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  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

Kennedy, M., Kreppner, J., Knights, N., Kumsta, R., Maughan, B., Golm, D., et al. (2016). 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. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 57(10), 1113-1125. doi:10.1111/jcpp.12576.

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sci-16-sch-01-early.pdf (Publisher version), 349KB
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sci-16-sch-01-early.pdf
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2016
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© 2016 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original

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 Creators:
Kennedy, Mark, Author
Kreppner, Jana, Author
Knights, Nicky, Author
Kumsta, Robert, Author
Maughan, Barbara, Author
Golm, Dennis, Author
Rutter, Michael, Author
Schlotz, Wolff1, Author                 
Sonuga‐Barke, Edmund J. S., Author
Affiliations:
1Scientific Services, Max Planck Institute for Empirical Aesthetics, Max Planck Society, ou_2421698              

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Free keywords: Adult attention‐deficit/hyperactivity disorder, institutional deprivation, Romanian adoptees, adult onset, longitudinal, adversity
 Abstract: BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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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Language(s): eng - English
 Dates: 2016-06-062016-10
 Publication Status: Issued
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: Other: PMC5042050
DOI: 10.1111/jcpp.12576
 Degree: -

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Title: Journal of Child Psychology and Psychiatry, and Allied Disciplines
Source Genre: Journal
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Publ. Info: Hoboken : John Wiley and Sons Inc.
Pages: - Volume / Issue: 57 (10) Sequence Number: - Start / End Page: 1113 - 1125 Identifier: ISSN: 0021-9630