Department of Psychology and Human Development, Vanderbilt University.
Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine.
J Consult Clin Psychol. 2020 Dec;88(12):1079-1090. doi: 10.1037/ccp0000613.
Early psychosocial deprivation is associated with increased risk for psychopathology, yet few studies have examined outcomes in adolescents.
At baseline (M age 22 months), 136 children from Bucharest, Romania, living in large institutions, were randomized into foster care (FCG) or to care as usual (CAUG). Caregivers completed psychiatric interviews regarding their children (52 FCG; 51 CAUG) at age 16 years (M = 16.67 years; SD = 0.78) to assess past year diagnoses and symptom counts. In addition, never-institutionalized community comparison children (n = 47) were included.
Ever-institutionalized children had higher rates of meeting criteria for any psychiatric disorder and higher symptom counts of internalizing, externalizing, attention-deficit/hyperactivity, and substance use disorders compared to never-institutionalized children (ps < .05). Using intent-to-treat analyses, we found that children in the CAUG had more than twice the rate of psychiatric disorders than children in the FCG (OR = 2.48, 95% CI [1.12, 5.48]). Furthermore, children in foster care who remained in their original placement did not significantly differ in their rates of psychiatric disorders compared to never-institutionalized children.
There are many ways children can be separated from parents, including placement into institutional care. The current findings indicate that such placements are associated with significant risks for psychopathology. Moreover, we provide causal evidence for the long-lasting positive effect of foster care in reducing the risk of psychopathology in adolescence, especially among those in stable placements. These results provide strong evidence that early and stable placements into quality foster care may mitigate risk for psychopathology following severe early psychosocial deprivation. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
早期心理社会剥夺与精神病理学风险增加有关，但很少有研究调查青少年的结果。
在基线（M 年龄 22 个月）时，136 名来自罗马尼亚布加勒斯特的儿童被随机分配到寄养（FCG）或常规护理（CAUG）。在 16 岁（M=16.67 岁；SD=0.78）时，照顾者完成了关于他们孩子的精神病学访谈，以评估过去一年的诊断和症状数。此外，还包括从未被机构收容的社区比较儿童（n=47）。
与从未被机构收容的儿童相比，曾被机构收容的儿童符合任何精神障碍标准的比例更高，内化、外化、注意力缺陷/多动、物质使用障碍的症状数更高（p<0.05）。使用意向治疗分析，我们发现 CAUG 组儿童的精神障碍发生率是 FCG 组的两倍多（OR=2.48，95%CI[1.12,5.48]）。此外，在寄养中仍留在原安置处的儿童与从未被机构收容的儿童相比，其精神障碍发生率没有显著差异。
儿童与父母分离的方式有很多，包括安置到机构护理中。目前的研究结果表明，这种安置与精神病理学的显著风险有关。此外，我们提供了寄养在减少青少年精神病理学风险方面具有长期积极影响的因果证据，尤其是在稳定安置中的儿童。这些结果有力地证明了早期和稳定的安置到高质量的寄养中可能减轻严重早期心理社会剥夺后精神病理学的风险。
