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Cortisol and Parenting Predict Pathways to Disinhibited Social Engagement and Social Functioning in Previously Institutionalized Children

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Abstract

Previously institutionalized children on average show persistent deficits in physiological and behavioral regulation, as well as a lack of normative reticence towards strangers, or disinhibited social engagement (DSE). Post-adoption parenting, specifically a combination of supportive presence and structure/limit-setting, may protect against DSE over time via better adrenocortical functioning. This study examined the impact of adrenocortical activity and post-adoption parenting on DSE across the first two years post-adoption (age at adoption: 16–36 months) and observed kindergarten social outcomes in previously institutionalized children (n = 94) compared to non-adopted children (n = 52). Path analyses indicated a developmental cascade from institutional care (operationalized as a dichotomous group variable, age at adoption, and months of institutionalization) to blunted adrenocortical activity, increased DSE, and lower kindergarten social competence. Consistent with a permissive parenting style, higher parental support was associated with increased DSE, but only when not accompanied by effective structure/limit-setting. Further, parental structure reduced the association between blunted adrenocortical activity and DSE behaviors.

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Notes

  1. Group differences cannot be assessed for caregiver-reported DSE symptoms because this measure was not collected with the non-adopted group, given that clinical levels of DSE symptoms were expected to be non-existent in these children (Garvin et al. 2012)

References

  • Almas, A. N., Degnan, K. A., Walker, O. L., Radulescu, A., Nelson, C. A., Zeanah, C. H., & Fox, N. A. (2015). The effects of early institutionalization and foster care intervention on children's social behaviors at the age of eight. Social Development, 24(2), 225–239. https://doi.org/10.1111/sode.12089.

    Article  PubMed  Google Scholar 

  • Baumrind, D. (1971). Current patterns of parental authority. Developmental Psychology, 4(1p2), 1–103.

    Article  Google Scholar 

  • Bernard, K., Dozier, M., Bick, J., & Gordon, M. K. (2015). Intervening to enhance cortisol regulation among children at risk for neglect: Results of a randomized clinical trial. Development and Psychopathology, 27(3), 829–841. https://doi.org/10.1017/S095457941400073X.

    Article  PubMed  Google Scholar 

  • Bruce, J., Tarullo, A. R., & Gunnar, M. R. (2009). Disinhibited social behavior among internationally adopted children. Development and Psychopathology, 21(1), 157–171. https://doi.org/10.1017/S0954579409000108.

    Article  PubMed  PubMed Central  Google Scholar 

  • Buckner, J. D., Lopez, C., Dunkel, S., & Joiner Jr., T. E. (2008). Behavior management training for the treatment of reactive attachment disorder. Child Maltreatment, 13(3), 289–297. https://doi.org/10.1177/1077559508318396.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carlson, E. A., Hostinar, C. E., Mliner, S. B., & Gunnar, M. R. (2014). The emergence of attachment following early social deprivation. Development and Psychopathology, 26(2), 479–489. https://doi.org/10.1017/S0954579414000078.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chisholm, K. (1998). A three year follow-up of attachment and indiscriminate friendliness in children adopted from Romanian orphanages. Child Development, 69, 1092–1106.

    Article  PubMed  Google Scholar 

  • Dadds, M. R., & Tully, L. A. (2019). What is it to discipline a child: What should it be? A reanalysis of time-out from the perspective of child mental health, attachment, and trauma. American Psychologist, 74(7), 794–808. https://doi.org/10.1037/amp0000449.

    Article  PubMed  Google Scholar 

  • Dickmann, C. R., & Allen, B. (2017). Parent–child interaction therapy for the treatment of disinhibited social engagement disorder: A case report. Evidence-Based Practice in Child and Adolescent Mental Health, 2(1), 19–29. https://doi.org/10.1080/23794925.2017.1286959.

    Article  Google Scholar 

  • Dobrova-Krol, N. A., Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., & Juffer, F. (2010). The importance of quality of care: Effects of perinatal HIV infection and early institutional rearing on preschoolers’ attachment and indiscriminate friendliness. Journal of Child Psychology and Psychiatry, 51(12), 1368–1376. https://doi.org/10.1111/j.1469-7610.2010.02243.x.

    Article  PubMed  Google Scholar 

  • Garvin, M. C., Tarullo, A. R., Van Ryzin, M., & Gunnar, M. R. (2012). Post-adoption parenting and socioemotional development in post-institutionalized children. Development and Psychopathology, 24(1), 35–48. https://doi.org/10.1017/S0954579411000642.

    Article  PubMed  Google Scholar 

  • Gorter, B., Helder, E. J., Oh, Y., & Gunnoe, M. (2017). Are disinhibited social behaviors among internationally adopted children mediated by the attachment environment or by children’s difficulties with inhibitory control? Adoption Quarterly, 20(4), 291–308. https://doi.org/10.1080/10926755.2017.1349699.

    Article  Google Scholar 

  • Granger, D. A., Hibel, L. C., Fortunato, C. K., & Kapelewski, C. H. (2009). Medication effects on salivary cortisol: Tactics and strategy to minimize impact in behavioral and developmental science. Psychoneuroendocrinology, 34(10), 1437–1448. https://doi.org/10.1016/j.psyneuen.2009.06.017.

    Article  PubMed  Google Scholar 

  • Gunnar, M. R., Bruce, J., & Grotevant, H. D. (2000). International adoption of institutionally reared children: Research and policy. Development and Psychopathology, 12(4), 677–693.

    Article  PubMed  Google Scholar 

  • Guyon-Harris, K. L., Humphreys, K. L., Fox, N. A., Nelson, C. A., & Zeanah, C. H. (2019). Signs of attachment disorders and social functioning among early adolescents with a history of institutional care. Child Abuse & Neglect, 88, 96–106. https://doi.org/10.1016/j.chiabu.2018.11.005.

    Article  Google Scholar 

  • Hammond, S. I., Müller, U., Carpendale, J. I., Bibok, M. B., & Liebermann-Finestone, D. P. (2012). The effects of parental scaffolding on preschoolers' executive function. Developmental Psychology, 48(1), 271–281. https://doi.org/10.1037/a0025519.

    Article  PubMed  Google Scholar 

  • Hostinar, C. E., Sullivan, R. M., & Gunnar, M. R. (2014). Psychobiological mechanisms underlying the social buffering of the hypothalamic–pituitary–adrenocortical axis: A review of animal models and human studies across development. Psychological Bulletin, 140(1), 256–282. https://doi.org/10.1037/a0032671.

    Article  PubMed  Google Scholar 

  • Isaksson, J., Nilsson, K. W., Nyberg, F., Hogmark, Å., & Lindblad, F. (2012). Cortisol levels in children with attention-deficit/hyperactivity disorder. Journal of Psychiatric Research, 46(11), 1398–1405. https://doi.org/10.1016/j.jpsychires.2012.08.021.

    Article  PubMed  Google Scholar 

  • Johnson, A. E., Bruce, J., Tarullo, A. R., & Gunnar, M. R. (2011). Growth delay as an index of allostatic load in young children: Predictions to disinhibited social approach and diurnal cortisol activity. Development and Psychopathology, 23(3), 859–871. https://doi.org/10.1017/S0954579411000356.

    Article  PubMed  PubMed Central  Google Scholar 

  • Juffer, F., Palacios, J., Le Mare, L., Sonuga-Barke, E. J., Tieman, W., Bakermans-Kranenburg, M. J., Vorria, P., van IJzendoorn, M. H., & Verhulst, F. C. (2011). II. Development of adopted children with histories of early adversity. Monographs of the Society for Research in Child Development, 76(4), 31–61.

    Article  Google Scholar 

  • Kerr, D. C., Capaldi, D. M., Pears, K. C., & Owen, L. D. (2009). A prospective three generational study of fathers’ constructive parenting: Influences from family of origin, adolescent adjustment, and offspring temperament. Developmental Psychology, 45(5), 1257–1275. https://doi.org/10.1037/a0015863.

    Article  PubMed  PubMed Central  Google Scholar 

  • Koss, K. J., Mliner, S. B., Donzella, B., & Gunnar, M. R. (2016). Early adversity, hypocortisolism, & behavior problems at school entry: A study of internationally adopted children. Psychoneuroendocrinology, 66, 31–38. https://doi.org/10.1016/j.psyneuen.2015.12.018.

    Article  PubMed  Google Scholar 

  • Kreppner, J., Kumsta, R., Rutter, M., Beckett, C., Castle, J., Stevens, S., & Sonuga-Barke, E. J. (2010). IV. Developmental course of deprivation-specific psychological patterns: Early manifestations, persistence to age 15, and clinical features. Monographs of the Society for Research in Child Development, 75(1), 79–101.

    Article  PubMed  Google Scholar 

  • Lawler, J. M., Hostinar, C. E., Mliner, S. B., & Gunnar, M. R. (2014). Disinhibited social engagement in postinstitutionalized children: Differentiating normal from atypical behavior. Development and Psychopathology, 26(2), 451–464. https://doi.org/10.1017/S0954579414000054.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lawler, J. M., Koss, K. J., Doyle, C. M., & Gunnar, M. R. (2016). The course of early disinhibited social engagement among post-institutionalized adopted children. Journal of Child Psychology and Psychiatry, 57(10), 1126–1134. https://doi.org/10.1111/jcpp.12606.

    Article  PubMed  Google Scholar 

  • LeCuyer-Maus, E. A. (2000). Maternal sensitivity and responsiveness, limit-setting style, and relationship history in the transition to toddlerhood. Issues in Comprehensive Pediatric Nursing, 23(2), 117–139. https://doi.org/10.1080/01460860050121439.

    Article  PubMed  Google Scholar 

  • Lehmann, S., Breivik, K., Heiervang, E. R., Havik, T., & Havik, O. E. (2016). Reactive attachment disorder and disinhibited social engagement disorder in school-aged foster children: A confirmatory approach to dimensional measures. Journal of Abnormal Child Psychology, 44(3), 445–457. https://doi.org/10.1007/s10802-015-0045-4.

    Article  PubMed  Google Scholar 

  • Lengua, L. J., Honorado, E., & Bush, N. R. (2007). Contextual risk and parenting as predictors of effortful control and social competence in preschool children. Journal of Applied Developmental Psychology, 28(1), 40–55. https://doi.org/10.1016/j.appdev.2006.10.001.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lyons-Ruth, K., Bureau, J. F., Riley, C. D., & Atlas-Corbett, A. F. (2009). Socially indiscriminate attachment behavior in the strange situation: Convergent and discriminant validity in relation to caregiving risk, later behavior problems, and attachment insecurity. Development and Psychopathology, 21(2), 355–372. https://doi.org/10.1017/S0954579409000376.

    Article  PubMed  PubMed Central  Google Scholar 

  • Matas, L., Arend, R. A., & Sroufe, L. A. (1978). Continuity of adaptation in the second year: The relationship between quality of attachment and later competence. Child Development, 49, 547–556.

    Article  Google Scholar 

  • McLaughlin, K. A., Sheridan, M. A., Tibu, F., Fox, N. A., Zeanah, C. H., & Nelson, C. A. (2015). Causal effects of the early caregiving environment on development of stress response systems in children. Proceedings of the National Academy of Sciences, 201423363. https://doi.org/10.1073/pnas.1423363112.

  • Meaney, M. J., & Szyf, M. (2005). Environmental programming of stress responses through DNA methylation: Life at the interface between a dynamic environment and a fixed genome. Dialogues in Clinical Neuroscience, 7(2), 103–123.

    PubMed  PubMed Central  Google Scholar 

  • Miron, D., & Zeanah, C. H. (2017). Disinhibited social engagement disorder. In S. Goldstein & M. DeVries (Eds.), Handbook of DSM-5 disorders in children and adolescents. Cham: Springer. https://doi.org/10.1007/978-3-319-57196-6_14.

    Chapter  Google Scholar 

  • O'Connor, T. G., Bredenkamp, D., Rutter, M., & English and Romanian Adoptees (ERA) Study Team. (1999). Attachment disturbances and disorders in children exposed to early severe deprivation. Infant Mental Health Journal, 20(1), 10–29.

    Article  Google Scholar 

  • Piotrowski, J. T., Lapierre, M. A., & Linebarger, D. L. (2013). Investigating correlates of self-regulation in early childhood with a representative sample of English-speaking American families. Journal of Child & Family Studies, 22, 423–436. https://doi.org/10.1007/s10826-012-9595-z.

    Article  Google Scholar 

  • Pitula, C. E., DePasquale, C. E., Mliner, S. B., & Gunnar, M. R. (2017). Peer problems among postinstitutionalized, internationally adopted children: Relations to hypocortisolism, parenting quality, and ADHD symptoms. Child Development. https://doi.org/10.1111/cdev.12986.

  • Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891. https://doi.org/10.3758/BRM.40.3.879.

    Article  PubMed  Google Scholar 

  • R Core Team. (2016). R: A language and environment for statistical computing. Vienna: R Foundation for statistical computing URL https://www.R-project.org/.

    Google Scholar 

  • Rinaldi, C. M., & Howe, N. (2012). Mothers’ and fathers’ parenting styles and associations with toddlers’ externalizing, internalizing, and adaptive behaviors. Early Childhood Research Quarterly, 27(2), 266–273. https://doi.org/10.1016/j.ecresq.2011.08.001.

    Article  Google Scholar 

  • Rosseel, Y. (2012). Lavaan: An R package for structural equation modeling and more. Version 0.5–12 (BETA). Journal of Statistical Software, 48(2), 1–36.

    Article  Google Scholar 

  • Rutter, M., Colvert, E., Kreppner, J., Beckett, C., Castle, J., Groothues, C., Hawkins, A., O’Connor, T. G., Stevens, S. E., & Sonuga-Barke, E. J. (2007). Early adolescent outcomes for institutionally-deprived and non-deprived adoptees. I: Disinhibited attachment. Journal of Child Psychology and Psychiatry, 48(1), 17–30. https://doi.org/10.1111/j.1469-7610.2006.01688.x.

    Article  PubMed  Google Scholar 

  • Shirtcliff, E. A., Allison, A. L., Armstrong, J. M., Slattery, M. J., Kalin, N. H., & Essex, M. J. (2012). Longitudinal stability and developmental properties of salivary cortisol levels and circadian rhythms from childhood to adolescence. Developmental Psychobiology, 54(5), 493–502. https://doi.org/10.1002/dev.20607.

    Article  PubMed  Google Scholar 

  • Smyke, A. T., Dumitrescu, A., & Zeanah, C. H. (2002). Attachment disturbances in young children. I: The continuum of caretaking casualty. Journal of the American Academy of Child & Adolescent Psychiatry, 41(8), 972–982.

    Article  Google Scholar 

  • Talge, N. M., Donzella, B., Kryzer, E. M., Gierens, A., & Gunnar, M. R. (2005). It's not that bad: Error introduced by oral stimulants in salivary cortisol research. Developmental Psychobiology, 47(4), 369–376. https://doi.org/10.1002/dev.20097.

    Article  PubMed  Google Scholar 

  • Tapp, J. (2003). Procoder for digital video. Nashville: Vanderbilt Kennedy Center.

    Google Scholar 

  • Tingley, D., Yamamoto, T., Hirose, K., Keele, L., & Imai, K. (2014). Mediation: R package for causal mediation analysis. Journal of Statistical Software, 59(5), 1–38 URL: http://www.jstatsoft.org/v59/i05/.

    Article  Google Scholar 

  • Tizard, B., & Rees, J. (1975). The effect of early institutional rearing on the behaviour problems and affectional relationships of four-year-old children. Child Psychology & Psychiatry & Allied Disciplines, 16(1), 61–73. https://doi.org/10.1111/j.1469-7610.1975.tb01872.x.

    Article  Google Scholar 

  • Zeanah, C. H., & Gleason, M. M. (2015). Annual research review: Attachment disorders in early childhood–clinical presentation, causes, correlates, and treatment. Journal of Child Psychology and Psychiatry, 56(3), 207–222. https://doi.org/10.1111/jcpp.12347.

    Article  PubMed  Google Scholar 

  • Zeanah, C. H., Smyke, A. T., Koga, S. F., Carlson, E., & Bucharest Early Intervention Project Core Group. (2005). Attachment in institutionalized and community children in Romania. Child Development, 76(5), 1015–1028.

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank the International Adoption Project and the families for their participation. Grant support was provided by the National Institute of Mental Health, R01 MH080905 and P50 MH078105 (to MRG), the Center for Neurobehavioral Development (University of Minnesota), and National Institute of Mental Health training grant T32 MH015755 (to CED). The content is solely the responsibility of the authors and does not represent the views of the National Institutes of Health.

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Correspondence to Carrie E. DePasquale.

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DePasquale, C.E., Lawler, J.M., Koss, K.J. et al. Cortisol and Parenting Predict Pathways to Disinhibited Social Engagement and Social Functioning in Previously Institutionalized Children. J Abnorm Child Psychol 48, 797–808 (2020). https://doi.org/10.1007/s10802-020-00633-8

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