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

  • Mark Kennedy (a1), Jana Kreppner (a2), Nicky Knights (a3), Robert Kumsta (a4), Barbara Maughan (a5), Dennis Golm (a6), Jonathan Hill (a7), Michael Rutter (a5), Wolff Schlotz (a8) and Edmund Sonuga-Barke (a6)...
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.

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Copyright
This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence.
Corresponding author
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@kcl.ac.uk
Footnotes
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Declaration of Interest

Over the past 3 years E.S.-B. has received speaker fees, consultancy, research funding and conference support from Shire Pharma and speaker fees from Janssen Cilag. He has received consultancy fees from Neurotech solutions, Aarhus University, Copenhagen University and Berhanderling, Skolerne, Copenhagen, KU Leuven. J.K. has received honoraria for invited presentations at professional associations from Association of Child and Adolescent Mental Health and the Association of Young People's Health.

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

  • Mark Kennedy (a1), Jana Kreppner (a2), Nicky Knights (a3), Robert Kumsta (a4), Barbara Maughan (a5), Dennis Golm (a6), Jonathan Hill (a7), Michael Rutter (a5), Wolff Schlotz (a8) and Edmund Sonuga-Barke (a6)...
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