THE IMPACT OF GLOBAL EARLY INSTITUTIONAL DEPRIVATION DURING EMERGING ADULTHOOD: PATHWAYS TO SUCCESFUL TRANSITION IN THE ERA STUDY

Lead Research Organisation: University of Southampton
Department Name: School of Psychology

Abstract

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Publications

10 25 50

 
Description This research investigated the young adult follow-up (ages 22 to 25) of children who experienced extreme deprivation in Romanian orphanages in the late 1980s and early 1990s and were subsequently adopted by families living in the UK. The full sample had previously been studied at ages 6, 11 and 15 years. There had been a devastating global initial impact of deprivation followed by evidence of emergent resilience displayed by many of the children as they grew. Despite this, there was a persistent and distinctive pattern of impairment in a substantial minority of individuals who experienced extended deprivation exposure (i.e., greater than 6 months in the institutions).
Key findings
1) Unsurprisingly attrition was somewhat higher than in previous follow-ups. We had data on 76% of the 217 families compared to 90% at age 15. Drop out was not selective for either the extent of deprivation or prior patterns of impairment.
2) There was continuing recovery from deprivation-related cognitive impairment in the individuals who had experienced extended deprivation. Strikingly, IQ was normalised in those who did not suffer institutional subnourishment. In the most deprived individuals there was an average gain of three standard deviations since entry to the UK.
3) In contrast, there was a strong degree of persistence in the other three distinctive developmental sequelae of deprivation: ADHD, quasi autism and disinhibited social engagement. ADHD was especially persistent with the inattentive presentation predominant. Clear patterns of disinhibited social engagement and quasi autistic persistence were also observed in the extended deprivation group. There was some evidence that the three elements tended to cluster as a function of deprivation. Evidence of an association between deprivation duration and callous unemotional traits found at age 15 was confirmed in the young adult sample.
4) Childhood assessments had found little evidence of more general emotional and behavioural problems in the extended deprivation group. However, since age 11 we have seen a substantial rise in emotional problems (low mood, worry and anxiety) -possibly escalating during the adolescent-adult transition. Around half of the extended deprivation group reported contact with mental health services since age 15. Levels of conduct problems remain low with no evidence of aggression/violence or substance use problems.
5) Early deprivation had long term effects on some general patterns of young adult achievement. Just less than half of the extended deprivation group left education at 16 and over a third were unemployed: Effects that are all the more striking given that the majority of the adoptees' families were from high social class backgrounds/groups.
6) Despite these difficulties, in nearly all cases the families remained extremely supportive of their adopted children providing both substantial practical and emotional support. The vast majority of adoptees regarded their relationships with their parents as close and secure irrespective of levels of deprivation or developmental/mental health problems. Nearly two thirds of the adoptees live separately from their adoptive parents. Just over a third were in relationships and about one fifth had children of their own. (7) Study of cortisol across the day suggested that early deprivation was association with a markedly attenuated morning awakening response.
Exploitation Route These results have important implications for policy and practice. In highlighting the long term persistence of the impact of extended institutional deprivation on mental health they reinforce the need to; (i) ensure high quality institutional care where it is necessary; (ii) place institutionally-living children in secure long-term family placements as early as possible; (iii) carefully monitor the long-term mental health outcomes of previously institutionalised adopted children as they enter adulthood and; (iv) ensure tailored educational and clinical services and support to the adopted young people and their families to facilitate a successful transition from adolescence-to-adulthood.
Sectors Education,Healthcare

 
Description ERA & BEIP 
Organisation Bucharest Early Intervention Project
Country United States 
Sector Multiple 
PI Contribution This is a partnership between the ERA study and the Bucharest Early Intervention study to explore common issues relating to deprivation in two samples of children brought up in Romanian Institutions.
Collaborator Contribution This is a partnership between the ERA study and the Bucharest Early Intervention study to explore common issues relating to deprivation in two samples of children brought up in Romanian Institutions.
Impact non yet
Start Year 2016
 
Description Aarhus University talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other audiences
Results and Impact Sonuga-Barke EJS (2015). Adult ADHD as a consequence of early deprivation. Departmental Seminar, Aarhus, Denmark.
Year(s) Of Engagement Activity 2015
 
Description Conference: 49. Kongress der Deutschen Gesellschaft für Psychologie 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Long-term consequences of institutional deprivation - the role of epigenetic mechanisms
Robert Kumsta, Sarah Marzi, Jonathan Mill, Edmund Sonuga-Barke
Conference: 49. Kongress der Deutschen Gesellschaft für Psychologie
21.-25. September 2014 - Ruhr-Universität Bochum, Bochum, Germany

A talk given at the bi-annual conference of the German Psychological Association; attendance of about 2000 people across all psychological disciplines
Year(s) Of Engagement Activity 2014
URL http://m.dgpskongress.de/frontend/index.php
 
Description Eunethydis 2015 talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Sonuga-Barke EJS and the ERA team (2015). Adult ADHD as a consequence of early deprivation. 14th Eunethydis, Stockholm Sweden
Year(s) Of Engagement Activity 2015
 
Description International Conferences 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Plenary Sonuga-Barke EJS (2017). Neuroplasticity and prevention neuroscience for disorders of impulse and attention: Sharpening the second blade of the sword. MQ - Annual Science Meeting, London. Jan 2016.
Invited: Sonuga-Barke EJS (2017). ADHD Neuroscience: What have we learnt in the last 20 years? Institute of Child Health, University of College London.
Plenary: Sonuga-Barke EJS (2017) ADHD following severe early deprivation: an extreme neuroplastic response to an extraordinary environment? 6th World Congress of ADHD, Vancouver, Canada.
Sonuga-Barke EJS and ERA team. (2017). The English and Romanian Adoptees study Young Adult Follow-up. ERA Impact Accelorator Meeting. London.
Invited: Sonuga-Barke EJS (2017) long term consequences of severe early deprivation for human development : the English and Romanian Adoptees study - young adult follow-up. Extreme neuroplastic effects of an extraordinary environment? University of Bergen.
Keynote: Sonuga-Barke EJS (2017). Young adult outcomes following severe institutional deprivation: testing attachment hypotheses in the English and Romanian Adoptees study. International Adoption Conference 2017. London.
Sonuga-Barke, EJS (2017). The long-term effects of early adversity on mental health: methodological challenges and the limits of causal inference. ESCAP research academy Geneva.
Sonuga-Barke EJS (2017). Neuropsychological correlates of ADHD following early deprivation.
26. Keynote: Sonuga-Barke EJS (2017). The long-term effects of early severe deprivation of human development: Insights from the ERA study. Psykiatrifonden. Copenhagen, Denmark.
Sonuga-Barke EJS (2017). Deprivation-Development: Attachment-Resilience; Lessons from the survivors of the Romanian Orphanages. Place2Be annual conference. London. UK.
Sonuga-Barke EJS (2017). The long-term effects of extreme institutional deprivation: Lessons from the English & Romanian Adoptees young adult follow-up. Annual Congress of the Chilean Society of Psychiatry and Neurology of Childhood and Adolescence. Pucon, Chile.
Sounga-Barke EJS (2018). Have studies of early deprivation changed the way we think about ADHD? APSARD 2018; Washington, US.
Sonuga-Barke (2018). Beyond heritability - Have studies of the effects of institutional deprivation changed how we conceptualise neuro-development? University of Oxford.
Sonuga-Barke (2018). The long-term impact of severe early deprivation on human development. Evidence from the Young Adult Follow-Up of the English and Romanian Adoptees study. Radboud UMC Child & Youth Symposium 2018.
Departmental Seminar: Can early deprivation cause neuro-developmental disorders. SGDP. IoPPN.
Miranda L, Jaekel J, Kreppner J, Rutter M, Sonuga-Barke E, & Wolke D (2018). Impact of early biological versus environmental adversity on temperament at 6 years: A comparison of the English and Romanian Adoptee Study and Bavarian Longitudinal Study. Pediatric Academic Societies. Toronto.
Sonuga-Barke, EJS (2018). Sex differences in the impact of extreme childhood deprivation on infant-to-adult growth: A Bayesian analysis using sparse data. Auxological Society Annual Meeting. Kiel, Germany, May 2018.
Sonuga-Barke E, Maughan B, Kreppner J, Kennedy M. (2018). Long-term consequences of severe early deprivation the young adult follow-up of the English and Romanian adoptees (era) study. Life History Society, Sorbonne University, Paris
Sonuga-Barke EJS (2018). The effects of extreme institutional deprivation in early childhood on adult functioning and mental health. Royal College of Psychiatry Annual Meeting: London.
Year(s) Of Engagement Activity 2017,2018
 
Description Interviews with press about ERA study paper in Lancet 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact In 2017 we published a paper in the Lancet - a press release was issued. I did a number of interviews with Sky, BBC, Associated Press etc- current Altmmetrics score of nearly 500.
Year(s) Of Engagement Activity 2017
URL http://www.bbc.com/news/health-39055704
 
Description Poster World Congress of Psychiatric Genetics 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Poster:
Severe psychosocial deprivation in early childhood is associated with hypermethylation
across a region spanning the transcription start-site of CYP2E1
Sarah Marzi, Robert Kumsta, Joana Viana, Michael Rutter, Jonathan Mill, Edmund Sonuga-Barke
Conference: World Congress of Psychiatric Genetics 2015, 16-20/10/15, Toronto
Poster presented during annual World Congress of Psychiatric Genetics
Year(s) Of Engagement Activity 2015
URL http://2015.ispg.net
 
Description Poster at Epigenomics of Common Diseases 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Poster:
Severe psychosocial deprivation in early childhood is associated with hypermethylation
across a region spanning the transcription start-site of CYP2E1
Sarah Marzi, Robert Kumsta, Joana Viana, Michael Rutter, Jonathan Mill, Edmund Sonuga-Barke
Conference: Epigenomics of Common Diseases 2015, 6-9/11/15, Cambridge
Poster presented during annual Epigenomics of Common Diseases conference
Year(s) Of Engagement Activity 2015
URL https://registration.hinxton.wellcome.ac.uk/events/item.aspx?e=515
 
Description Presentation and discussion with Duchess of Cambridge 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Schools
Results and Impact This was the place2be annual meeting. I was a keynote and the Duccess of Cambridge was the guest of honour. I presented the findings of the ERA study. I also had the chance to chat with her at lunch about the work.
Year(s) Of Engagement Activity 2017
 
Description Talk at ACAMH meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact A talk to an audience of clinicians
Year(s) Of Engagement Activity 2016
 
Description Update for A level student 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Schools
Results and Impact An update of the ERA study for A level students in journal - A Level Psychology
Year(s) Of Engagement Activity 2016
 
Description short talk at Quantitative Genomics 2015 London 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Severe psychosocial deprivation in early childhood is associated with hypermethylation across a region of the CYP2E1 gene
Sarah Marzi, Robert Kumsta, Joana Viana, Michael Rutter, Edmund Sonuga-Barke, Jonathan Mill
Conference: Quantitative Genomics 2015, 29/05/15, London
Short talk at a 1 day conference for postgraduate students held in London, no Q&A but direct interaction with other attendees during networking sessions
Year(s) Of Engagement Activity 2015
URL http://quantgen.soc.srcf.net/qg15/programme/schedule/