Sydney, Sydney, Australia
| | - David J Hawes
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Mark R Dadds
- School of Psychology, The University of Sydney, Sydney, Australia
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Sheridan MA, Mukerji CE, Wade M, Humphreys KL, Garrisi K, Goel S, Patel K, Fox NA, Zeanah CH, Nelson CA, McLaughlin KA. Early deprivation alters structural brain development from middle childhood to adolescence. SCIENCE ADVANCES 2022; 8:eabn4316. [PMID: 36206331 PMCID: PMC9544316 DOI: 10.1126/sciadv.abn4316] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 08/24/2022] [Indexed: 05/21/2023]
Abstract
Hypotheses concerning the biologic embedding of early adversity via developmental neuroplasticity mechanisms have been proposed on the basis of experimental studies in animals. However, no studies have demonstrated a causal link between early adversity and neural development in humans. Here, we present evidence from a randomized controlled trial linking psychosocial deprivation in early childhood to changes in cortical development from childhood to adolescence using longitudinal data from the Bucharest Early Intervention Project. Changes in cortical structure due to randomization to foster care were most pronounced in the lateral and medial prefrontal cortex and in white matter tracts connecting the prefrontal and parietal cortex. Demonstrating the causal impact of exposure to deprivation on the development of neural structure highlights the importance of early placement into family-based care to mitigate lasting neurodevelopmental consequences associated with early-life deprivation.
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Affiliation(s)
- Margaret A. Sheridan
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, 235 E. Cameron Street, Chapel Hill, NC 27599, USA
- Corresponding author.
| | - Cora E. Mukerji
- Department of Psychology, Bryn Mawr College, 101 North Merion Ave, Bryn Mawr, PA 19010, USA
- Division of Developmental Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, USA
| | - Mark Wade
- University of Toronto, Department of Applied Psychology and Human Development, 252 Bloor St. West, Toronto, ON M5S 1V6, Canada
| | - Kathryn L. Humphreys
- Department of Psychology and Human Development, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | - Kathryn Garrisi
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, 235 E. Cameron Street, Chapel Hill, NC 27599, USA
| | - Srishti Goel
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, 235 E. Cameron Street, Chapel Hill, NC 27599, USA
- Department of Psychology, Yale University, Box 208205, New Haven, CT 06520-8205, USA
| | - Kinjal Patel
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, 235 E. Cameron Street, Chapel Hill, NC 27599, USA
| | - Nathan A. Fox
- Department of Human Development, University of Maryland, College Park, MD 20740, USA
| | - Charles H. Zeanah
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1430 Tulane Ave, New Orleans, LA 70112, USA
| | - Charles A. Nelson
- Division of Developmental Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, USA
- Department of Pediatrics, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
- Harvard Graduate School of Education, 13 Appian Way, Cambridge, MA 02138, USA
| | - Katie A. McLaughlin
- Department of Psychology, Harvard University, 33 Kirkland St, Cambridge, MA, 02138, USA
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McGinnis EW, Sheridan M, Copeland W. Impact of dimensions of early adversity on adult health and functioning: A 2-decade, longitudinal study. Dev Psychopathol 2022; 34:527-538. [PMID: 35074038 PMCID: PMC9309184 DOI: 10.1017/s095457942100167x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Recent neurodevelopmental and evolutionary theories offer strong theoretical rationales and some empirical evidence to support the importance of specific dimensions of early adversity. However, studies have often been limited by omission of other adversity dimensions, singular outcomes, and short follow up durations. 1,420 participants in the community, Great Smoky Mountains Study, were assessed up to eight times between age 9 and 16 for four dimensions of early adversity: Threat, Material Deprivation, Unpredictability, and Loss (as well as a Cumulative Adversity measure). Participants were followed up to four times in adulthood (ages 19, 21, 25, and 30) to measure psychiatric disorders, substance disorder, and "real-world" functioning. Every childhood adversity dimension was associated with multiple adult psychiatric, substance, or functional outcomes when tested simultaneously in a multivariable analysis that accounted for other childhood adversities. There was evidence of differential impact of dimensions of adversity exposure on proximal outcomes (e.g., material deprivation and IQ) and even on distal outcomes (e.g., threat and emotional functioning). There were similar levels of prediction between the best set of individual adversity scales and a single cumulative adversity measure when considering distal outcomes. All dimensions of childhood adversity have lasting, pleiotropic effects, on adult health and functioning, but these dimensions may act via distinct proximal pathways.
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Affiliation(s)
| | - Margaret Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
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Reiss D, Ganiban JM, Leve LD, Neiderhiser JM, Shaw DS, Natsuaki MN. Parenting in the Context of the Child: Genetic and Social Processes. Monogr Soc Res Child Dev 2022; 87:7-188. [PMID: 37070594 PMCID: PMC10329459 DOI: 10.1111/mono.12460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 04/19/2023]
Abstract
The focus on the role of parenting in child development has a long-standing history. When measures of parenting precede changes in child development, researchers typically infer a causal role of parenting practices and attitudes on child development. However, this research is usually conducted with parents raising their own biological offspring. Such research designs cannot account for the effects of genes that are common to parents and children, nor for genetically influenced traits in children that influence how they are parented and how parenting affects them. The aim of this monograph is to provide a clearer view of parenting by synthesizing findings from the Early Growth and Development Study (EGDS). EGDS is a longitudinal study of adopted children, their birth parents, and their rearing parents studied across infancy and childhood. Families (N = 561) were recruited in the United States through adoption agencies between 2000 and 2010. Data collection began when adoptees were 9 months old (males = 57.2%; White 54.5%, Black 13.2%, Hispanic/Latinx 13.4%, Multiracial 17.8%, other 1.1%). The median child age at adoption placement was 2 days (M = 5.58, SD = 11.32). Adoptive parents were predominantly in their 30s, White, and coming from upper-middle- or upper-class backgrounds with high educational attainment (a mode at 4-year college or graduate degree). Most adoptive parents were heterosexual couples, and were married at the beginning of the project. The birth parent sample was more racially and ethnically diverse, but the majority (70%) were White. At the beginning of the study, most birth mothers and fathers were in their 20s, with a mode of educational attainment at high school degree, and few of them were married. We have been following these family members over time, assessing their genetic influences, prenatal environment, rearing environment, and child development. Controlling for effects of genes common to parents and children, we confirmed some previously reported associations between parenting, parent psychopathology, and marital adjustment in relation to child problematic and prosocial behavior. We also observed effects of children's heritable characteristics, characteristics thought to be transmitted from parent to child by genetic means, on their parents and how those effects contributed to subsequent child development. For example, we found that genetically influenced child impulsivity and social withdrawal both elicited harsh parenting, whereas a genetically influenced sunny disposition elicited parental warmth. We found numerous instances of children's genetically influenced characteristics that enhanced positive parental influences on child development or that protected them from harsh parenting. Integrating our findings, we propose a new, genetically informed process model of parenting. We posit that parents implicitly or explicitly detect genetically influenced liabilities and assets in their children. We also suggest future research into factors such as marital adjustment, that favor parents responding with appropriate protection or enhancement. Our findings illustrate a productive use of genetic information in prevention research: helping parents respond effectively to a profile of child strengths and challenges rather than using genetic information simply to identify some children unresponsive to current preventive interventions.
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Affiliation(s)
- David Reiss
- Yale Child Study Center, Yale University School of Medicine
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9
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Tang A, McLaughlin KA, Sheridan MA, Nelson C, Zeanah C, Fox NA. Autonomic reactivity to social rejection, peer difficulties, and the buffering effects of adolescent friendships following early psychosocial deprivation. Emotion 2022; 22:318-330. [PMID: 34766790 PMCID: PMC9661887 DOI: 10.1037/emo0001016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Autonomic nervous system reactivity has been posited to be a mechanism contributing to social and emotional problems among children exposed to early adversity. Leveraging data from the Bucharest Early Intervention Project, a longitudinal randomized controlled trial of foster care versus institutional care of abandoned children in Romania, we assessed whether altered sympathetic reactivity to peer rejection feedback in early adolescence mediated the relation between early institutional rearing and peer problems in later adolescence. We also assessed whether adolescent friendship quality or randomized placement in foster care early in life moderated these associations. Participants include 68 institutionalized children randomized to care as usual, 68 institutionalized children randomized to foster care, and 135 never-institutionalized children. At age 12, participants reported friendship quality with respect to a best friend and completed a social rejection task while electrocardiogram and impedance cardiography were recorded. Sympathetic nervous system reactivity to rejection feedback was assessed using preejection period (PEP). At ages 12 and 16, peer problems were reported by parents. Mediation analysis revealed that less PEP reactivity to social rejection at age 12 partially mediated the association between early institutionalization and greater peer problems at age 16. Further moderated mediation analysis revealed that this indirect effect was evidenced among previously institutionalized youths with low, but not high, quality friendships. We did not observe foster care intervention effects. These findings suggest that altered sympathetic reactivity to social rejection might be a mechanism linking early institutionalization to social difficulties into adolescence, however, positive adolescent friendships may buffer these effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Alva Tang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD
| | | | - Margaret A. Sheridan
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charles Nelson
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA,Harvard Graduate School of Education, Cambridge, MA, USA
| | - Charles Zeanah
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD
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Rijnders RJP, Terburg D, Bos PA, Kempes MM, van Honk J. Unzipping empathy in psychopathy: Empathy and facial affect processing in psychopaths. Neurosci Biobehav Rev 2021; 131:1116-1126. [PMID: 34695456 DOI: 10.1016/j.neubiorev.2021.10.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 12/26/2022]
Abstract
Psychopathy is a neurodevelopmental disorder that has a highly deleterious effect upon both individuals and society at large. Psychopaths grossly neglect and disrespect the interests of others. Their antisocial behavior is thought to originate from a lack of empathy. However, empathy is multidimensional in nature, as evidenced by the considerable heterogeneity in extant theorizing on the subject. Here, we present the "Zipper model of empathy" that reconsiders how both its affective and cognitive components converge in mature empathic behavior. Furthermore, the Zipper model of empathy is expedient for explaining the empathy deficits in psychopathy, insofar as it brings together current theories on the dysfunctional affective components of empathy, violence inhibition, and automatic versus goal-directed attention. According to the literature, the neurobiological underpinnings of these theories are amygdala-centered; however, this article traces this specifically to the basolateral and central amygdala subregions. When viewed together, the cognitive and affective components of empathy are zipped together in a natural fashion in healthy empathic behavior, whereas psychopaths leave the zipper substantially unzipped in pursuit of their purely self-centered goals.
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Affiliation(s)
- Ronald J P Rijnders
- Netherlands Institute of Forensic Psychiatry and Psychology, Forensic Observation Clinic "Pieter Baan Centrum", Carl Barksweg 3, 1336 ZL, Almere, the Netherlands; Utrecht University, Faculty of Social Sciences, Department of Psychology, Heidelberglaan 8, 3584 CS, Utrecht, the Netherlands.
| | - David Terburg
- Utrecht University, Faculty of Social Sciences, Department of Psychology, Heidelberglaan 8, 3584 CS, Utrecht, the Netherlands; University of Cape Town, Department of Psychiatry and Mental Health, J-Block, Groote Schuur Hospital, Observatory, 7925, Cape Town, South Africa
| | - Peter A Bos
- Leiden University, Faculty of Social and Behavioural Sciences, Institute of Education and Child Studies, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands
| | - Maaike M Kempes
- Leiden University, Faculty of Social and Behavioural Sciences, Institute of Education and Child Studies, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands; Netherlands Institute of Forensic Psychiatry and Psychology, Department of Science and Education, Herman Gorterstraat 5, 3511 EW, Utrecht, the Netherlands
| | - Jack van Honk
- University of Cape Town, Department of Psychiatry and Mental Health, J-Block, Groote Schuur Hospital, Observatory, 7925, Cape Town, South Africa; University of Cape Town, Institute of Infectious Diseases and Molecular Medicine, Anzio Rd, Observatory, 7925, Cape Town, South Africa
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11
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Zutshi I, Gupta S, Zanoletti O, Sandi C, Poirier GL. Early life adoption shows rearing environment supersedes transgenerational effects of paternal stress on aggressive temperament in the offspring. Transl Psychiatry 2021; 11:533. [PMID: 34657124 PMCID: PMC8520526 DOI: 10.1038/s41398-021-01659-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/25/2021] [Accepted: 10/04/2021] [Indexed: 11/21/2022] Open
Abstract
Prenatal experience and transgenerational influences are increasingly recognized as critical for defining the socio-emotional system, through the development of social competences and of their underlying neural circuitries. Here, we used an established rat model of social stress resulting from male partner aggression induced by peripubertal (P28-42) exposure to unpredictable fearful experiences. Using this model, we aimed to first, characterize adult emotionality in terms of the breadth of the socio-emotional symptoms and second, to determine the relative impact of prenatal vs postnatal influences. For this purpose, male offspring of pairs comprising a control or a peripubertally stressed male were cross-fostered at birth and tested at adulthood on a series of socio-emotional tests. In the offspring of peripubertally stressed males, the expected antisocial phenotype was observed, as manifested by increased aggression towards a female partner and a threatening intruder, accompanied by lower sociability. This negative outcome was yet accompanied by better social memory as well as enhanced active coping, based on more swimming and longer latency to immobility in the forced swim test, and less immobility in the shock probe test. Furthermore, the cross-fostering manipulation revealed that these adult behaviors were largely influenced by the post- but not the prenatal environment, an observation contrasting with both pre- and postnatal effects on attacks during juvenile play behavior. Adult aggression, other active coping behaviors, and social memory were determined by the predominance at this developmental stage of postnatal over prenatal influences. Together, our data highlight the relative persistence of early life influences.
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Affiliation(s)
- Ipshita Zutshi
- Laboratory of Behavioral Genetics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015, Lausanne, Switzerland.
- Neuroscience Institute and Department of Neurology, Langone Medical Center, New York University, New York, NY, USA.
| | - Sonakshi Gupta
- Laboratory of Behavioral Genetics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015, Lausanne, Switzerland
- Pharmacy Department, Birla Institute of Technology & Science Pilani, Hyderabad Campus, Hyderabad, India
| | - Olivia Zanoletti
- Laboratory of Behavioral Genetics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015, Lausanne, Switzerland
| | - Carmen Sandi
- Laboratory of Behavioral Genetics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015, Lausanne, Switzerland.
| | - Guillaume L Poirier
- Laboratory of Behavioral Genetics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015, Lausanne, Switzerland.
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12
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Colich NL, Sheridan MA, Humphreys KL, Wade M, Tibu F, Nelson CA, Zeanah CH, Fox NA, McLaughlin KA. Heightened sensitivity to the caregiving environment during adolescence: implications for recovery following early-life adversity. J Child Psychol Psychiatry 2021; 62:10.1111/jcpp.13347. [PMID: 33215715 PMCID: PMC8134501 DOI: 10.1111/jcpp.13347] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Adolescence has been proposed to be a period of heightened sensitivity to environmental influence. If true, adolescence may present a window of opportunity for recovery for children exposed to early-life adversity. Recent evidence supports adolescent recalibration of stress response systems following early-life adversity. However, it is unknown whether similar recovery occurs in other domains of functioning in adolescence. METHODS We use data from the Bucharest Early Intervention Project - a randomized controlled trial of foster care for children raised in psychosocially depriving institutions - to examine the associations of the caregiving environment with reward processing, executive functioning, and internalizing and externalizing psychopathology at ages 8, 12, and 16 years, and evaluate whether these associations change across development. RESULTS Higher quality caregiving in adolescence was associated with greater reward responsivity and lower levels of internalizing and externalizing symptoms, after covarying for the early-life caregiving environment. The associations of caregiving with executive function and internalizing and externalizing symptoms varied by age and were strongest at age 16 relative to ages 8 and 12 years. This heightened sensitivity to caregiving in adolescence was observed in both children with and without exposure to early psychosocial neglect. CONCLUSIONS Adolescence may be a period of heightened sensitivity to the caregiving environment, at least for some domains of functioning. For children who experience early psychosocial deprivation, this developmental period may be a window of opportunity for recovery of some functions. Albeit correlational, these findings suggest that it may be possible to reverse or remediate some of the lasting effects of early-life adversity with interventions that target caregiving during adolescence.
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Affiliation(s)
- Natalie L. Colich
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Margaret A. Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathryn L. Humphreys
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Mark Wade
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON, Canada
| | - Florin Tibu
- Department of Research, Institute for Child Development, Bucharest, Romania
| | - Charles A. Nelson
- Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA,Harvard Graduate School of Education, Cambridge, MA, USA
| | - Charles H. Zeanah
- Department of Psychiatry, Tulane University School of Medicine, New Orleans, LA, USA
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
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Humphreys KL, Guyon-Harris KL, Tibu F, Wade M, Nelson CA, Fox NA, Zeanah CH. Psychiatric outcomes following severe deprivation in early childhood: Follow-up of a randomized controlled trial at age 16. J Consult Clin Psychol 2020; 88:1079-1090. [PMID: 33370132 DOI: 10.1037/ccp0000613] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Early psychosocial deprivation is associated with increased risk for psychopathology, yet few studies have examined outcomes in adolescents. METHOD At baseline (M age 22 months), 136 children from Bucharest, Romania, living in large institutions, were randomized into foster care (FCG) or to care as usual (CAUG). Caregivers completed psychiatric interviews regarding their children (52 FCG; 51 CAUG) at age 16 years (M = 16.67 years; SD = 0.78) to assess past year diagnoses and symptom counts. In addition, never-institutionalized community comparison children (n = 47) were included. RESULTS Ever-institutionalized children had higher rates of meeting criteria for any psychiatric disorder and higher symptom counts of internalizing, externalizing, attention-deficit/hyperactivity, and substance use disorders compared to never-institutionalized children (ps < .05). Using intent-to-treat analyses, we found that children in the CAUG had more than twice the rate of psychiatric disorders than children in the FCG (OR = 2.48, 95% CI [1.12, 5.48]). Furthermore, children in foster care who remained in their original placement did not significantly differ in their rates of psychiatric disorders compared to never-institutionalized children. CONCLUSIONS There are many ways children can be separated from parents, including placement into institutional care. The current findings indicate that such placements are associated with significant risks for psychopathology. Moreover, we provide causal evidence for the long-lasting positive effect of foster care in reducing the risk of psychopathology in adolescence, especially among those in stable placements. These results provide strong evidence that early and stable placements into quality foster care may mitigate risk for psychopathology following severe early psychosocial deprivation. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Mark Wade
- Department of Applied Psychology and Human Development, University of Toronto
| | - Charles A Nelson
- Department of Pediatrics, Boston Children's Hospital/ Harvard Medical School
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
| | - Charles H Zeanah
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine
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Callous-unemotional traits and reduced default mode network connectivity within a community sample of children. Dev Psychopathol 2020; 33:1170-1183. [PMID: 32654667 DOI: 10.1017/s0954579420000401] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Callous-unemotional (CU) traits characterize a subset of youth at risk for persistent and serious antisocial behavior. Differences in resting state connectivity in the default mode network (DMN) have been associated with CU traits in forensic and clinical samples of adolescents and with deficient interpersonal/affective traits (often operationalized as Factor 1 psychopathy traits) in adults. It is unclear whether these brain-behavior associations extend to community-based children. Using mixed model analyses, we tested the associations between CU traits and within-network resting-state connectivity of seven task-activated networks and the DMN using data from 9,636 9-11-year-olds in the Adolescent Brain Cognitive Development (ABCD) study. Even after accounting for comorbid externalizing problems, higher levels of CU traits were associated with reduced connectivity within the DMN. This finding is consistent with prior literature surrounding psychopathy and CU traits in clinically and forensically based populations, suggesting the correlation likely exists on a spectrum, can be detected in childhood, and is not restricted to children with significant antisocial behavior.
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15
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Lehmann S, Monette S, Egger H, Breivik K, Young D, Davidson C, Minnis H. Development and Examination of the Reactive Attachment Disorder and Disinhibited Social Engagement Disorder Assessment Interview. Assessment 2020; 27:749-765. [PMID: 30175603 PMCID: PMC7227130 DOI: 10.1177/1073191118797422] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The fifth edition of the Diagnostic and Statistical Manual (DSM) categorizes reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) as two separate disorders, and their criteria are revised. For DSED, the core symptoms focus on abnormal social disinhibition, and symptoms regarding lack of selective attachment have been removed. The core symptoms of RAD are the absence of attachment behaviors and emotional dysregulation. In this study, an international team of researchers modified the Child and Adolescent Psychiatric Assessment for RAD to update it from DSM-IV to DSM-5 criteria for RAD and DSED. We renamed the interview the reactive attachment disorder and disinhibited social engagement disorder assessment (RADA). Foster parents of 320 young people aged 11 to 17 years completed the RADA online. Confirmatory factor analysis of RADA items identified good fit for a three-factor model, with one factor comprising DSED items (indiscriminate behaviors with strangers) and two factors comprising RAD items (RAD1: failure to seek/accept comfort, and RAD2: withdrawal/hypervigilance). The three factors showed differential associations with clinical symptoms of emotional and social impairment. Time in foster care was not associated with scores on RAD1, RAD2, or DSED. Higher age was associated with lower scores on DSED, and higher scores on RAD1.
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Affiliation(s)
- Stine Lehmann
- Regional Centre for Child and Youth Mental Health and Child Welfare -West, Uni Research Health, Bergen, Norway
| | - Sebastien Monette
- Department of Psychology, Université du Québec à Montréal (UQAM), Quebec, Canada
| | - Helen Egger
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, NY, USA
| | - Kyrre Breivik
- Regional Centre for Child and Youth Mental Health and Child Welfare -West, Uni Research Health, Bergen, Norway
| | - David Young
- Department of Mathematics and Statistics, University of Strathclyde, NHS, Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - Claire Davidson
- Adverse Childhood Experiences Clinical and Research Centre, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Helen Minnis
- Adverse Childhood Experiences Clinical and Research Centre, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
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Portnoy J, Cui N, Raine A, Frazier A, Rudo-Hutt AS, Liu J. Autonomic nervous system activity and callous-unemotional traits in physically maltreated youth. CHILD ABUSE & NEGLECT 2020; 101:104308. [PMID: 31918354 PMCID: PMC8791011 DOI: 10.1016/j.chiabu.2019.104308] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 11/18/2019] [Accepted: 11/26/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Research into callous-unemotional (CU) traits often focuses exclusively on biological risk factors without integrating social factors. This gap exists despite a growing body of research showing that the social environment may actually impact physiological functioning, which could in turn affect behavior. OBJECTIVE The current study addresses this limitation by examining physical maltreatment and heart rate stress reactivity as potential risk factors for CU traits. PARTICIPANTS AND SETTING This research was conducted in a community sample of Chinese youth (mean age = 11.83 years, 44.3 % female). METHODS Each child separately reported frequency of physical maltreatment experiences by his or her mother and father over the past 12 months. Children completed a self-report measure of CU traits. RESULTS Frequency of maternal physical maltreatment was associated with uncaring traits in females, but not in males. Paternal physical maltreatment was associated with uncaring traits in both males and females and with callous traits in females only. While paternal physical maltreatment was associated with lower heart rate reactivity in females, maternal physical maltreatment was associated with higher heart rate reactivity in females. CONCLUSION Findings provide mixed support for a potential physiological pathway through which child maltreatment may impact callous traits and provide a multilevel, biosocial lens through which to understand CU traits.
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Affiliation(s)
- Jill Portnoy
- School of Criminology and Justice Studies, University of Massachusetts Lowell, United States
| | - Naixue Cui
- School of Nursing, Shandong University, China
| | - Adrian Raine
- Departments of Criminology, Psychiatry, and Psychology, University of Pennsylvania, United States
| | - Annabelle Frazier
- Department of Psychology, University of Massachusetts Lowell, United States
| | | | - Jianghong Liu
- School of Nursing, University of Pennsylvania, United States.
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17
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Humphreys KL, Gabard-Durnam L, Goff B, Telzer EH, Flannery J, Gee DG, Park V, Lee SS, Tottenham N. Friendship and social functioning following early institutional rearing: The role of ADHD symptoms. Dev Psychopathol 2019; 31:1477-1487. [PMID: 30588896 PMCID: PMC6597328 DOI: 10.1017/s0954579418001050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Early institutional rearing is associated with increased risk for subsequent peer relationship difficulties, but the underlying mechanisms have not been identified. Friendship characteristics, social behaviors with peers, normed assessments of social problems, and social cue use were assessed in 142 children (mean age = 10.06, SD = 2.02; range 7-13 years), of whom 67 were previously institutionalized (PI), and 75 were raised by their biological families. Anxiety and attention-deficit/hyperactivity disorder (ADHD) symptoms, often elevated among PI children, were examined as potential mediators of PI status and baseline social functioning and longitudinal follow-ups (2 and 4 years later). Twenty-seven percent of PI children fell above the Child Behavior Checklist Social Problems cutoff. An examination of specific social behaviors with peers indicated that PI and comparison children did not differ in empathic concern or peer social approach, though parents were more likely to endorse aggression/overarousal as a reason that PI children might struggle with friendships. Comparison children outperformed PI children in computerized testing of social cue use learning. Finally, across these measures, social difficulties exhibited in the PI group were mediated by ADHD symptoms with predicted social problems assessed 4 years later. These findings show that, when PI children struggle with friendships, mechanisms involving attention and behavior regulation are likely contributors.
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18
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Neglect, HPA axis reactivity, and development. Int J Dev Neurosci 2019; 78:100-108. [DOI: 10.1016/j.ijdevneu.2019.07.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/27/2019] [Accepted: 07/29/2019] [Indexed: 11/22/2022] Open
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Guyon-Harris KL, Humphreys KL, Degnan K, Fox NA, Nelson CA, Zeanah CH. A prospective longitudinal study of Reactive Attachment Disorder following early institutional care: considering variable- and person-centered approaches. Attach Hum Dev 2019; 21:95-110. [PMID: 30037301 PMCID: PMC6344314 DOI: 10.1080/14616734.2018.1499208] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Although the study of reactive attachment disorder (RAD) in early childhood has received considerable attention, there is emerging interest in RAD that presents in school age children and adolescents. We examined the course of RAD signs from early childhood to early adolescence using both variable-centered (linear mixed modeling) and person-centered (growth mixture modeling) approaches. One-hundred twenty-four children with a history of institutional care from the Bucharest Early Intervention Project, a randomized controlled trial of foster care as an alternative to institutional care, as well as 69 community comparison children were included in the study. While foster care was associated with steep reductions in RAD signs across development, person-centered approaches indicated that later age of placement into families and greater percent time in institutional care were each associated with prolonged elevated RAD signs. Findings suggest the course of RAD is variable but substantially influenced by early experiences.
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Affiliation(s)
| | | | | | | | - Charles A. Nelson
- Boston Children’s Hospital/Harvard Medical School
- Harvard Graduate School of Education
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20
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Humphreys KL. Future Directions in the Study and Treatment of Parent-Child Separation. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 48:166-178. [PMID: 30556737 DOI: 10.1080/15374416.2018.1534209] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Children require adult caregivers to survive and thrive. In the absence of committed and nurturing care, children face increased risk for a number of difficulties, including internalizing and externalizing psychopathology, cognitive and language deficits, and social difficulties. Recent changes in the U.S. immigration system have resulted in a large number of children removed from their parents, drawing increased scrutiny to the impact of parent-child separation and best practices for caring for children who have been separated. Drawing from work on children exposed to institutional care, as well as research on children separated from caregivers due to validated abuse and neglect, it is clear that children belong in families that are safe and supportive and that some forms of substitute care (i.e., institutional or group-based care) are insufficient to meet children's needs. However, it is difficult to know the specific impact of parent-child separation on child outcomes given that stressors often cluster and pre-separation experiences and post-separation placements also contribute to the experience of separation from a parent and subsequent functioning. Attempts to parse the specific contributions of each separation-related stressor, examining sensitive periods in the impact of separation, studying the mechanisms by which separations affect children, and consideration of the broader social and political context are useful future directions for moving this area of study forward. We must also more fully probe the roles that caregivers play in child development. Lastly, we must endeavor to cease practices of removing children from loving and capable caregivers and, when necessary, provide support to parents and children who have experienced separation.
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21
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Johnson DE, Tang A, Almas AN, Degnan KA, McLaughlin KA, Nelson CA, Fox NA, Zeanah CH, Drury SS. Caregiving Disruptions Affect Growth and Pubertal Development in Early Adolescence in Institutionalized and Fostered Romanian Children: A Randomized Clinical Trial. J Pediatr 2018; 203:345-353.e3. [PMID: 30172435 PMCID: PMC6271564 DOI: 10.1016/j.jpeds.2018.07.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 07/05/2018] [Accepted: 07/09/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To determine the effects of foster care vs institutional care, as well as disruptions in the caregiving environment on physical development through early adolescence. STUDY DESIGN This was a randomized controlled trial of 114 institutionalized, though otherwise healthy, children from 6 orphanages and 51 never institutionalized control children living in birth families (family care group) in Bucharest, Romania. Children were followed from baseline (21 months, range 5-31) through age 12 years for caregiving disruptions and growth trajectories and through age 14 years for pubertal development. RESULTS Children randomized to the foster care group showed greater rates of growth in height, weight, and body mass index (BMI) through age 12 years than institutionalized group. Tanner development was delayed in institutionalized group boys compared with foster care group and family care group boys at 12 but not 14 years. There were no differences in Tanner development and age of menarche among foster care group, institutionalized group, and family care group girls at ages 12 and 14 years. More disruptions in caregiving between 30 months and 12 years moderated decreases in growth rates of height in foster care group and weight in foster care group and institutionalized group across age. institutionalized group boys with ≥2 disruptions showed lower Tanner scores at age 12 vs institutionalized group and foster care group boys with <2 disruptions. foster care group girls with ≥2 disruptions had higher Tanner scores at age 14 vs foster care group girls with <2 disruptions. Age of menarche was not affected by caregiving disruptions. CONCLUSIONS For children who experienced early institutionalization, stable placement within family care is essential to ensuring the best outcomes for physical developmental. TRIAL REGISTRATION clinicaltrials.gov: NCT00747396.
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Affiliation(s)
- Dana E Johnson
- Division of Neonatology and Global Pediatrics, Department of Pediatrics, University of Minnesota Medical School, Minnesota, MN.
| | - Alva Tang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD
| | - Alisa N Almas
- The Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia
| | - Kathryn A Degnan
- Department of Psychology, Catholic University of America, Washington, DC
| | | | - Charles A Nelson
- Harvard Graduate School of Education, Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Cambridge, MA
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD
| | - Charles H Zeanah
- Department of Psychiatry, Tulane University Health Science Center, New Orleans, LA
| | - Stacy S Drury
- Department of Psychiatry, Tulane University Health Science Center, New Orleans, LA
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22
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Collins JL, Thomas LJ. The influence of social determinants of health among young adults after they have left foster care in the US. J Clin Nurs 2018; 27:2022-2030. [PMID: 29493839 DOI: 10.1111/jocn.14317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To describe the influence of the social determinants of health on health care seeking among young adults after they left foster care. BACKGROUND Extensive research suggests that stakeholders in foster care systems throughout the world struggle to consistently and effectively manage the health and well-being of youth. These struggles extend beyond time in foster care as indicated by poor health and social outcomes throughout the life course. Evidence that describes how young adults address health and related social needs after leaving foster care is missing. DESIGN A phenomenological design, Phenomenology of Practice, was used to collect data. Content analysis was used to analyse the data, using constructs from the Healthy People 2020 SDOH Model to organise the data. METHODS Thirteen young adults who left foster care in the southwestern US were recruited using convenience sampling. Data were collected via individual interviews. RESULTS Young adults formerly in foster care reported using and lacking social support networks to navigate SDOH. The interrelatedness of SDOH on health outcomes after foster care is evident. CONCLUSIONS Social support networks can help explain how young adults are both able and unable to navigate systems to address health issues. Evaluating social networks used to access care is an important aspect of assessment and intervention for these vulnerable young adults. RELEVANCE TO CLINICAL PRACTICE Healthcare providers facilitate healthcare access for young adults who have been in foster care through evaluation of social determinants. Assessment and care planning based on social determinants for those who have been in foster care are critical to ensure the efficacy of interventions designed to address health outcomes. Social support systems are key factors for young adults formerly in foster care to access resources, substantiating the need for ongoing assessment and development of these support systems.
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Affiliation(s)
| | - Laura J Thomas
- Texas Tech University Health Sciences Center, Lubbock, TX, USA
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23
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Humphreys KL, King LS, Choi P, Gotlib IH. Maternal depressive symptoms, self-focus, and caregiving behavior. J Affect Disord 2018; 238:465-471. [PMID: 29929156 PMCID: PMC6604802 DOI: 10.1016/j.jad.2018.05.072] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/27/2018] [Accepted: 05/28/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND Parent-child interactions set the stage for child mental health and development. Given that maternal depressive symptoms are associated with poorer observed caregiving behaviors, examining potential cognitive mediators is important for identifying mechanisms underlying the intergenerational transmission of risk and possible targets for intervention. METHODS We assessed depressive symptoms and levels of self-focus and psychological distancing from infant-centered verbal narratives obtained from 54 mothers, and examined caregiving behaviors in a structured interaction with their six-month-old infants. RESULTS Higher depressive symptoms were associated with pronoun use in narratives (i.e., greater "I" and reduced "we" use), reflecting increased self-focus and psychological distancing. Further, increased self-focus was associated with lower levels of caregiver warmth, and mediated the association between depressive symptoms and caregiving warmth. LIMITATIONS This observational study does not allow for causal interpretations. CONCLUSION These findings suggest that the cognitive styles associated with depression interfere with the caregiving relationship, affecting behavior in parent-child interactions that may increase the risk for the intergenerational transmission of depression.
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Affiliation(s)
- Kathryn L Humphreys
- Department of Psychology, Stanford University, Jordan Hall, 450 Serra Mall, Building 420, Stanford, CA 94305, United States.
| | - Lucy S King
- Department of Psychology, Stanford University, Jordan Hall, 450 Serra Mall, Building 420, Stanford, CA 94305, United States
| | - Peter Choi
- Department of Psychology, Stanford University, Jordan Hall, 450 Serra Mall, Building 420, Stanford, CA 94305, United States
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Jordan Hall, 450 Serra Mall, Building 420, Stanford, CA 94305, United States
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24
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Wright N, Hill J, Sharp H, Pickles A. Maternal sensitivity to distress, attachment and the development of callous-unemotional traits in young children. J Child Psychol Psychiatry 2018; 59:790-800. [PMID: 29380375 PMCID: PMC6033174 DOI: 10.1111/jcpp.12867] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND Callous-unemotional (CU) traits are characterized by a lack of responsiveness to the emotions of others, particularly negative emotions. A parenting environment where the child's own distress emotions are sensitively responded to may help foster the child's ability to respond to the emotions of others. We tested whether maternal sensitivity to distress, and other parenting characteristics, were associated with CU traits over the preschool period, and examined whether this was mediated via infant attachment status. METHOD In an epidemiological cohort, CU traits were assessed at age 2.5, 3.5, and 5.0 years by mother report. Dimensions of parenting were assessed in free play at age 29 weeks in a stratified subsample of 272, and attachment status at 14 months (n = 265). Structural equation modelling with maximum likelihood estimation was used to examine predictions from parenting dimensions and attachment status. RESULTS A parenting factor comprised of sensitivity to distress (n = 207), sensitivity to non-distress, positive regard toward the infant (or warmth), and intrusiveness, predicted child CU traits (p = .023). This effect was accounted for mainly by sensitivity to distress (p = .008) and positive regard (p = .023) which showed a synergistic effect as evidenced by a significant interaction (p = .01). This arose because the combination of low sensitivity to distress and low positive regard created the risk for elevated CU traits. Although sensitivity and positive regard predicted attachment security and disorganization, there were no associations between attachment status and CU traits. CONCLUSIONS The finding of contributions from both sensitivity to distress and positive regard to reduced CU traits suggests that children's responsiveness to others' emotions may be increased by their own mothers' responsiveness to them and their mothers' warmth. There was no evidence that this was mediated via attachment status. Implications for intervention and future directions are discussed.
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Affiliation(s)
- Nicola Wright
- Institute of Psychology, Health and SocietyUniversity of LiverpoolLiverpoolUK
| | - Jonathan Hill
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Helen Sharp
- Institute of Psychology, Health and SocietyUniversity of LiverpoolLiverpoolUK
| | - Andrew Pickles
- Biostatistics Department at the Institute of PsychiatryKing's College LondonLondonUK
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Early deprivation disruption of associative learning is a developmental pathway to depression and social problems. Nat Commun 2018; 9:2216. [PMID: 29880851 PMCID: PMC5992195 DOI: 10.1038/s41467-018-04381-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 04/23/2018] [Indexed: 12/20/2022] Open
Abstract
Exposure to psychosocial deprivation is associated with elevations in numerous forms of impairment throughout the life-course. Disruptions in associative learning may be a key mechanism through which adversity, particularly psychosocial deprivation, increases risk for impairment. Existing data consistent with this claim come entirely from correlational studies. Here, we present the first experimental evidence relating psychosocial deprivation and disruptions in multiple forms of associative learning. Using data from the Bucharest Early Intervention Project, we demonstrate that randomized placement into a family caregiving environment during the infant/toddler period as compared to prolonged institutional care normalizes two forms of associative learning in early adolescence: reward responsivity and implicit motor learning. These forms of associative learning significantly mediate the effect of institutional rearing on depressive symptoms and peer relationships. In sum, we provide evidence for a novel pathway linking early experience to psychopathology and peer relationships through basic associative learning mechanisms. Early childhood deprivation such as institutionalization can greatly affect early development. Here, the authors study children who were raised in institutions but later randomly placed in foster care vs. not, to understand how early-life deprivation affects associative learning in adolescence.
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26
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Jost J, Havlisova H, Bilkova Z, Stefankova Z, Zemkova L. Adolescents with Persistent History of Maltreatment Fail in Antisaccadic Task. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2018; 11:163-171. [PMID: 32318147 PMCID: PMC7163873 DOI: 10.1007/s40653-017-0195-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The antisaccadic task is sensitive to what is called frontal dysfunction, i.e. dysfunction of the frontal lobes of the cerebral cortex which are the basis for a wide range of symptoms. The present study examined saccadic eye movements in adolescents with persistent history of maltreatment. Participants included 17 female subjects with maltreatment history. The control group consisted of 54 typically developing female subjects. All participants were administered Child Behavior Checklist (CBCL) and saccadic eye movement tests. CBCL showed significant differences between the maltreated and control groups. The prosaccadic test revealed insignificant results between both groups. The antisaccadic test revealed a highly significant difference (longer latencies, more prosaccadic mistakes in the group of maltreated subjects). Antisaccadic eye movements may be regarded as a possible indicator of persistent maltreatment and following emotional and behavioral problems and may therefore enhance diagnostic methods.
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Affiliation(s)
- Jiri Jost
- Department of Special Education, University of South Bohemia, Ceske Budejovice, Czech Republic
- Faculty of Education, Dukelska 9, CZ 370 01 Ceske Budejovice, Czech Republic
| | - Helena Havlisova
- Department of Special Education, University of South Bohemia, Ceske Budejovice, Czech Republic
| | - Zuzana Bilkova
- Department of Special Education, University of South Bohemia, Ceske Budejovice, Czech Republic
| | - Zuzana Stefankova
- Department of Special Education, University of South Bohemia, Ceske Budejovice, Czech Republic
| | - Ludmila Zemkova
- Department of English Studies, Faculty of Education, University of South Bohemia, Ceske Budejovice, Czech Republic
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Engh L, Janson S, Svensson B, Bornehag CG, Eriksson UB. Swedish population-based study of pupils showed that foster children faced increased risks for ill health, negative lifestyles and school failure. Acta Paediatr 2017; 106:1635-1641. [PMID: 28664570 DOI: 10.1111/apa.13966] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 01/31/2017] [Accepted: 06/26/2017] [Indexed: 11/30/2022]
Abstract
AIM This population-based study explored whether foster children faced a higher risk of health problems than children of the same age who were not in foster care. METHODS Data for 13 739 pupils aged 10, 13 and 16 years were obtained from the Pupil Health Database in the county of Värmland, Sweden, for the school years 2012/2013 and 2013/2014. These included data on school performance, health, lifestyle and social relationships, based on children's interviews with school nurses. RESULTS Of all the pupils, 171 (1.2%) were in foster care. Children in foster care were generally unhealthier than other children. Both girls and boys were at higher risk of chronic health problems, daily smoking, use of drugs and school failure. When the girls in foster care were compared to other girls, we found that they faced a higher risk of psychological and psychosomatic symptoms. This difference was not found for boys. Foster children were also more likely to express a more negative view on life. CONCLUSION We confirmed earlier studies that children in foster care tended to have inferior health and well-being than other children. These findings emphasise that health, risky behaviour and school performance should be considered together when assessing foster children.
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Affiliation(s)
- Lisbet Engh
- Division of Public Health Sciences; Karlstad University; Karlstad Sweden
| | - Staffan Janson
- Division of Public Health Sciences; Karlstad University; Karlstad Sweden
| | - Birgitta Svensson
- Center for Criminological And PsychoSocial Research; School of Law; Psychology and Social Work; Örebro University; Örebro Sweden
| | - Carl-Gustaf Bornehag
- Division of Public Health Sciences; Karlstad University; Karlstad Sweden
- Icahn School of Medicine at Mount Sinai; New York City NY USA
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Zeanah CH, Humphreys KL, Fox NA, Nelson CA. Alternatives for abandoned children: insights from the Bucharest Early Intervention Project. Curr Opin Psychol 2017; 15:182-188. [PMID: 28813259 PMCID: PMC5607636 DOI: 10.1016/j.copsyc.2017.02.024] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 02/10/2017] [Indexed: 01/23/2023]
Abstract
The Bucharest Early Intervention Project is the first and only randomized controlled trial of foster care as an alternative to institutional care for orphaned and abandoned children. Across various domains of brain and behavioral development we demonstrated that children in families developed more favorably than children in institutions, that foster care remediates some but not all compromises associated with institutional placement and that earlier placement in foster care leads to more developmental gains in some but not all domains. In addition to early placement, higher quality of care provided and more stable placements for children all enhanced outcomes. These results have important implications for science, practice and policy.
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Affiliation(s)
| | | | | | - Charles A Nelson
- Boston Children's Hospital and Harvard Medical School, USA; Harvard Graduate School of Education, USA
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Mayes SD, Calhoun SL, Waschbusch DA, Breaux RP, Baweja R. Reactive attachment/disinhibited social engagement disorders: Callous-unemotional traits and comorbid disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 63:28-37. [PMID: 28254669 DOI: 10.1016/j.ridd.2017.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 02/16/2017] [Accepted: 02/20/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND DSM-5 Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) are rare, understudied, and controversial disorders. METHODS Comorbidity in children diagnosed with RAD or DSED was compared with comorbidity in ADHD and autism to determine if RAD/DSED comorbidity differed from that for the two most common disorders in child psychiatric clinics. Samples included 4-17-year-olds, 20 with RAD and/or DSED, 933 with autism, and 895 with ADHD. Children with RAD/DSED were removed from their neglectful environments at a mean of 4 years and were a mean 10 years when studied. Mothers rated the children on the Pediatric Behavior Scale assessing oppositional behavior, conduct problems, ADHD, anxiety, depression, and other symptoms. RESULTS Five of the 20 children with RAD/DSED had DSED without RAD, 15 had RAD with DSED, and none had RAD without DSED. All children with RAD had callous-unemotional traits (CU) and 73% had conduct disorder (CD). No children with DSED-no RAD had CU or CD. Children with RAD+DSED were considerably more impaired than children with DSED-no RAD, autism, and ADHD. CONCLUSIONS Findings are consistent with other studies indicating high CD/CU comorbidity in RAD and extreme rarity of RAD without DSED, findings which are not noted in the DSM-5.
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Affiliation(s)
| | - Susan L Calhoun
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
| | | | - Rosanna P Breaux
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
| | - Raman Baweja
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
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Fox NA, Nelson CA, Zeanah CH. The Effects of Psychosocial Deprivation on Attachment: Lessons from the Bucharest Early Intervention Project. Psychodyn Psychiatry 2017; 45:441-450. [PMID: 29244624 PMCID: PMC5813245 DOI: 10.1521/pdps.2017.45.4.441] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The absence of typical caregiving, including warm and responsive parenting, has been suggested to significantly affect the young child's ability to form adaptive relationships with adults and peers. The Bucharest Early Intervention Project (BEIP), a randomized controlled trial of foster/family care for young children with a history of institutionalization has provided the context to assess these relationships. Here we review data from the BEIP with specific focus on attachment. The findings clearly show the importance of early family care on the emergence of attachment, on the prevention of psychopathology, and on links between brain and social behavior.
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Affiliation(s)
- Nathan A Fox
- Professor, Department of Human Development and Quantitative Methodology, University of Maryland
| | - Charles A Nelson
- Professor of Pediatrics and Neuroscience, Harvard Medical School; Professor of Education, Harvard University
| | - Charles H Zeanah
- Department of Psychiatry and Behavioral Sciences, Tulane University Medical School
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The Importance of Early Nurturance for Social Development. J Am Acad Child Adolesc Psychiatry 2015; 54:972-3. [PMID: 26598470 DOI: 10.1016/j.jaac.2015.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 09/28/2015] [Indexed: 11/21/2022]
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