Do Theory of Mind and Executive Function Deficits Underlie the Adverse Outcomes Associated with Profound Early Deprivation?: Findings from the English and Romanian Adoptees Study

Abstract

Theory of Mind (ToM) and Executive Function (EF) have been associated with autism and with attention-deficit hyperactivity disorder (ADHD), and hence might play a role in similar syndromes found following profound early institutional deprivation. In order to examine this possibility the current study included a group of 165 Romanian adoptees, of whom 144 were adopted into the UK from deprived institutional settings before 43months of age, and a group of 52 within-UK adoptees, all adopted before 6months of age. Both groups were assessed at 6 and 11years. The Strange Stories task was used to assess ToM and the Stroop task was used to assess EF, both at age 11. The Romanian adoptees displayed deficits in both ToM and EF compared with the within-UK adoptee group. The degree of deficit was greater for children who had experienced more than 6months of institutional deprivation. Deficits in both domains (ToM and EF) were associated with each of the three apparently deprivation-specific problems, namely quasi-autism, disinhibited attachment and inattention/overactivity. Statistical analyses indicated a mediating role for both ToM and EF with respect to quasi-autism; possibly a partial mediating role for EF with respect to inattention/overactivity; and probably no mediating role for either ToM or EF in the case of disinhibited attachment. In conclusion, there is evidence for a possible mediating role for ToM and EF in the development of some apparently deprivation-specific difficulties in institution-reared Romanian adoptees, but neither accounts for the overall pattern of deprivation-related difficulties.

The effect of COMT Val158Met and DRD2 C957T polymorphisms on executive function and the impact of early life stress

“…Although the decreased D2 receptor binding (CC genotype) has been associated with poorer performance on timed attention tests in previous studies (Slagter et al., 2012; Yang et al., 2004), the main effect of genotype in our study emerged in two‐way ANCOVA with childhood trauma category as another fixed factor, showing that CC homozygotes who have experienced childhood trauma perform more poorly on a sustained attention test, compared to those who have not experienced childhood adversity. The effect of early life stress on cognitive outcomes has been repeatedly demonstrated in earlier studies (Bos et al., 2009; Colvert et al., 2008), and it is to be expected due to the long maturation period of the PFC (Gogtay & Thompson, 2010; Gogtay et al., 2004) and high concentration of glucocorticoid receptors and dopaminergic projections in the PFC (Pani et al., 2000). However, it should be noted that the genotype–early life stress interaction was only found in the RVP test.…”

“…This susceptibility may be due to its high density of glucocorticoid receptors and dopaminergic projections (Pani, Porcella, & Gessa, 2000), and the fact that it is one of the last brain regions to reach maturity (Gogtay & Thompson, 2010; Gogtay et al., 2004). In support of this, deficits in functions mediated by PFC and cortico‐striatal networks, such as attention, working memory and other executive functions, have also been reported in individuals who have experienced childhood trauma (Bos, Fox, Zeanah, & Nelson, 2009; Colvert et al., 2008). …”

Associations between early life adversity and executive function in children adopted internationally from orphanages

“…EF has been thought of as comprising three overlapping component skills: cognitive flexibility/rule shifting, updating/working memory, and inhibitory control (30). Previous laboratory studies with older PI children have shown reduced performance on each of these components: cognitive flexibility (11), working memory performance (11,12,15), and inhibitory control (13,15,31). Additionally, there are extensive reports that PI children show attention deficits and hyperactivity symptoms that persist into adolescence (32,33), which could signal long-term difficulties with EF.…”

EEG Correlation during Social Decision-making in Institutionalized Adolescents

“…Children are institutionalized due to different factors like abandonment, orphaning, maltreatment and also physical or mental disabilities. Many authors have related the institutionalization with a lack of stimulation in different spheres like motor, cognitive and social-affective [2][3][4], since factors like the absence of personalized treatment according to the ratio between infants and caregivers (15:1) [5] and the lack of quality care of caregivers [6,7] since the poor commitment for wellbeing of infants and the poor response and insensibility for the necessities of the infants [8], the round-toclock type of work [1], the constant rotation of caregiver [9] and the lack of professional training of caregivers [8] among others deficiencies. Therefore, institutionalization has been associated with consequences in brain and behavioral development.…”