Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK.
Cognitive Neuroscience & Neuropsychiatry Section, University College London, London, UK.
Psychol Med. 2021 Nov;51(15):2675-2684. doi: 10.1017/S0033291720001294. Epub 2020 May 18.
Institutional deprivation in early childhood is associated with neuropsychological deficits in adolescence. Using 20-year follow-up data from a unique natural experiment - the large-scale adoption of children exposed to extreme deprivation in Romanian institutions in the 1980s -we examined, for the first time, whether such deficits are still present in adulthood and whether they are associated with deprivation-related symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).
Adult neuropsychological functioning was assessed across five domains (inhibitory control, emotion recognition, decision-making, prospective memory and IQ) in 70 previously institutionalized adoptees (mean age = 25.3, 50% female) and 22 non-deprived UK adoptees (comparison group, mean age = 24.6, 41% female). ADHD and ASD symptoms were assessed using parent-completed questionnaires.
Early institutionalization was associated with impaired performance on all tasks in adulthood. Prospective memory deficits persisted after controlling for IQ. ADHD and ASD symptoms were positively correlated. After controlling for ASD symptoms, ADHD symptoms remained associated with deficits in IQ, prospective memory, proactive inhibition, decision-making quality and emotion recognition. ASD symptoms were not independently associated with neuropsychological deficits when accounting for their overlap with ADHD symptoms. Multiple regression analysis revealed that the link between childhood deprivation and adult ADHD symptoms was statistically explained by deprivation-related differences in adult IQ and prospective memory.
These results represent some of the most compelling evidence to date of the enduring power of early, time-limited childhood adversity to impair long-term neuropsychological functioning across the lifespan - effects that are linked specifically to deprivation-related adult ADHD symptoms.
儿童早期的机构剥夺与青少年时期的神经心理缺陷有关。利用 20 年的后续数据进行了一项独特的自然实验 - 20 世纪 80 年代罗马尼亚大规模收养暴露于极端剥夺环境中的儿童 - 我们首次研究了这些缺陷是否仍然存在于成年期，以及它们是否与注意力缺陷/多动障碍（ADHD）和自闭症谱系障碍（ASD）的与剥夺相关的症状有关。
在 70 名曾被机构收养的成年被试（平均年龄=25.3 岁，50%为女性）和 22 名未被剥夺的英国收养者（对照组，平均年龄=24.6 岁，41%为女性）中，评估了五个领域（抑制控制、情绪识别、决策、前瞻性记忆和 IQ）的成人神经心理功能。使用父母填写的问卷评估 ADHD 和 ASD 症状。
早期机构化与成年后所有任务的表现受损有关。在控制 IQ 后，前瞻性记忆缺陷仍然存在。ADHD 和 ASD 症状呈正相关。在控制 ASD 症状后，ADHD 症状仍然与 IQ、前瞻性记忆、主动抑制、决策质量和情绪识别缺陷相关。在考虑到与 ADHD 症状的重叠后，ASD 症状与神经心理缺陷没有独立相关。多元回归分析表明，童年时期的剥夺与成年期 ADHD 症状之间的联系在统计学上可以用成年期与剥夺相关的 IQ 和前瞻性记忆的差异来解释。
这些结果代表了迄今为止最有说服力的证据之一，证明了早期、限时的儿童逆境对终身神经心理功能的持久影响 - 这些影响与与剥夺相关的成年 ADHD 症状具体相关。
