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

Abstract

Background: early 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 impact on, functioning in adulthood.

Aims: we examine these issues in the young adult follow-up of the English and Romanian Adoptees study.

Method: 122 of the original 165 Romanian adoptees who had spent up to 43 months as children in Ceaușescu’s Romanian orphanages and 42 UK adoptees were assessed for DSE behaviours, neuro-developmental and mental health problems, and impairment between ages 22-25 years.

Results: young adult DSE behaviour was strongly associated with early childhood deprivation, with a six-fold increase for those who spent more than 6 months in institutions. However, while DSE overlapped with autistic spectrum disorder and ADHD symptoms it was not, in itself, related to broader patterns of mental health problems or impairments in daily functioning in young adulthood.

Conclusion: DSE behaviour remained a prominent, but largely clinically benign, young-adult feature of some adoptees who experienced early deprivation.

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Identifiers

ORCID for Jana Kreppner: orcid.org/0000-0003-3527-9083

ORCID for Dennis Golm: orcid.org/0000-0002-2950-7935

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