Skip to main content Accessibility help
×
Home

Friendship and social functioning following early institutional rearing: The role of ADHD symptoms

  • Kathryn L. Humphreys (a1), Laurel Gabard-Durnam (a2), Bonnie Goff (a3), Eva H. Telzer (a4), Jessica Flannery (a5), Dylan G. Gee (a6), Valentina Park (a7), Steve S. Lee (a3) and Nim Tottenham (a8)...

Abstract

Early institutional rearing is associated with increased risk for subsequent peer relationship difficulties, but the underlying mechanisms have not been identified. Friendship characteristics, social behaviors with peers, normed assessments of social problems, and social cue use were assessed in 142 children (mean age = 10.06, SD = 2.02; range 7–13 years), of whom 67 were previously institutionalized (PI), and 75 were raised by their biological families. Anxiety and attention-deficit/hyperactivity disorder (ADHD) symptoms, often elevated among PI children, were examined as potential mediators of PI status and baseline social functioning and longitudinal follow-ups (2 and 4 years later). Twenty-seven percent of PI children fell above the Child Behavior Checklist Social Problems cutoff. An examination of specific social behaviors with peers indicated that PI and comparison children did not differ in empathic concern or peer social approach, though parents were more likely to endorse aggression/overarousal as a reason that PI children might struggle with friendships. Comparison children outperformed PI children in computerized testing of social cue use learning. Finally, across these measures, social difficulties exhibited in the PI group were mediated by ADHD symptoms with predicted social problems assessed 4 years later. These findings show that, when PI children struggle with friendships, mechanisms involving attention and behavior regulation are likely contributors.

Copyright

Corresponding author

Author for correspondence: Kathryn L. Humphreys, Department of Psychology and Human Development, Vanderbilt University, Peabody College, 230 Appleton Place #552, Nashville, TN 37203; E-mail: k.humphreys@vanderbilt.edu

References

Hide All
Achenbach, T. M., & Rescorla, L. A. (2001). ASEBA school age forms and profiles. University of Vermont. Burlington, VT: ASEBA.
Almas, A. N., Degnan, K. A., Radulescu, A., Nelson, C. A., Zeanah, C. H., & Fox, N. A. (2012). Effects of early intervention and the moderating effects of brain activity on institutionalized children's social skills at age 8. PNAS, 109 Suppl, 1722817231. doi: 10.1073/pnas.1121256109
Almas, A. N., Degnan, K. A., Walker, O. L., Radulescu, A., Nelson, C. A., Zeanah, C. H., & Fox, N. A. (2015). The effects of early institutionalization and foster care intervention on children's social behaviors at the age of eight. Social Development, 24(2), 225239. doi: 10.1111/sode.12089
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Arlington, VA, DC: American Psychiatric Publishing.
Bagwell, C. L., Molina, B. S. G., Pelham, W. E., & Hoza, B. (2001). Attention-deficit hyperactivity disorder and problems in peer relations: Predictions from childhood to adolescence. Journal of the American Academy of Child and Adolescent Psychiatry, 40(11), 12851292. doi: 10.1097/00004583-200111000-00008
Bick, J., Luyster, R., Fox, N. A., Zeanah, C. H., & Nelson, C. A. (2017). Effects of early institutionalization on emotion processing in 12-year-old youth. Development and Psychopathology, 29(05), 17491761. doi: 10.1017/S0954579417001377
Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. (1997). The Screen for Child Anxiety Related Emotional Disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 545553. doi: 10.1097/00004583-199704000-00018
Bornstein, M. H., Hendricks, C., Haynes, O. M., & Painter, K. M. (2007). Maternal sensitivity and child responsiveness: Associations with social context, maternal characteristics, and child characteristics in a multivariate analysis. Infancy, 12(2), 189223.
Bruce, J., Tarullo, A. R., & Gunnar, M. R. (2009). Disinhibited social behavior among internationally adopted children. Development and Psychopathology, 21(1), 157171. doi: 10.1017/S0954579409000108
Callaghan, B. L., & Tottenham, N. (2015). The neuro-environmental loop of plasticity: A cross-species analysis of parental effects on emotion circuitry development following typical and adverse caregiving. Neuropsychopharmacology, 41(1), 114. doi: 10.1038/npp.2015.204
Csáky, C. (2009). Keeping children out of harmful institutions: Why we should be investing in family-based care. Save the Children, 134.
de Boo, G. M., & Prins, P. J. M. (2007). Social incompetence in children with ADHD: Possible moderators and mediators in social-skills training. Clinical Psychology Review, 27, 7897. doi: 10.1016/j.cpr.2006.03.006
Delis, D. C., Freeland, J., Kramer, J. H., & Kaplan, E. (1988). Integrating clinical assessment with cognitive neuroscience: Construct validation of the California Verbal Learning Test. Journal of Consulting and Clinical Psychology, 56(1), 123130. doi: 10.1037/0022-006X.56.1.123
Ellis, B. H., Fisher, P. A., & Zaharie, S. (2004). Predictors of disruptive behavior, developmental delays, anxiety, and affective symptomatology among institutionally reared Romanian children. Journal of the American Academy of Child and Adolescent Psychiatry, 43(10), 12831292. doi: 10.1097/01.chi.0000136562.24085.160
Erath, S. A., Flanagan, K. S., & Bierman, K. L. (2007). Social anxiety and peer relations in early adolescence: Behavioral and cognitive factors. Journal of Abnormal Child Psychology, 35, 405416. doi: 10.1007/s10802-007-9099-2
Erol, N., Simsek, Z., & Münir, K. (2010). Mental health of adolescents reared in institutional care in Turkey: Challenges and hope in the twenty-first century. European Child and Adolescent Psychiatry, 19(2), 113124. doi: 10.1007/s00787-009-0047-2
Feldman, R., & Klein, P. S. (2003). Toddlers’ self-regulated compliance to mothers, caregivers, and fathers: Implications for theories of socialization. Developmental Psychology, 39(4), 680692. doi: 10.1037/0012-1649.39.4.680
Frankel, F. D. (2005). Parent-Assisted Children's Friendship Training. In Psychosocial treatments for child and adolescent disorders: Empirically based strategies for clinical practice (2nd ed., pp. 693715).
Frankel, F. D., & Feinberg, D. (2002). Social problems associated with ADHD vs. ODD in children referred for friendship problems. Child Psychiatry and Human Development, 33(2), 125146. doi: 10.1023/A:1020730224907
Frankel, F. D., Myatt, R., Cantwell, D. P., & Feinberg, D. T. (1997). Parent-assisted transfer of children's social skills training: Effects on children with and without attention-deficit hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 36(8), 10561064. doi: 10.1097/00004583-199708000-00013
Fries, A. B. W., & Pollak, S. D. (2004). Emotion understanding in postinstitutionalized Eastern European children. Development and Psychopathology, 16, 355369. doi: 10.1017/S0954579404044554
Gabard-Durnam, L. J., Flannery, J., Goff, B., Gee, D. G., Humphreys, K. L., Telzer, E., … Tottenham, N. (2014). The development of human amygdala functional connectivity at rest from 4 to 23 years: A cross-sectional study. NeuroImage, 95, 193207. doi: 10.1016/j.neuroimage.2014.03.038
Gleason, M. M., Fox, N. A., Drury, S., Smyke, A. T., Egger, H. L., Nelson, C. A., … Zeanah, C. H. (2011). Validity of evidence-derived criteria for reactive attachment disorder: Indiscriminately social/disinhibited and emotionally withdrawn/inhibited types. Journal of the American Academy of Child and Adolescent Psychiatry, 50, 216231. doi: 10.1016/j.jaac.2010.12.012
Goff, B., & Tottenham, N. (2015). Early-life adversity and adolescent depression: Mechanisms involving the ventral striatum. CNS Spectrums, 20(4), 337345. doi: 10.1017/S1092852914000674
Groza, V., Ryan, S. D., & Cash, S. J. (2003). Institutionalization, behavior and international adoption: Predictors of behavior problems. Journal of Immigrant Health, 5(1), 517. doi: 10.1023/A:1021096028003
Guyon-Harris, K. L., Humphreys, K. L., Degnan, K. A., Fox, N. A., Nelson, C. A., & Zeanah, C. H. (2018). A prospective longitudinal study of reactive attachment disorder following early institutional care: Considering variable- and person-centered approaches. Attachment & Human Development, 23, 116. doi: 10.1080/14616734.2018.1499208
Guyon-Harris, K. L., Humphreys, K. L., Fox, N. A., Nelson, C. A., & Zeanah, C. H. (2018a). Course of disinhibited social engagement disorder from early childhood to early adolescence. Journal of the American Academy of Child and Adolescent Psychiatry, 57(5), 329335.e2. doi: 10.1016/J.JAAC.2018.02.009
Guyon-Harris, K. L., Humphreys, K. L., Fox, N. A., Nelson, C. A., & Zeanah, C. H. (2018b). Signs of attachment disorders and social functioning among early adolescents with a history of institutional care. Child Abuse and Neglect, 88, 96106. doi: 10.1016/j.chiabu.2018.11.005
Hawk, B., & McCall, R. B. (2010). CBCL behavior problems of post-institutionalized international adoptees. Clinical Child and Family Psychology Review, 13(2), 199211. doi: 10.1007/s10567-010-0068-x
Hayes, A. (2013). Introduction to mediation, moderation, and conditional process analysis. New York, NY: Guilford Press. doi: 978-1-60918-230-4
Hodges, J., & Tizard, B. (1989). Social and family relationships of ex-institutional adolescents. Journal of Child Psychology and Psychiatry, 30, 7797. doi: 10.1111/j.1469-7610.1989.tb00770.x
Humphreys, K. L., Galán, C. A., Tottenham, N., & Lee, S. S. S. (2016). Impaired social decision-making mediates the association between ADHD and social problems. Journal of Abnormal Child Psychology, 44(5), 10231032. doi: 10.1007/s10802-015-0095-7
Humphreys, K. L., Gleason, M. M., Drury, S. S., Miron, D., Nelson, C. A., Fox, N. A., & Zeanah, C. H. (2015). Effects of institutional rearing and foster care on psychopathology at age 12 years in Romania: Follow-up of an open, randomised controlled trial. The Lancet Psychiatry, 2(7), 625634. doi: 10.1016/S2215-0366(15)00095-4
Humphreys, K. L., McGoron, L., Sheridan, M. A., McLaughlin, K. A., Fox, N. A., Nelson, C. A., & Zeanah, C. H. (2015). High-quality foster care mitigates callous-unemotional traits following early deprivation in boys: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 54(12), 977983. doi: 10.1016/j.jaac.2015.09.010
Humphreys, K. L., Miron, D., McLaughlin, K. A., Sheridan, M. A., Nelson, C. A., Fox, N. A., & Zeanah, C. H. (2018). Foster care promotes adaptive functioning in early adolescence among children who experienced severe, early deprivation. Journal of Child Psychology and Psychiatry, 59, 811821. doi: 10.1111/jcpp.12865.
Humphreys, K. L., Nelson, C. A., Fox, N. A., & Zeanah, C. H. (2017). Signs of reactive attachment disorder and disinhibited social engagement disorder at age 12 years: Effects of institutional care history and high-quality foster care. Development and Psychopathology, 29(2), 675684. doi: 10.1017/S0954579417000256
Humphreys, K. L., & Zeanah, C. H. (2015). Deviations from the expectable environment in early childhood and emerging psychopathology. Neuropsychopharmacology, 40(1), 154170. doi: 10.1038/npp.2014.165
Julian, M. M. (2013). Age at adoption from institutional care as a window into the lasting effects of early experiences. Clinical Child and Family Psychology Review, 16(2), 101145. doi: 10.1007/s10567-013-0130-6
Julian, M. M., & McCall, R. B. (2016). Social skills in children adopted from socially-emotionally depriving institutions. Adoption Quarterly, 19(1), 4462. doi: 10.1080/10926755.2015.1088106
Kim, W. J., Shin, Y. J., & Carey, M. P. (1999). Comparison of Korean-American adoptees and biological children of their adoptive parents: A pilot study. Child Psychiatry and Human Development, 29(3), 221228. doi: 10.1023/A:1022665024514
Kirsh, S. J., & Mounts, J. R. W. (2007). Violent video game play impacts facial emotion recognition. Aggressive Behavior, 33(4), 353358. doi: 10.1002/ab.20191
Kreppner, J. M., O'Connor, T. G., & Rutter, M. (2001). Can inattention/overactivity be an institutional deprivation syndrome? Journal of Abnormal Child Psychology, 29(6), 513528.
Kumsta, R., Kreppner, J., Rutter, M., Beckett, C., Castle, J., Stevens, S., & Sonuga-Barke, E. J. (2010). III. Deprivation-specific psychological patterns. Monographs of the Society for Research in Child Development, 75(1), 4878. doi: 10.1111/j.1540-5834.2010.00550.x
Kumsta, R., Sonuga-Barke, E., & Rutter, M. (2012). Adolescent callous-unemotional traits and conduct disorder in adoptees exposed to severe early deprivation. British Journal of Psychiatry, 200, 197201. doi: 10.1192/bjp.bp.110.089441
Laible, D., & Thompson, R. A. (2007). Early socialization: A relationship perspective. In Grusec, J. E. & Hastings, P. D. (Eds.), Handbook of Socialization: Theory and Research (pp. 181207). New York: Guilford Press.
Landry, S. H., Smith, K. E., Miller-Loncar, C. L., & Swank, P. R. (1997). Predicting cognitive-language and social growth curves from early maternal behaviors in children at varying degrees of biological risk. Developmental Psychology, 33(6), 10401053. doi: 10.1037/0012-1649.33.6.1040
Lejuez, C. W., Aklin, W. M., Jones, H. A., Richards, J. B., Strong, D. R., Kahler, C. W., & Read, J. P. (2003). The Balloon Analogue Risk Task (BART) differentiates smokers and nonsmokers. Experimental and Clinical Psychopharmacology, 11, 2633. doi: 10.1037/1064-1297.11.1.26
Levin, A. R., Fox, N. A., Zeanah, C. H., & Nelson, C. A. (2015). Social communication difficulties and autism in previously institutionalized children. Journal of the American Academy of Child and Adolescent Psychiatry, 54(2), 108115.e1. doi: 10.1016/j.jaac.2014.11.011
Li, Y. H., & Tottenham, N. (2013). Exposure to the self-face facilitates identification of dynamic facial expressions: Influences on individual differences. Emotion, 13(2), 196202. doi: 10.1037/a0030755
McLaughlin, K. A., Sheridan, M. A., & Nelson, C. A. (2017). Neglect as a violation of species-expectant experience: Neurodevelopmental consequences. Biological Psychiatry, 82, 462471. doi: 10.1016/j.biopsych.2017.02.1096
Merrell, K. W., & Boelter, E. (2001). An investigation of relationships between social behavior and ADHD in children and youth: Construct validity of the Home and Community Social Behavior Scales. Journal of Emotional and Behavioral Disorders, 9(4), 260269. doi: 10.1177/106342660100900406
Merz, E. C., & McCall, R. B. (2010). Behavior problems in children adopted from psychosocially depriving institutions. Journal of Abnormal Child Psychology, 38(4), 459470. doi: 10.1007/s10802-009-9383-4
Rutter, M., Colvert, E., Kreppner, J., Beckett, C., Castle, J., Groothues, C., … Sonuga-Barke, E. J. S. S. (2007). Early adolescent outcomes for institutionally-deprived and non-deprived adoptees. I: Disinhibited attachment. Journal of Child Psychology and Psychiatry, 48(1), 1730. doi: 10.1111/j.1469-7610.2006.01688.x
Rutter, M., Kreppner, J., Croft, C., Murin, M., Colvert, E., Beckett, C., … Sonuga-Barke, E. (2007). Early adolescent outcomes of institutionally deprived and non-deprived adoptees. III. Quasi-autism. Journal of Child Psychology and Psychiatry, 48(12), 12001207. doi: 10.1111/j.1469-7610.2007.01792.x
Rutter, M., Sonuga-Barke, E. J., & Castle, J. (2010). I. Investigating the impact of early institutional deprivation on development: Background and research strategy of the English and Romanian Adoptees (ERA) study. Monographs of the Society for Research in Child Development, 75(1), 120. doi: 10.1111/j.1540-5834.2010.00548.x
Shaw, D. S., Bell, R. Q., & Gilliom, M. (2000). A truly early starter model of antisocial behavior revisited. Clinical Child and Family Psychology Review, 3(3), 155172. doi: 10.1023/A:1009599208790
Smyke, A. T., Koga, S. F., Johnson, D. E., Fox, N. A., Marshall, P. J., Nelson, C. A., & Zeanah, C. H. (2007). The caregiving context in institution-reared and family-reared infants and toddlers in Romania. Journal of Child Psychology and Psychiatry, 48, 210218. doi: 10.1111/j.1469-7610.2006.01694.x
Sonuga-Barke, E. J. S., Kennedy, M., Kumsta, R., Knights, N., Golm, D., Rutter, M., … Kreppner, J. (2017). Child-to-adult neurodevelopmental and mental health trajectories after early life deprivation: The young adult follow-up of the longitudinal English and Romanian adoptees study. The Lancet, 389(10078), 15391548. doi: 10.1016/S0140-6736(17)30045-4
Sonuga-Barke, E. J. S., Schlotz, W., & Kreppner, J. (2010). V. Differentiating developmental trajectories for conduct, emotion, and peer problems following early deprivation. Monographs of the Society for Research in Child Development, 75(1), 102124.
Stevens, S. E., Sonuga-Barke, E. J. S., Kreppner, J. M., Beckett, C., Castle, J., Colvert, E., … Rutter, M. (2008). Inattention/overactivity following early severe institutional deprivation: Presentation and associations in early adolescence. Journal of Abnormal Child Psychology, 36(3), 385398. doi: 10.1007/s10802-007-9185-5
Strauss, C. C., Lease, C. A., Kazdin, A. E., Dulcan, M. K., & Last, C. G. (1989). Multimethod assessment of the social competence of children with anxiety disorders. Journal of Clinical Child Psychology, 18, 184189. doi: 10.1207/s15374424jccp1802_10
Tibu, F., Humphreys, K. L., Fox, N. A., Nelson, C. A., & Zeanah, C. H. (2014). Psychopathology in young children in two types of foster care following institutional rearing. Infant Mental Health Journal, 35(2), 123131. doi: 10.1002/imhj.21428
Tottenham, N. (2012). Risk and developmental heterogeneity in previously institutionalized children. The Journal of Adolescent Health, 51(2 Suppl), S29S33. doi: 10.1016/j.jadohealth.2012.04.004
Tottenham, N. (2015). Social scaffolding of human amygdala-mPFCcircuit development. Social Neuroscience, 10(5), 111. doi: 10.1080/17470919.2015.1087424
Tottenham, N., Hare, T. A., Quinn, B. T., McCarry, T. W., Nurse, M., Gilhooly, T., … Casey, B. J. (2010). Prolonged institutional rearing is associated with atypically large amygdala volume and difficulties in emotion regulation. Developmental Science, 13, 4661. doi: 10.1111/j.1467-7687.2009.00852.x
Tottenham, N., Tanaka, J. W., Leon, A. C., McCarry, T., Nurse, M., Hare, T. A., … Nelson, C. (2009). The NimStim set of facial expressions: Judgments from untrained research participants. Psychiatry Research, 168(3), 242249. doi: 10.1016/j.psychres.2008.05.006
van IJzendoorn, M. H., Palacios, J., Sonuga-Barke, E. J. S., Gunnar, M. R., Vorria, P., McCall, R. B., … Juffer, F. (2011). I. Children in institutional care: Delayed development and resilience. Monographs of the Society for Research in Child Development, 76(4), 830. doi: 10.1111/j.1540-5834.2011.00626.x
VanTieghem, M. R., Gabard-Durnam, L., Goff, B., Flannery, J., Humphreys, K. L., Telzer, E. H., … Tottenham, N. (2017). Positive valence bias and parent–child relationship security moderate the association between early institutional caregiving and internalizing symptoms. Development and Psychopathology, 29, 519533. doi: 10.1017/S0954579417000153
Wiik, K. L., Loman, M. M., Van Ryzin, M. J., Armstrong, J. M., Essex, M. J., Pollak, S. D., & Gunnar, M. R. (2011). Behavioral and emotional symptoms of post-institutionalized children in middle childhood. Journal of Child Psychology and Psychiatry, 52, 5663. doi: 10.1111/j.1469-7610.2010.02294.x
Young, A., Luyster, R. J., Fox, N. A., Zeanah, C. H., & Nelson, C. A. (2017). The effects of early institutionalization on emotional face processing: Evidence for sparing via an experience-dependent mechanism. British Journal of Developmental Psychology, 35(3), 439453. doi: 10.1111/bjdp.12185
Zeanah, C. H., Humphreys, K. L., Fox, N. A., & Nelson, C. A. (2017). Alternatives for abandoned children: Insights from the Bucharest Early Intervention Project. Current Opinion in Psychology, 15, 182188. doi: 10.1016/j.copsyc.2017.02.024
Zeanah, C. H., Nelson, C. A., Fox, N. A., Smyke, A. T., Marshall, P., Parker, S. W., & Koga, S. (2003). Designing research to study the effects of institutionalization on brain and behavioral development: The Bucharest Early Intervention Project. Development and Psychopathology, 15, 885907. doi: 10.1017/S0954579403000452
Zeanah, C. H., Smyke, A. T., & Settles, L. (2006). Children in orphanages. In McCartney, K. & Phillips, D. (Eds.), Blackwell Handbook of Early Childhood Development (pp. 224254). Malden, MA: Blackwell Publishing.

Keywords

Related content

Powered by UNSILO
Type Description Title
WORD
Supplementary materials

Humphreys et al. supplementary material
Humphreys et al. supplementary material 1

 Word (15 KB)
15 KB

Friendship and social functioning following early institutional rearing: The role of ADHD symptoms

  • Kathryn L. Humphreys (a1), Laurel Gabard-Durnam (a2), Bonnie Goff (a3), Eva H. Telzer (a4), Jessica Flannery (a5), Dylan G. Gee (a6), Valentina Park (a7), Steve S. Lee (a3) and Nim Tottenham (a8)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.