The interactive effect of maltreatment in the family and unstable institutional caregiving in predicting behavior problems in toddlers

Abstract

a b s t r a c tThe current study extends research on the effects of institutionalization, most notably by examining whether-and how-both pre-institutional maltreatment in the family and the stability and consistency of institutional care interact to shape emotional and behavioral development. Fifty Portuguese children, placed in residential institutions when 8 days to 26 months of age, were evaluated using the Child Behavior Checklist when aged 18-31 months. Caregiver-rated internalizing and externalizing behavior problems proved to be unrelated to both early family and institutional experiences, as main effects, but the interaction of these factors significantly predicted externalizing problems: a history of maltreatment in the family coupled with unstable institutional caregiving arrangements predicted especially elevated levels of externalizing problems. Results are discussed in terms of the importance of more distal and proximate developmental experiences.

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

“…These latter institutions not only have severe deficiencies in psychosocial care, but also in physical resources (see, for instance, [69]). In contrast, Portuguese institutions meet children's nutritional and health needs, even if failing to do so with regard to social and emotional support, and cognitive stimulation [45,46]. Thus, because Portuguese institutional care offers higher quality than typically found in Eastern Europe, this needs to be kept in mind when considering results reported here and elsewhere.…”

“…These institutions receive children abandoned or removed from their biological families, due to various reasons considered to endanger young children's physical and/or emotional well-being, such as abuse, neglect, or extreme economic hardship. These institutions are characterized by adequate physical resources, including medical care and nutrition [45], but simultaneously by high variability in the quality of their psychosocial care, including high child-to-caregiver ratios and frequent changes in caregivers over time [46]. By the time of assessment, children were 36-77 months old (M = 54.67, SD = 10.68).…”

“…Expanding the scope of caregiving assessment might further illuminate additional environmental and GXE interaction influences on ADHD symptoms among institutionalized children. Such expanded assessment might focus on indicators of caregiving stability and consistency (e.g., daily child-to-caregiver ratio, the format and predictability of the caregivers' working shifts), as suggested by results of other investigations [46]. Moreover, the primary caregiver provided information about ADHD symptoms, making it impossible to rule out informant bias.…”

Institutionalization and indiscriminate social behavior: Differential-susceptibility versus diathesis-stress models for the 5-HTTLPR and BDNF genotypes

“…What makes this notable is that there are empirical grounds for regarding the quality of institutional care different in these two settings [28,29]. According to Gunnar's classification of quality of institutional rearing [30], Portuguese institutions perform at Level 2 because they meet children's nutrition and health needs, even if failing to do so with regard to cognitive stimulation, social-relational support and emotional care; or even as Level 3, as some of the institutions do provide sufficient support for healthy development, except with regard to the provision of a consistent and stable relationship of children with specific caregivers.…”

Early Maltreatment and Current Quality of Relational Care Predict Socioemotional Problems Among Institutionalized Infants and Toddlers

“…Studies published over the past 50 years have demonstrated that children raised in residential institutions are at higher risk for a variety of mental health problems compared to never‐institutionalized peers (Lawler, Koss, Doyle, & Gunnar, ; Rutter et al., ; Wiik et al., ). Research on this topic has documented the early appearing of such difficulties, indicating a high rate of social and emotional difficulties among deprived infants and toddlers (Baptista et al., ; Smyke et al., ). Disconcerting findings have suggested that these difficulties tend to persist up to adolescence and young adulthood, even when children have departed the institution often to be adopted (Humphreys, Nelson, Fox, & Zeanah, ; Sonuga‐Barke et al., ).…”