Early severe institutional deprivation is associated with a persistent variant of adult attention-deficit/hyperactivity disorder: clinical presentation, developmental continuities and life circumstances in the English and Romanian Adoptees study.
Early severe institutional deprivation is associated with a persistent variant of adult attention-deficit/hyperactivity disorder: clinical presentation, developmental continuities and life circumstances in the English and Romanian Adoptees study.
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DOI：
10.1111/jcpp.12576
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发表时间：
2016-10
期刊：
影响因子：
--
通讯作者：
Sonuga-Barke EJ
中科院分区：
文献类型：
--
作者：
Kennedy M;Kreppner J;Knights N;Kumsta R;Maughan B;Golm D;Rutter M;Schlotz W;Sonuga-Barke EJ
早期生活中的机构剥夺与儿童期和青春期后期的注意力缺陷/多动障碍（ADHD）有关。在本文中，我们首次研究了在极度贫困的罗马尼亚孤儿院度过一段时期后被英国家庭收养的幼儿样本中与贫困相关的多动症持续到成年早期的情况。我们估计了低（LoDep；非贫困英国被收养者和罗马尼亚被收养者在机构暴露时间少于 6 个月）和高剥夺相关风险（HiDep；暴露在机构暴露时间超过 6 个月的罗马尼亚被收养者）个人 15 岁和青年时期（22-25 岁）的 ADHD 发生率。估计是基于使用 DSM-5 儿童症状和损伤标准的家长报告。 15 岁时，可获得 108 例 LoDep 和 86 例 HiDep 病例的数据，而在成年早期，这一数字分别为 83 例和 60 例。还收集了有关教育和就业状况、智商、年轻人去抑制社交参与（DSE）的并发症状、自闭症谱系障碍（ASD）、认知障碍、品行障碍（CD）、冷酷无情（CU）特征、焦虑、抑郁和生活质量（QoL）的数据。 LoDep 组的 ADHD 发生率在青春期 (5.6%) 和成年期 (3.8%) 与一般人群相似。 HiDep 个体符合标准的可能性分别是 LoDep 的近四倍 (19%) 和七倍以上 (29.3%)。出现了 9 例“发病”的年轻成人病例，但这些病例在 6 岁、11 岁和 15 岁时都有过 ADHD 行为加重的儿童病史。年轻成人 ADHD 在男性和女性中同样常见，主要表现为注意力不集中，并伴有高水平的 ASD、DSE 和 CU 特征。多动症与高失业率和低教育程度有关。我们提供了第一个证据，证明一种独特的复杂性和损害性剥夺相关的多动症变异体在成年后会持续存在。我们的研究结果证实了早期经历与后期发展之间的强大联系，这表明了大脑结构和功能的深层次改变的作用。
Early‐life institutional deprivation is associated with attention‐deficit/hyperactivity disorder (ADHD) later in childhood and adolescence. In this article, we examine, for the first time, the persistence of deprivation‐related ADHD into young adulthood in a sample of individuals adopted as young children by UK families after periods in extremely depriving Romanian orphanages. We estimated rates of ADHD at age 15 years and in young adulthood (ages 22–25 years) in individuals at low (LoDep; nondeprived UK adoptees and Romanian adoptees with less than 6‐month institutional exposure) and high deprivation‐related risk (HiDep; Romanian adoptees with more than 6‐month exposure). Estimates were based on parent report using DSM‐5 childhood symptom and impairment criteria. At age 15, data were available for 108 LoDep and 86 HiDep cases, while in young adulthood, the numbers were 83 and 60, respectively. Data on education and employment status, IQ, co‐occurring symptoms of young adult disinhibited social engagement (DSE), autism spectrum disorder (ASD), cognitive impairment, conduct disorder (CD), callous‐unemotional (CU) traits, anxiety, depression and quality of life (QoL) were also collected. ADHD rates in the LoDep group were similar to the general population in adolescence (5.6%) and adulthood (3.8%). HiDep individuals were, respectively, nearly four (19%) and over seven (29.3%) times more likely to meet criteria, than LoDep. Nine ‘onset’ young adult cases emerged, but these had a prior childhood history of elevated ADHD behaviours at ages 6, 11 and 15 years. Young adult ADHD was equally common in males and females, was predominantly inattentive in presentation and co‐occurred with high levels of ASD, DSE and CU features. ADHD was associated with high unemployment and low educational attainment. We provide the first evidence of a strong persistence into adulthood of a distinctively complex and impairing deprivation‐related variant of ADHD. Our results confirm the powerful association of early experience with later development in a way that suggests a role for deep‐seated alterations to brain structure and function.
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DOI：
10.1111/jcpp.12337
发表时间：
2015-06
期刊：
Journal of child psychology and psychiatry, and allied disciplines
影响因子：
--
作者：
Arnett AB;Pennington BF;Willcutt EG;DeFries JC;Olson RK
通讯作者：
Olson RK
影响因子：
4
作者：
Kreppner, Jana M.;Rutter, Michael;Sonuga-Barke, Edmund J. S.
通讯作者：
Sonuga-Barke, Edmund J. S.
DOI：
10.1111/j.1540-5834.2010.00553.x
发表时间：
2010-01-01
影响因子：
9.5
作者：
Beckett, Celia;Castle, Jennifer;Sonuga-Barke, Edmund J. S.
通讯作者：
Sonuga-Barke, Edmund J. S.
影响因子：
3
作者：
Faraone, Stephen V;Biederman, Joseph
通讯作者：
Biederman, Joseph
影响因子：
3.8
作者：
Essau, Cecilia A.;Sasagawa, Satoko;Frick, Paul J.
通讯作者：
Frick, Paul J.