Linking caregiving quality during infancy to brain activity in early childhood and later executive function.

There is no relationship more vital than the one a child shares with their primary caregivers early in development. Yet many children worldwide are raised in settings that lack the warmth, connection, and stimulation provided by a responsive primary caregiver. In this study, we used data from the Bucharest Early Intervention Project (BEIP), a longitudinal study of institutionally-reared and family-reared children, to test how caregiving quality during infancy is associated with average EEG power over the first 3.5 years of life in alpha, beta, and theta frequency bands, and associations with later executive function (EF) at age 8 years. The sample comprised 189 children (129 institutionally-reared; 60 family-reared) who contributed data on observed caregiving quality during infancy (baseline; average age of 22 months), resting EEG power at baseline, 30, and 42 months, and performance-based data on a series of EF tasks at 8 years. Using Bayesian estimation, observed caregiving quality at baseline was marginally linked with higher average alpha and beta power, and lower theta power, from baseline to 42 months. In turn, higher average beta power and lower average theta power were marginally associated with higher EF at 8 years. In indirect effects models, higher caregiving quality at baseline was associated with higher EF at 8 years, with a marginal indirect effect through average theta power from baseline to 42 months. Variation in the quality of the early caregiving environment may be associated with later executive function, which is partially underpinned by individual differences in brain activity during early childhood. RESEARCH HIGHLIGHTS: Examined associations between caregiving quality during infancy, brain activity during early childhood, and executive function during mid-childhood in sample of never-institutionalized and institutionally-reared children. Significant associations between higher quality caregiving during infancy and higher executive function during middle childhood. Marginal associations between caregiving quality during infancy and brain activity during early childhood. Marginal associations between brain activity during early childhood and executive function during mid-childhood.

Resting brain activity in early childhood predicts IQ at 18 years.

Resting brain activity has been widely used as an index of brain development in neuroscience and clinical research. However, it remains unclear whether early differences in resting brain activity have meaningful implications for predicting long-term cognitive outcomes. Using data from the Bucharest Early Intervention Project (Zeanah et al., 2003), we examined the impact of institutional rearing and the consequences of early foster care intervention on 18-year IQ. We found that higher resting theta electroencephalogram (EEG) power, reflecting atypical neurodevelopment, across three assessments from 22 to 42 months predicted lower full-scale IQ at 18 years, providing the first evidence that brain activity in early childhood predicts cognitive outcomes into adulthood. In addition, both institutional rearing and later (vs. earlier) foster care intervention predicted higher resting theta power in early childhood, which in turn predicted lower IQ at 18 years. These findings demonstrate that experientially-induced changes in brain activity early in life have profound impact on long-term cognitive development, highlighting the importance of early intervention for promoting healthy development among children living in disadvantaged environments.

Parent-child separation and cardiometabolic outcomes and risk factors in adulthood: A systematic review.

BACKGROUND: Parent-child separation has been associated with negative mental health across childhood and adulthood, yet little is known about the long-term impacts for cardiovascular health. This systematic review synthesized and evaluated the quality of the literature examining the association between exposures to parent-child separation and cardiometabolic outcomes in adulthood. METHODS: Following a registered protocol, online databases (Pubmed, PsycInfo, and Web of Science) were searched for relevant studies. Studies were included if they (a) defined the exposure before age 18 as institutionalization, foster care placement, parental incarceration, separation due to parents migrating for economic reasons, or asylum and war; and (b) quantified the association between parent-child separation and cardiometabolic events and diagnoses (e.g., coronary heart disease, diabetes) and risk factors (e.g., body mass index, fat distribution, serum-based metabolic markers, inflammatory markers in adulthood (≥ age 18). Studies lacking an unexposed comparison group were excluded. The risk for bias in each study was assessed with a modified Newcastle-Ottawa Scale. RESULTS: Of the 1938 studies identified, 13 met our inclusion criteria. Two of the four studies examining associations between parent-child separation and cardiometabolic events and diagnoses found positive associations with coronary heart disease and diabetes. Amongst the 13 studies examining associations with any type of adult cardiometabolic risk factors, eight studies reported at least one positive association. Sub-analyses considering separate reasons for parent-child separation provided clearer insights: War evacuation was associated with hypertension and high blood pressure across four studies from the same cohort; out-of home care experiences largely evidenced null results across five different studies, and two studies on parental incarceration suggested positive associations with elevated inflammation, BMI and blood pressure. CONCLUSIONS: The connections between parent-child separation and adult cardiometabolic outcomes and risk factors are currently inconsistent. The results may depend on the reason for separation, age of assessment, analytic differences and other psychosocial variables that are often unmeasured in this literature.

Longitudinal patterns of childhood homelessness and early adolescent trajectories of internalising and externalising behaviour.

BACKGROUND: Child homelessness has been associated with elevated mental health problems during early adolescence, a period of onset for psychiatric problems. Prior literature has relied on cross-sectional studies, limiting the understanding of temporality and trajectories of psychopathology. We extend prior literature by examining associations between child homelessness and internalising and externalising symptom trajectories in early adolescence, with consideration of timing and persistence of homelessness. METHODS: Using population-based longitudinal data from the Avon Longitudinal Study of Parents and Children, we used multilevel models to examine the effects of homelessness prior to age 9, the timing of homelessness (eg, early vs middle childhood) and cumulative exposure to homelessness on internalising and externalising trajectories across ages <0-9 years. We also tested for sex differences in these associations. RESULTS: Of the 8391 participants, 5.5% reported exposure to homelessness at least once before age 9. Children who experienced homelessness had elevated internalising and externalising symptoms compared with their consistently housed peers, with excess risk evident among children who first experienced homelessness in middle childhood (relative to early childhood) and children who experienced recurrent homelessness. We did not observe changes in symptom trajectories over the course of 4 years. Men who experienced homelessness displayed a more pronounced risk of internalising symptoms relative to women and men who did not experience homelessness. CONCLUSION: Childhood homelessness is associated with persistently elevated internalising and externalising symptoms across early adolescence compared with their consistently housed peers. Interventions and policies to address family homelessness may lead to better mental health among adolescents.

Effects of foster care intervention and caregiving quality on the bidirectional development of executive functions and social skills following institutional rearing.

Institutional rearing negatively impacts the development of children's social skills and executive functions (EF). However, little is known about whether childhood social skills mediate the effects of the foster care intervention (FCG) and foster caregiving quality following early institutional rearing on EF and social skills in adolescence. We examined (a) whether children's social skills at 8 years mediate the impact of the FCG on the development of EF at ages 12 and 16 years, and (b) whether social skills and EF at ages 8 and 12 mediate the relation between caregiving quality in foster care at 42 months and subsequent social skills and EF at age 16. Participants included abandoned children from Romanian institutions, who were randomly assigned to a FCG (n = 68) or care as usual (n = 68), and a never-institutionalized group (n = 135). At ages 8, 12, and 16, social skills were assessed via caregiver and teacher reports and EF were assessed via the Cambridge Neuropsychological Test Automated Battery. Caregiving quality of foster caregivers was observed at 42 months. FCG predicted better social skills at 8 years, which in turn predicted better EF in adolescence. Higher caregiver quality in foster care at 42 months predicted better social skills at 8 and 12 years, and better EF at 12 years, which in turn predicted 16-year EF and social skills. These findings suggest that interventions targeting caregiving quality within foster care home environments may have long-lasting positive effects on children's social skills and EF.

Striatal Activity to Reward Anticipation as a Moderator of the Association Between Early Behavioral Inhibition and Changes in Anxiety and Depressive Symptoms From Adolescence to Adulthood.

Importance: The early childhood temperament of behavioral inhibition (BI), characterized by inhibited and fearful behaviors, has been associated with heightened risk for anxiety and depression across the lifespan. Although several neurocognitive correlates underlying vulnerability to the development of anxiety among inhibited children have been identified, little is known about the neurocognitive correlates underlying vulnerability to the development of depression. Objective: To examine whether blunted striatal activation to reward anticipation, a well-documented neurocognitive vulnerability marker of depression, moderates the association between early BI and the developmental changes in depression and anxiety from adolescence to adulthood. Design, Setting, and Participants: Participants in this prospective longitudinal study were recruited at age 4 months between 1989 and 1993 in the US. Follow-up assessments extended into 2018 (age 26 years). Data were analyzed between September 2021 to March 2022. Main Outcomes and Measures: BI was measured through an observation paradigm in infancy (ages 14 and 24 months). Neural activity to anticipated rewards during a monetary incentive delay task was measured using functional magnetic resonance imaging in adolescence (between ages 15-18 years; 83 individuals had usable data). Anxiety and depressive symptoms were self-reported across adolescence to young adulthood (ages 15 and 26 years; n = 108). A latent change score model, accounting for the interdependence between anxiety and depression, tested the moderating role of striatal activity to reward anticipation in the association between early BI and changes in anxiety and depressive symptoms. A region of interest approach limited statistical tests to regions within the striatum (ie, nucleus accumbens, caudate head, caudate body, putamen). Results: Of 165 participants, 84 (50.1%) were female and 162 (98%) were White. Preliminary analyses revealed significant increases in anxiety and depressive symptoms across ages 15 to 26 years, as well as individual variation in the magnitude of changes. Main analyses showed that reduced activity in the nucleus accumbens to reward anticipation moderated the association between early BI and increases in depressive (ß = -0.32; b = -4.23; 95% CI, -7.70 to -0.76; P = .02), and more depressive symptoms at age 26 years (ß = -0.47; b = -5.09; 95% CI, -7.74 to -2.43; P < .001). However, there were no significant interactions associated with latent changes in anxiety across age nor anxiety at age 26 years. Activity in the caudate and putamen did not moderate these associations. Conclusions and Relevance: Blunted reward sensitivity in the ventral striatum may be a developmental risk factor connecting an inhibited childhood temperament and depression over the transition to adulthood. Future studies should examine the efficacy of prevention programs, which target maladaptive reward processing and motivational deficits among anxious youths, in reducing risks for later depression.

Structural Brain Correlates of Childhood Inhibited Temperament: An ENIGMA-Anxiety Mega-analysis.

Temperament involves stable behavioral and emotional tendencies that differ between individuals, which can be first observed in infancy or early childhood and relate to behavior in many contexts and over many years.1 One of the most rigorously characterized temperament classifications relates to the tendency of individuals to avoid the unfamiliar and to withdraw from unfamiliar people, objects, and unexpected events. This temperament is referred to as behavioral inhibition or inhibited temperament (IT).2 IT is a moderately heritable trait1 that can be measured in multiple species.3 In humans, levels of IT can be quantified from the first year of life through direct behavioral observations or reports by caregivers or teachers. Similar approaches as well as self-report questionnaires on current and/or retrospective levels of IT1 can be used later in life.

Examination of Early Childhood Temperament of Shyness and Social Avoidance and Associations With Cardiometabolic Health in Young Adulthood.

Importance: A child temperament characterized by shyness and avoidance of social interactions is associated with poor peer relationships and emotional problems, yet its long-term associations with adult cardiometabolic health are largely unknown. Objective: To examine whether a childhood temperament characterized by shyness and avoidance of social interactions is associated with poor cardiometabolic health. Design, Setting, and Participants: This cohort study included participants who were recruited at birth between April 1991 to December 1992 as part of a prospective longitudinal cohort, the Avon Longitudinal Study of Parents and Children. Follow-up assessments of health behaviors and cardiometabolic health extended into young adulthood (age 24 years). Data analysis was conducted between April and October 2021. Main Outcomes and Measures: Parent reports of temperament across ages 3 to 6 years were used to derive childhood temperament profiles in a longitudinal clustering analysis. Accelerometry measures of adolescent moderate to vigorous physical activity (MVPA) from ages 11 to 15 years and adult social occupation class were examined as mediators using path analyses. At age 24 years, 9 cardiometabolic outcomes were measured through anthropometrics and fasting blood samples: triglyceride levels, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol levels, glycated hemoglobin levels, insulin levels, systolic and diastolic blood pressure, body mass index, and C-reactive protein (CRP) levels. Results: Of the 9491 participants included in the analyses, 4908 (51.7%) were male, and 8668 of 9027 (96.0%) were White. Four childhood temperament profiles were identified: (1) introverted (2810 [29.6%]), (2) extraverted (2527 [26.6%]), (3) conflicted-shy (2335 [24.6%]), and (4) avoidant-shy (1819 [19.2%]). Lower childhood socioeconomic status was a precursor associated with the development of an avoidant-shy temperament (eg, introvert vs avoidant-shy: odds ratio, 1.13; 95% CI, 1.04-1.23). Path analyses showed that avoidant-shy children spent less time in MVPA in adolescence compared with all other temperament profiles (eg, introvert vs avoidant-shy: ß = 0.10; b = 0.25; 95% CI, 0.14-0.35; P < .001), which in turn was associated with a cluster of cardiometabolic indices at age 24 years, including lower HDL cholesterol levels (ß = 0.07; b = 0.95; 95% CI, 0.12-1.78; P = .03) and higher LDL cholesterol levels (ß = -0.07; b = -1.69; 95% CI = -3.32 to -0.06; P = .04), insulin levels (ß = -0.10; b = -0.57; 95% CI, -1.04 to -0.10; P = .02), diastolic blood pressure (ß = -0.09; b = -0.59; 95% CI, -0.97 to -0.21; P = .002), and body mass index (ß = -0.07; b = -0.32; 95% CI, -0.56 to -0.07; P = .01). Additionally, children classified as avoidant-shy attained lower social occupation classes at age 24 years, which was concurrently associated with higher BMI (ß = 0.06; b = 0.21; 95% CI, 0.08-0.35; P = .002). Notably, these results were adjusted for a range of early developmental precursors and confounders, suggesting an independent association of temperament. Conclusions and Relevance: In this cohort study, less engagement in physical activity across adolescence seemed to be a developmental mechanism connecting an avoidant-shy childhood temperament and greater cardiometabolic risks over the life course. Future studies should examine the efficacy of physical activity and social skill programs that specially target the needs of different children to thereby reduce cardiometabolic risks.

Infant temperament prospectively predicts general psychopathology in childhood.

Recent models of psychopathology suggest the presence of a general factor capturing the shared variance among all symptoms along with specific psychopathology factors (e.g., internalizing and externalizing). However, few studies have examined predictors that may serve as transdiagnostic risk factors for general psychopathology from early development. In the current study we examine, for the first time, whether observed and parent-reported infant temperament dimensions prospectively predict general psychopathology as well as specific psychopathology dimensions (e.g., internalizing and externalizing) across childhood. In a longitudinal cohort (N = 291), temperament dimensions were assessed at 4 months of age. Psychopathology symptoms were assessed at 7, 9, and 12 years of age. A bifactor model was used to estimate general, internalizing, and externalizing psychopathology factors. Across behavioral observations and parent-reports, higher motor activity in infancy significantly predicted greater general psychopathology in mid to late childhood. Moreover, low positive affect was predictive of the internalizing-specific factor. Other temperament dimensions were not related with any of the psychopathology factors after accounting for the general psychopathology factor. The results of this study suggest that infant motor activity may act as an early indicator of transdiagnostic risk. Our findings inform the etiology of general psychopathology and have implications for the early identification for children at risk for psychopathology.

Autonomic reactivity to social rejection, peer difficulties, and the buffering effects of adolescent friendships following early psychosocial deprivation.

Autonomic nervous system reactivity has been posited to be a mechanism contributing to social and emotional problems among children exposed to early adversity. Leveraging data from the Bucharest Early Intervention Project, a longitudinal randomized controlled trial of foster care versus institutional care of abandoned children in Romania, we assessed whether altered sympathetic reactivity to peer rejection feedback in early adolescence mediated the relation between early institutional rearing and peer problems in later adolescence. We also assessed whether adolescent friendship quality or randomized placement in foster care early in life moderated these associations. Participants include 68 institutionalized children randomized to care as usual, 68 institutionalized children randomized to foster care, and 135 never-institutionalized children. At age 12, participants reported friendship quality with respect to a best friend and completed a social rejection task while electrocardiogram and impedance cardiography were recorded. Sympathetic nervous system reactivity to rejection feedback was assessed using preejection period (PEP). At ages 12 and 16, peer problems were reported by parents. Mediation analysis revealed that less PEP reactivity to social rejection at age 12 partially mediated the association between early institutionalization and greater peer problems at age 16. Further moderated mediation analysis revealed that this indirect effect was evidenced among previously institutionalized youths with low, but not high, quality friendships. We did not observe foster care intervention effects. These findings suggest that altered sympathetic reactivity to social rejection might be a mechanism linking early institutionalization to social difficulties into adolescence, however, positive adolescent friendships may buffer these effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Enhanced Brief Motivational Intervention for College Student Drinkers With ADHD: Goal-Directed Activation as a Mechanism of Change.

College students with attention-deficit/hyperactivity disorder (ADHD) are at risk for alcohol-related problems and disorders relative to their typically developing peers. Despite risk, the optimal therapeutic approach for reducing problem alcohol use in students with ADHD, and mechanisms of change underlying treatment effects in this population, are largely unknown. The current study evaluated putative mechanisms of change in a randomized controlled trial of two harm reduction interventions for college student drinkers with ADHD (N = 113; 49% male): brief motivational intervention plus supportive counseling (BMI + SC) versus brief motivational intervention plus behavioral activation (BMI + BA). Results showed that participants in the BMI + BA condition engaged in more goal-directed activation and less avoidant behavior over the course of treatment compared to those in the BMI + SC condition, in turn predicting reductions in alcohol-related negative consequences. Effects were more robust 1 month following intervention, and diminished by 3 months. Sensitivity analyses revealed a significant indirect effect of treatment condition on alcohol-related negative consequence via reductions in avoidance over treatment. Post hoc moderated mediations showed that BMI + BA engaged target mechanisms more robustly for students with more severe ADHD and depressive symptoms compared to BMI + SC. These findings support the application of BMI + BA intervention, particularly in targeting goal-directed activation and avoidance/rumination in at-risk student drinkers with ADHD.

Children's shyness and neural responses to social exclusion: Patterns of midfrontal theta power usually not observed until adolescence.

Adverse peer experiences, such as social exclusion, are known risks for socioemotional problems among shy youth. Yet, little is known about how shy children and adolescents process social exclusion in the brain and whether these responses are amplified in adolescence. Using the Cyberball task, we examined mediofrontal theta (4-7 Hz) event-related EEG spectral power during conditions of fair play and social exclusion in 122 participants (58 children, ages 10-12 years, and 64 adolescents, ages 14-17 years). Age effects of the task showed that adolescents displayed heightened theta power to both outright rejection and baseline "not my turn" events, whereas children showed higher theta power to rejection compared with "not my turn" events. Further results on individual differences showed that children with relatively higher levels of shyness displayed enhanced theta power to both rejection and "not my turn" events-a pattern that also was observed in adolescents. These findings suggest that a pattern of heightened neural sensitivity to both outright social exclusion and threats of exclusion, which is the norm by adolescence, also is observed in children with higher levels of shyness. The similar neural response pattern might be driven by salient social motivations that similarly modify the social cognition and behaviors of these groups and might reflect neural antecedents of rejection sensitivity.

Long-Term Effects of Institutional Care and Enhanced Attachment Relationships on Close Adolescent Friendships.

This study examined whether early institutional rearing and attachment security influence the quality and quantity of friendships at age 16 in 138 participants, including children abandoned to institutions in Bucharest, Romania, who were randomized to care as usual (n = 45, 26 female), or foster care (n = 47, 25 female), and a never-institutionalized group (n = 46, 18 female). Adolescents in the foster care group with secure attachment to their foster mothers at 42 months were comparable to never-institutionalized adolescents in having more friends and more positive behaviors with their friend during dyadic interactions, compared to the foster care group with insecure attachment and care as usual group. Interventions targeting early child-caregiver attachment relationships may help foster the ability to build positive friendships in adolescence.

Infant behavioral inhibition predicts personality and social outcomes three decades later.

Does infant temperament predict adult personality and life-course patterns? To date, there is scant evidence examining relations between child temperament and adult outcomes, and extant research has relied on limited methods for measuring temperament such as maternal report. This prospective longitudinal study followed a cohort of infants (n = 165) for three decades to examine whether infant behavioral inhibition, a temperament characterized by cautious and fearful behaviors to unfamiliar situations, shapes long-term personality, social relationships, vocational/education, and mental health outcomes in adulthood. At age 14 mo, behavioral inhibition was assessed using an observation paradigm. In adolescence (15 y; n = 115), error monitoring event-related potentials were measured in a flanker task. In adulthood (26 y; n = 109), personality, psychopathology, and sociodemographics were self-reported using questionnaires. We found that infants with higher levels of behavioral inhibition at 14 mo grew up to become more reserved and introverted adults (ß = 0.34) with lower social functioning with friends and family (ß = -0.23) at age 26. Infant behavioral inhibition was also a specific risk factor for adult internalizing (i.e., anxiety and depression, ß = 0.20) psychopathology, rather than a transdiagnostic risk for general and externalizing psychopathology. We identified a neurophysiologic mechanism underlying risk and resilience for later psychopathology. Heightened error monitoring in adolescence moderated higher levels of adult internalizing psychopathology among behaviorally inhibited individuals. These findings suggest meaningful continuity between infant temperament and the development of adult personality. They provide the earliest evidence suggesting that the foundation of long-term well-being is rooted in individual differences in temperament observed in infancy.

Alpha EEG asymmetry, childhood maltreatment, and problem behaviors: A pilot home-based study.

BACKGROUND: Child maltreatment, trauma symptoms, and alpha electroencephalography (EEG) asymmetry have been linked to problem behaviors and alcohol use disorders. OBJECTIVE: The goal of this pilot study was to clarify the role of alpha EEG asymmetry in the relation of maltreatment and problem behaviors. It was hypothesized that adolescents with more maltreatment, trauma symptoms, and right alpha EEG asymmetry would have more problem behaviors and alcohol use. It was also hypothesized that alpha EEG asymmetry would moderate the association between maltreatment/trauma symptoms and problem behaviors. PARTICIPANTS AND SETTING: Participants were 52 adolescents aged 12-14 years. Resting-state alpha EEG asymmetry was measured in this home-based study as a potential moderator in the association of child maltreatment and trauma symptoms to problem behaviors including alcohol use. RESULTS: Child maltreatment reports and trauma symptoms were significantly associated with problem behaviors (ß = 0.259, p = 0.037 and ß = 0.594, p < 0.001, respectively). Trauma symptoms were associated with alcohol-use (Incidence Rate Ratio = 1.048, p = 0.032). Right alpha EEG asymmetry moderated the positive association of trauma symptoms and problem behaviors (ß = -0.383, p = 0.024). However, this was not the case for left alpha EEG asymmetry. CONCLUSIONS: Neural correlates associated with individuals' affective-behavioral profiles may play a role in the susceptibility for problem behaviors among adolescents exposed to higher levels of childhood trauma. This could be useful in developing targeted assessments and interventions to prevent or treat these problems in adolescents.

Conducting Event-Related Potential (ERP) Research with Young Children: A Review of Components, Special Considerations and Recommendations for Research on Cognition and Emotion.

There has been an unprecedented increase in the number of research studies employing event-related potential (ERP) techniques to examine dynamic and rapidly-occurring neural processes with children during the preschool and early childhood years. Despite this, there has been little discussion of the methodological and procedural differences that exist for studies of young children versus older children and adults. That is, reviewers, editors, and consumers of this work often expect developmental studies to simply apply adult techniques and procedures to younger samples. Procedurally, this creates unrealistic expectations for research paradigms, data collection, and data reduction and analyses. Scientifically, this leads to inappropriate measures and methods that hinder drawing conclusions and advancing theory. Based on ERP work with preschoolers and young children from 10 laboratories across North America, we present a summary of the most common ERP components under study in the area of emotion and cognition in young children along with 13 realistic expectations for data collection and loss, laboratory procedures and paradigms, data processing, ERP averaging, and typical challenges for conducting this type of work. This work is intended to supplement previous guidelines for work with adults and offer insights to aid researchers, reviewers, and editors in the design and evaluation of developmental research using ERPs. Here we make recommendations for researchers who plan to conduct or who are conducting ERP studies in children between ages 2 and 12, focusing on studies of toddlers and preschoolers. Recommendations are based on both data and our cumulative experience and include guidelines for laboratory setup, equipment and recording settings, task design, and data processing.

The prospective association between stressful life events and inflammation among adolescents with a history of early institutional rearing.

Early adversity has been shown to sensitize individuals to the effects of later stress and enhance risk of psychopathology. Using a longitudinal randomized trial of foster care as an alternative to institutional care, we extend the stress sensitization hypothesis to examine whether early institutional rearing sensitizes individuals to stressful events in adolescence engendering chronic low-grade inflammation. At baseline, institutionalized children in Romania (ages 6-31 months) were randomly assigned to foster care or to remain in usual care within institutions. A group of never-institutionalized children was recruited as an in-country comparison sample. At ages 12 and 16, participants reported stressful events. At age 16, Interleukin-6 (IL-6) and C-reactive protein (CRP) were derived from blood spots. Among children assigned to care as usual, more stressful events at age 12, but not age 16, were associated with higher IL-6. In the same group, stressful events at age 16 were associated with higher CRP, though these effects attenuated after adjusting for covariates. These associations were not observed in the foster care or never-institutionalized groups. The findings suggest that heightened inflammation following stress exposure is one pathway through which early neglect could compromise physical health. In contrast, early family care might buffer against these risks.

The long-term effects of institutional rearing, foster care intervention and disruptions in care on brain electrical activity in adolescence.

Exposure to early psychosocial deprivation as a result of institutional care disrupts typical brain development. The Bucharest Early Intervention Project (BEIP) is the first longitudinal study to investigate the neurodevelopment of institutionalized infants randomized to a foster care (FCG) intervention versus care as usual (CAUG). Here, we present findings from a follow-up assessment of brain electrical activity as indexed by resting EEG at age 16 years. In addition, we examined the effects of disruption of foster care placement (e.g. the number of moves among foster care placements) on brain electrical activity. Resting-state EEG was collected from 48 CAUG, 46 FCG and 48 never institutionalized (NIG) control participants. Absolute (µV2 ) and relative (proportion) power were computed from eyes closed, resting EEG data for theta, alpha and beta frequency bands. The CAUG displayed higher relative theta and lower relative alpha power compared to the FCG at 16 years of age. The FCG showed brain activity comparable to the NIG. The results further showed that disruptions following the original foster care placement had an adverse effect on brain electrical activity. Within the foster care group, there were no effects of age of placement on EEG power. Placement of children who have experienced early institutional rearing into stable foster care settings ensure long-term improvement in brain functioning.

Externalizing trajectories predict elevated inflammation among adolescents exposed to early institutional rearing: A randomized clinical trial.

BACKGROUND: There has been mounting interest in the pathophysiological relation between inflammation and psychopathology. In this paper, we examined associations between internalizing and externalizing psychopathology and inflammation in adolescents with a history of severe psychosocial deprivation and children reared in typical family contexts. METHOD: The Bucharest Early Intervention Project is a longitudinal randomized trial of high-quality foster care as an alternative to institutional care. This report is based on 56 institutionalized children randomized to care as usual, 59 institutionalized children randomized to foster care, and 101 never institutionalized children who were recruited as an in-country comparison sample. Externalizing and internalizing behaviors were reported by parents and teachers at ages 8, 12, and 16. At age 16, C-reactive protein (CRP) was derived from blood spots in a subset of participants (n = 127). Multiple-group latent growth curve models were used to examine externalizing and internalizing trajectories and their associations with CRP. RESULTS: Among children assigned to care as usual, higher levels of externalizing behaviors at age 8, as well as smaller decreases in these behaviors from 8 to 16 years predicted higher levels of CRP at age 16. In the same group of children, higher internalizing behaviors at age 8, but not the rate of change in these behaviors, also predicted higher levels of CRP. In contrast, these relations were not observed in the children assigned to foster care and never institutionalized controls. CONCLUSIONS: Early institutional rearing is associated with a coupling of psychopathology and inflammation, whereas early placement into foster care buffers against these risks. These findings have implications for promoting healthy mental and physical development amongst institutionalized children.

Multisensory factors in postural control: Varieties of visual and haptic effects.

Background Previous work on balance control in children and adults highlights the importance of multisensory information. Work in this vein has examined two principal input sources - the role of visual and haptic information on balance. Recent work has explored the impact of a different form of haptic input - object holding - on balance in young infants. Research question This experiment examined the impact of simultaneous visual input and haptic input on balance in children and adults, employing two novel forms of haptic input. Methods Static balance was measured in 3-5 year olds, 7-9 year olds, and young adults, in the presence of all possible combinations of manipulated visual input (eyes open, eyes closed) and haptic input (no touch, object hold, touch an unstable support, touch a stable support). Results Analysis of postural stability (mean velocity) indicated that stability was influenced by visual input, haptic input, and age group. For visual input stability increased in eyes open versus eyes closed conditions. For haptic input, stability systematically increased with increasing levels of fixed haptic input (e.g., no touch, object hold, unstable touch, stable touch). Stability also increased as a function of increasing age group. There were no interactions between the factors. Significance The finding that the two novel forms of haptic input - object hold and touch with an unstable support surface - increased stability relative to no touch input, but not as much as touch with a stable support, indicates that children use haptic information in a self-referential fashion for controlling posture. The failure to observe any interactions between visual and haptic inputs with age suggests that multisensory processing is generally additive across development, and has implications for the occurrence of sensory weighting across developmental epochs.