Delayed Maturation in Brain Electrical Activity Partially Explains the Association Between Early Environmental Deprivation and Symptoms of Attention-Deficit/Hyperactivity Disorder

doi:10.1016/j.biopsych.2010.04.005

Biological Psychiatry

Volume 68, Issue 4, 15 August 2010, Pages 329-336

https://doi.org/10.1016/j.biopsych.2010.04.005 Get rights and content

Background

Children raised in institutional settings are exposed to social and environmental circumstances that may deprive them of expected environmental inputs during sensitive periods of brain development that are necessary to foster healthy development. This deprivation is thought to underlie the abnormalities in neurodevelopment that have been found in previously institutionalized children. It is unknown whether deviations in neurodevelopment explain the high rates of developmental problems evident in previously institutionalized children, including psychiatric disorders.

Methods

We present data from a sample of children raised in institutions in Bucharest, Romania (n = 117) and an age- and sex-matched sample of community control subjects (n = 49). Electroencephalogram data were acquired following entry into the study at age 6 to 30 months, and a structured diagnostic interview of psychiatric disorders was completed at age 54 months.

Results

Children reared in institutions evidenced greater symptoms of attention-deficit/hyperactivity disorder, anxiety, depression, and disruptive behavior disorders than community controls. Electroencephalogram revealed significant reductions in alpha relative power and increases in theta relative power among children reared in institutions in frontal, temporal, and occipital regions, suggesting a delay in cortical maturation. This pattern of brain activity predicted symptoms of hyperactivity and impulsivity at age 54 months, and significantly mediated the association between institutionalization and attention-deficit/hyperactivity disorder symptoms. Electroencephalogram power was unrelated to depression, anxiety, or disruptive behaviors.

Conclusions

These findings document a potential neurodevelopmental mechanism underlying the association between institutionalization and psychiatric morbidity. Deprivation in social and environmental conditions may perturb early patterns of neurodevelopment and manifest as psychiatric problems later in life.

Section snippets

Sample

The BEIP is a longitudinal study that has followed a sample of children who were raised from early infancy in institutions in Bucharest, Romania. The BEIP was designed as the first randomized controlled trial of foster care among abandoned children placed in institutions (24). A sample of 136 children (aged 6–30 months) was recruited from institutions in Bucharest. An age-matched sample of 72 children who had never been institutionalized was recruited for participation from pediatric clinics in

Institutionalization and Psychopathology

Elevations in psychiatric symptomatology were evident among institutionalized children relative to community control subjects at 54 months. Children who were institutionalized had a greater number of ADHD symptoms of inattention [F(1,147) = 21.3, p < .001], hyperactivity [F(1,147) = 11.4, p < .001], and impulsivity [F(1,147) = 16.6, p < .001], at 54 months than community control subjects (Table 1). Symptoms of anxiety [F(1,147) = 10.3, p = .002], depression [F(1,147) = 15.0, p < .001], and ODD [

Discussion

We provide evidence for a neurodevelopmental mechanism linking early institutional rearing with hyperactivity and impulsivity, two core features of ADHD. Specifically, we find that differences in brain activity among young children raised in Romanian institutions relative to community control subjects explain, in part, differences in the prevalence of symptoms of ADHD between these groups at 54 months. This neurodevelopmental mechanism is specific to the development of the ADHD symptoms of

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Archival ReportDelayed Maturation in Brain Electrical Activity Partially Explains the Association Between Early Environmental Deprivation and Symptoms of Attention-Deficit/Hyperactivity Disorder

Background

Methods

Results

Conclusions

Section snippets

Sample

Institutionalization and Psychopathology

Discussion

Neuroimage

Clin Neurophysiol

Biol Psychiatry

Pediatr Neurol

Clin Neurophysiol

Clin Neurophysiol

Clin Neurophysiol

Electroencephalogr Clin Neurophysiol

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Child Abus Negl

Electroencephalogr Clin Neurophysiol

Electroencephalogr Clin Neurophysiol

A neurobiological perspective on early human deprivation

Child Dev Perspect

Inattention/overactivity following early severe institutional deprivation: Presentation and associations in early adolescence

J Abnorm Child Psych

Institutional rearing and psychiatric disorders in Romanian preschool children

Am J Psychiatry

Can inattention/overactivity be an institutional deprivation syndrome?

J Abnorm Child Psych

Specificity and heterogeneity in children's responses to profound institutional privation

Br J Psychiatry

Children without parental care

Total Adoptions to the United States

Developmental catch-up, and deficit, following adoption after severe global early privation

J Child Psych Psychiatry

Cognitive recovery in socially deprived young children: The Bucharest Early Intervention Project

Science

Child–parent attachment following early institutional deprivation

Dev Psychopathol

Attachment in institutionalized and community children in Romania

Child Dev

Normality and impairment following profound early institutional deprivation: A longitudinal follow-up into early adolescence

Dev Psych

Mechanisms of brain development: Neuronal sculpting by the physical and social environment

A comparison of the electroencephalogram between institutionalized and community children

J Cognit Neurosci

Archival Report
Delayed Maturation in Brain Electrical Activity Partially Explains the Association Between Early Environmental Deprivation and Symptoms of Attention-Deficit/Hyperactivity Disorder