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Why does early childhood deprivation increase the risk for depression and anxiety in adulthood? A developmental cascade model

Why does early childhood deprivation increase the risk for depression and anxiety in adulthood? A developmental cascade model
Why does early childhood deprivation increase the risk for depression and anxiety in adulthood? A developmental cascade model

Background: Using data from the English & Romanian Adoptees (ERA) study, we recently reported that early time-limited exposure to severe institutional deprivation is associated with early-onset and persistent neurodevelopmental problems and later-onset emotional problems. Here, we examine possible reasons for the late emergence of emotional problems in this cohort. Our main focus is on testing a developmental cascade mediated via the functional impact of early-appearing neurodevelopmental problems on late adolescent functioning. We also explore a second putative pathway via sensitization to stress. Methods: The ERA study includes 165 Romanian individuals who spent their early lives in grossly depriving institutions and were subsequently adopted into UK families, along with 52 UK adoptees with no history of deprivation. Age six years symptoms of neurodevelopmental problems and age 15 anxiety/depression symptoms were assessed via parental reports. Young adult symptoms of depression and anxiety were assessed by both parent and self-reports; young adults also completed measures of stress reactivity, exposure to adverse life events, and functioning in work and interpersonal relationships. Results: The path between early institutional deprivation and adult emotional problems was mediated via the impact of early neurodevelopmental problems on unemployment and poor friendship functioning during the transition to adulthood. The findings with regard to early deprivation, later life stress reactivity, and emotional problems were inconclusive. Conclusions: Our analysis suggests that the risk for adult depression and anxiety following extreme institutional deprivation is explained through the effects of early neurodevelopmental problems on later social and vocational functioning. Future research should more fully examine the role of stress susceptibility in this model.

anxiety, depression, developmental cascades, emotional problems, institutional deprivation, longitudinal, natural experiment, neurodevelopmental problems, prospective
1469-7610
1043-1053
Golm, Dennis
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Maughan, Barbara
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Barker, Edward
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Hill, Jonathan
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Kennedy, Mark
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Knights, Nicola
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Kreppner, Jana
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Kumsta, Robert
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Schlotz, Wolff
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Rutter, Michael
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Sonuga-Barke, Edmund
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Golm, Dennis
ae337f61-561e-4d44-9cf3-3e5611c7b484
Maughan, Barbara
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Barker, Edward
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Hill, Jonathan
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Kennedy, Mark
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Knights, Nicola
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Kreppner, Jana
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Kumsta, Robert
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Schlotz, Wolff
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Rutter, Michael
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Sonuga-Barke, Edmund
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Golm, Dennis, Maughan, Barbara, Barker, Edward, Hill, Jonathan, Kennedy, Mark, Knights, Nicola, Kreppner, Jana, Kumsta, Robert, Schlotz, Wolff, Rutter, Michael and Sonuga-Barke, Edmund (2020) Why does early childhood deprivation increase the risk for depression and anxiety in adulthood? A developmental cascade model. Journal of Child Psychology & Psychiatry, 61 (9), 1043-1053. (doi:10.1111/jcpp.13205).

Record type: Article

Abstract

Background: Using data from the English & Romanian Adoptees (ERA) study, we recently reported that early time-limited exposure to severe institutional deprivation is associated with early-onset and persistent neurodevelopmental problems and later-onset emotional problems. Here, we examine possible reasons for the late emergence of emotional problems in this cohort. Our main focus is on testing a developmental cascade mediated via the functional impact of early-appearing neurodevelopmental problems on late adolescent functioning. We also explore a second putative pathway via sensitization to stress. Methods: The ERA study includes 165 Romanian individuals who spent their early lives in grossly depriving institutions and were subsequently adopted into UK families, along with 52 UK adoptees with no history of deprivation. Age six years symptoms of neurodevelopmental problems and age 15 anxiety/depression symptoms were assessed via parental reports. Young adult symptoms of depression and anxiety were assessed by both parent and self-reports; young adults also completed measures of stress reactivity, exposure to adverse life events, and functioning in work and interpersonal relationships. Results: The path between early institutional deprivation and adult emotional problems was mediated via the impact of early neurodevelopmental problems on unemployment and poor friendship functioning during the transition to adulthood. The findings with regard to early deprivation, later life stress reactivity, and emotional problems were inconclusive. Conclusions: Our analysis suggests that the risk for adult depression and anxiety following extreme institutional deprivation is explained through the effects of early neurodevelopmental problems on later social and vocational functioning. Future research should more fully examine the role of stress susceptibility in this model.

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Accepted/In Press date: 19 December 2019
e-pub ahead of print date: 6 February 2020
Published date: 1 September 2020
Additional Information: Funding Information: The Economic and Social Research Council funded the young adult follow‐up of the English and Romanian Adoptees (ERA) study (RES‐062‐23‐3300). The ERA received funding from the Department of Health (age 4‐, 6‐, 11 and 15‐year assessments; reference number 3700295; January 1, 1993, to December 31, 1997; age 15 years follow‐up; 3700295; September 1, 2003, to March 31, 2009 (National Institute for Health Research Central Commissioning Facility)), the Medical Research Council, Jacobs Foundation (October 1, 2003, to September 30, 2009), and the Nuffield Foundation (OPD/00248/G; October 1, 2003, to September 30, 2007). Funding Information: The authors would like to express their sincere gratitude to all the families and young people who have participated in this study over the many years it has been running. Without them, this work would not be possible. The authors are also grateful for comments from Graeme Fairchild (University of Bath, UK) during initial planning meetings and to Victoria Hayter and Helen Loader (University of Southampton, UK) for their support. The authors would like to thank all previous researchers on the project, especially Tom O'Connor (University of Rochester Medical Center, Rochester, NY, USA), Celia Beckett (Bournemouth University, UK), Jenny Castle (King's College London, UK), Suzanne Stevens (University of Auckland, New Zealand), Emma Colvert (King's College London, UK), Christine Groothues (retired), and Amanda Hawkins who were involved in the collection of data during the mid‐adolescent phase of the project. The authors would also like to thank their advisory board for all their useful suggestions, especially Megan Gunnar (University of Minnesota, MN, USA), Trevor Robbins (University of Cambridge, UK), and John Simmonds (CoramBAAF Adoption and Fostering Academy, London, UK). E.S.B. received speaker fees, research funding, and conference support from, and has served as consultant to, Shire Pharma, and received speaker fees from Janssen‐Cilag. E.S.B. served as consultant to Neurotech Solutions, Aarhus University, Copenhagen University, and Berhanderling, Skolerne, Copenhagen and KU Leuven. E.S.B. has received royalties from Oxford University Press and Jessica Kingsley. The remaining authors have declared that they have no competing or potential conflicts of interest. Publisher Copyright: © 2020 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.
Keywords: anxiety, depression, developmental cascades, emotional problems, institutional deprivation, longitudinal, natural experiment, neurodevelopmental problems, prospective

Identifiers

Local EPrints ID: 436787
URI: http://eprints.soton.ac.uk/id/eprint/436787
ISSN: 1469-7610
PURE UUID: 9cf427ad-072e-470d-90a0-5848bb78294c
ORCID for Dennis Golm: ORCID iD orcid.org/0000-0002-2950-7935
ORCID for Jana Kreppner: ORCID iD orcid.org/0000-0003-3527-9083

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Date deposited: 09 Jan 2020 17:30
Last modified: 17 Mar 2024 05:10

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Contributors

Author: Dennis Golm ORCID iD
Author: Barbara Maughan
Author: Edward Barker
Author: Jonathan Hill
Author: Mark Kennedy
Author: Nicola Knights
Author: Jana Kreppner ORCID iD
Author: Robert Kumsta
Author: Wolff Schlotz
Author: Michael Rutter
Author: Edmund Sonuga-Barke

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