Departamento de Psicología Evolutiva y de la Educación, Universidad de Sevilla, Spain.
Departamento de Psicología Evolutiva y de la Educación, Universidad de Sevilla, Spain.
Child Abuse Negl. 2022 Aug;130(Pt 2):105308. doi: 10.1016/j.chiabu.2021.105308. Epub 2021 Sep 17.
A high incidence of Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) has been reported for children with experiences of trauma and other forms of adversity.
The present study aims to explore symptoms of RAD and DSED in children in two protection alternatives (international adoption and residential care) after experiences of early adversity.
The participants were 146 children: 40 children adopted into Spanish families from Russia, 49 children in residential care in Spanish institutions (40.8% in long-term foster centers) and 57 community comparison children.
The Relationship Problems Questionnaire was used to explore both RAD and DSED. All adoptive parents and institutional caregivers retrospectively reported the problems at time of placement (Wave 0), as well as the symptoms observed at the time of the study, with children aged 4-8 years old (Wave 1). At this stage, the assessment of the community comparison group was added.
Adopted and children in residential care presented high levels of RAD and DSED symptoms at placement. For adoptees, previous experiences of abuse and neglect were marginally associated with the initial presence of RAD symptoms and a significant recovery was observed after an average of three years in their families, with a certain level of longitudinal continuity between initial and later assessments. In children currently placed in long-term residential centers in Spain, DSED symptoms worsened from W0 to W1.
Adoption appears to be an effective intervention that promotes recovery of RAD and DSED symptomatology after early adversity, whereas institutionalization causes negative effects.
有研究报道，经历创伤和其他逆境的儿童中，出现反应性依恋障碍（RAD）和去抑制型社会参与障碍（DSED）的发病率较高。
本研究旨在探讨经历早期逆境后，两种保护替代方式（国际收养和机构照料）中儿童的 RAD 和 DSED 症状。
共有 146 名儿童参与了本研究：40 名从俄罗斯被收养到西班牙家庭的儿童、49 名在西班牙机构接受机构照料的儿童（40.8%在长期寄养中心）和 57 名社区对照儿童。
采用关系问题问卷（Relationship Problems Questionnaire）来探索 RAD 和 DSED。所有收养父母和机构照顾者在安置时（第 0 波）回顾性地报告了问题，以及在研究时观察到的症状，当时儿童年龄在 4-8 岁（第 1 波）。在这个阶段，还增加了对社区对照组的评估。
收养和机构照料的儿童在安置时表现出较高水平的 RAD 和 DSED 症状。对于收养儿童，以前的虐待和忽视经历与初始 RAD 症状的出现呈边缘相关，在被收养家庭中平均三年后观察到显著恢复，初始和后期评估之间存在一定的纵向连续性。在西班牙长期居住在机构中心的儿童中，DSED 症状从 W0 到 W1 恶化。
收养似乎是一种有效的干预措施，可促进经历早期逆境后 RAD 和 DSED 症状的恢复，而机构化则会产生负面影响。
