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Serotonin transporter polymorphism moderates the effects of caregiver intrusiveness on ADHD symptoms among institutionalized preschoolers

Abstract

Research consistently chronicles a variety of mental health difficulties that plague institutionally reared children, including attention-deficit/hyperactivity disorder (ADHD), even if not all institutionalized children evince such problems. In seeking to extend work in this area, this research on gene × environment (GXE) interplay investigated whether the effect of the quality of institutional care—most notably, caregiver intrusiveness—on ADHD symptoms is moderated by the serotonin transporter (5-HTTLPR) polymorphism. One hundred and twenty-seven institutionalized preschoolers were evaluated using the Child Behavior Checklist. Caregiver-rated attention problems and hyperactivity were unrelated to both 5-HTTLPR polymorphism and caregiver intrusiveness. A significant GXE effect, independent of age at placement or duration of institutionalization, emerged, however, consistent with the differential-susceptibility hypothesis: s/s homozygotes manifest the most and least ADHD symptoms when they experienced, respectively, more and less intrusive caregiving. These results provide new insight into the reasons why some institutionalized children, but not others, exhibit ADHD symptoms.

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Acknowledgments

This study was conducted within the Psychology Research Centre, University of Minho, and partially supported by the Portuguese Foundation for Science and Technology (PTDC/PSI-PCL/101506/2008 and PTDC/PSI-PCL/116897/2010; also grant SFRH/BPD/100994/2014 assigned to the first author) and by the Portuguese Ministry of Education and Science through national funds and when applicable co-financed by FEDER under the PT2020 Partnership Agreement (UID/PSI/01662/2013). This study was also partially supported by grant 13/06 from Fundação BIAL. The authors are very grateful to the students who helped in data collection. Special thanks go to the children, caregivers, and other institutional staff who participated in the study.

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Correspondence to Isabel Soares.

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Baptista, J., Belsky, J., Mesquita, A. et al. Serotonin transporter polymorphism moderates the effects of caregiver intrusiveness on ADHD symptoms among institutionalized preschoolers. Eur Child Adolesc Psychiatry 26, 303–313 (2017). https://doi.org/10.1007/s00787-016-0890-x

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Keywords

  • Institutionalized children
  • ADHD
  • Caregiver intrusiveness
  • Serotonin transporter polymorphism
  • Differential susceptibility