The Effects of Early Psychosocial Deprivation on Mental Health in Early Adulthood

项目总结/摘要 在过去的17年里，我们进行了有史以来第一次随机对照试验（RCT）的寄养，作为一个 布加勒斯特早期干预项目是幼儿机构照料的替代方案。我们现在 建议对该项目21岁的参与者进行评估。新的评估期将 提供有关向成年过渡的新颖而重要的数据，并使我们能够及时回答问题 关于青春期可能是对环境影响明显敏感的第二个时期， 神经重组，在此过程中，积极的体验可能会减轻，至少部分，消极的 早期逆境对认知、情绪、神经生物学过程以及精神病理学的影响。 拟议的分析将利用从2004年开始进行的密集的重复评估， 当参与者是仍然生活在机构中的婴儿和幼儿时，在随机化后跟踪他们， 或在童年和青少年时期被寄养。纵向设计独一无二， 测量多个结构随着时间的推移跨越早期，中期和晚期的童年，以及青春期前 青春期和向青春期的过渡。这使我们能够检查是否发展领域， 不受早期干预的影响（例如，认知控制）可能会在青春期改善， 儿童在稳定的替代安置，以及是否有额外的改善发生在领域， 受到干预措施的积极影响，但与儿童相比， 通常是发育中的儿童（例如，奖励响应）。这些问题将不仅使用 行为数据，但也在几个神经生物学领域，没有早期逆境的研究已经评估 在这么长的时间里。这包括神经成像领域的EEG、ERP、MRI和DTI数据，以及 在每个时间点对认知、社交和情感功能进行全面测量。我们的纵向 随机对照试验设计，重复评估患者关系、精神病理学和认知、情感， 和大脑的发育使我们能够研究早期和后期的经历对大脑发育的共同影响。 形成广泛的发展进程。我们将研究早期和晚期之间的关系 青春期和成年早期的经历和精神病理学风险，时期 其特征在于精神障碍发作的风险显著升高。我们独特的数据使我们能够 评估认知、情感和神经生物学发展的特定领域是否“恢复”， “追赶”儿童经历了严重的早期剥夺，随后在青春期稳定的成长。 我们还将评估早期逆境和积极的成长经历对出现 在年轻的成年期发展适当的能力。确定青少年的相关性 在成年期形成精神病理学的过程中积累经验对于设计 有可能缓冲美国和世界各地早期逆境影响的干预措施。

Project Summary/Abstract Over the past 17 years, we have conducted the first-ever randomized controlled trial (RCT) of foster care as an alternative to institutional care for young children, the Bucharest Early Intervention Project (BEIP). We now propose an assessment of the participants in this project at age 21 years. The new assessment period will provide novel and important data regarding the transition to adulthood and allow us to answer timely questions about the possibility that adolescence is a second period of marked sensitivity to environmental influences and neural reorganization during which positive caregiving experiences may mitigate, at least in part, the negative effects of early adversity on cognitive, emotional, and neurobiological processes as well as psychopathology. The proposed analyses will make use of the intensive repeated assessments that have occurred beginning when participants were infants and toddles still living in institutions, following them after randomization to care as usual or foster care placement through childhood and adolescence. The longitudinal design is unique in measuring multiple constructs over time spanning early, middle, and late childhood, as well as the pre-pubertal period and the transition to adolescence. This allows us to examine whether domains of development that were unaffected by the early intervention (e.g., Cognitive Control) may improve during adolescence among children in stable caregiving placements, as well as whether additional improvements occur in domains that were positively influenced by the intervention, but where children continued to show difficulties compared to typically developing children (e.g., Reward Responsiveness). These questions will be examined not only using behavioral data, but also in several neurobiological domains that no prior study of early adversity has assessed over such a long period. This includes EEG, ERP, MRI, and DTI data in the neuroimaging domain, as well as comprehensive measures of cognitive, social, and emotional functioning at every time point. Our longitudinal RCT design with repeated assessment of caregiving relationships, psychopathology, and cognitive, emotional, and brain development allows us to examine the joint influence of early and later caregiving experiences in shaping a wide range of developmental processes. We will examine relations between early and later caregiving experiences and risk for psychopathology during adolescence and early adulthood, periods characterized by markedly elevated risk for the onset of psychiatric disorders. Our unique data allow us to evaluate whether specific domains of cognitive, emotional, and neurobiological development “recover” or “catch up” for children who experienced severe early deprivation followed by stable caregiving in adolescence. We will also assess the effects of early adversity and positive caregiving experiences on the emergence of developmentally appropriate competencies during young adulthood. Determining the relevance of adolescent caregiving experiences in shaping psychopathology in emerging adulthood is essential to designing interventions that have the potential to buffer the effects of early adversity in the US and worldwide.