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

Mark Kennedy; Jana Kreppner; Nicky Knights; Robert Kumsta; Barbara Maughan; Dennis Golm; Jonathan Hill; Michael Rutter; Wolff Schlotz; Edmund Sonuga-Barke

doi:10.1192/bjp.bp.117.200618

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

Br J Psychiatry. 2017 Nov;211(5):289-295. doi: 10.1192/bjp.bp.117.200618. Epub 2017 Sep 21.

Authors

Affiliations

¹ 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.
² 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 edmund.sonuga-barke@kcl.ac.uk.

Abstract

BackgroundEarly-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.AimsWe examine these issues in the young adult follow-up of the English and Romanian Adoptees study.MethodA 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.ResultsYoung 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.ConclusionsDSE behaviour remained a prominent, but largely clinically benign, young adult feature of some adoptees who experienced early deprivation.

MeSH terms

Adolescent
Adoption / psychology*
Adult
Child
Child, Institutionalized / psychology*
Child, Institutionalized / statistics & numerical data
Child, Preschool
Humans
Infant
Inhibition, Psychological*
Interpersonal Relations*
Maternal Deprivation*
Orphanages / statistics & numerical data
Paternal Deprivation*
Romania
United Kingdom
Young Adult