The impact of childhood deprivation on adult neuropsychological functioning is associated with ADHD symptom persistence

Dennis Golm; Sagari Sarkar; Nuria Mackes; Graeme Fairchild; Mitul Mehta; Michael Rutter; Edmund  Sonuga-Barke

doi:10.1017/S0033291720001294

The impact of childhood deprivation on adult neuropsychological functioning is associated with ADHD symptom persistence

Dennis Golm
, Sagari Sarkar
, Nuria Mackes
, Graeme Fairchild
, Mitul Mehta
, Michael Rutter
, Edmund Sonuga-Barke

Department of Psychology

King's College London

Research output: Contribution to journal › Article › peer-review

21 Citations (SciVal)

366 Downloads (Pure)

Abstract

Background: Institutional deprivation in early childhood is associated with neuropsychological deficits in adolescence. Using 20-year follow-up data from a unique natural experiment – the large scale adoption of children exposed to extreme deprivation in Romanian institutions in the 1980s – we examined, for the first time, whether such deficits are still present in adulthood and whether they are associated with deprivation-related symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).
Methods: Adult neuropsychological functioning was assessed across five domains (inhibitory control, facial emotion recognition, decision-making, prospective memory and IQ) in 70 previously-institutionalized adoptees (mean age= 25.3, 50% female) and 22 non-deprived UK adoptees (comparison group, mean age= 24.6, 41% female). ADHD and ASD symptoms were assessed using parent-completed questionnaires.
Results: Early institutionalization was associated with impaired performance on all tasks in adulthood. Prospective memory deficits persisted after controlling for IQ. ADHD and ASD symptoms were positively correlated. After controlling for ASD symptoms, ADHD symptoms remained associated with deficits in IQ, prospective memory, proactive inhibition, decision-making quality and emotion
recognition. ASD symptoms were not independently associated with neuropsychological deficits when accounting for their overlap with ADHD symptoms. Multiple regression analysis revealed that the link between childhood deprivation and adult ADHD symptoms was statistically explained by deprivation-related differences in adult IQ and prospective memory.
Conclusions: These results represent some of the most compelling evidence to date of the enduring power of early, time-limited childhood adversity to impair neuropsychological functioning across the lifespan – effects that are linked specifically to deprivation-related adult ADHD symptoms.

Original language	English
Pages (from-to)	2675 - 2684
Journal	Psychological Medicine
Volume	51
Issue number	15
Early online date	18 May 2020
DOIs	https://doi.org/10.1017/S0033291720001294
Publication status	Published - 1 Nov 2021

Funding

Our study team acknowledges the support of the National Institute for Health Research Clinical Research Network (NIHR CRN). We also thank Niall Bourke for his assistance with data collection and Laura Archer for her preparatory work on the Go-NoGo data. The Young Adult Follow-up was funded by the Economic and Social Research Council (E.S-B., RES-062-23-3300). The Brain Imaging Study was funded by the Medical Research Council (E.S-B., M.M., G.F., MR/K022474/1). This study represents independent research that was part-funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London.

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Cite this

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title = "The impact of childhood deprivation on adult neuropsychological functioning is associated with ADHD symptom persistence",

abstract = "Background: Institutional deprivation in early childhood is associated with neuropsychological deficits in adolescence. Using 20-year follow-up data from a unique natural experiment – the large scale adoption of children exposed to extreme deprivation in Romanian institutions in the 1980s – we examined, for the first time, whether such deficits are still present in adulthood and whether they are associated with deprivation-related symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Methods: Adult neuropsychological functioning was assessed across five domains (inhibitory control, facial emotion recognition, decision-making, prospective memory and IQ) in 70 previously-institutionalized adoptees (mean age= 25.3, 50\% female) and 22 non-deprived UK adoptees (comparison group, mean age= 24.6, 41\% female). ADHD and ASD symptoms were assessed using parent-completed questionnaires. Results: Early institutionalization was associated with impaired performance on all tasks in adulthood. Prospective memory deficits persisted after controlling for IQ. ADHD and ASD symptoms were positively correlated. After controlling for ASD symptoms, ADHD symptoms remained associated with deficits in IQ, prospective memory, proactive inhibition, decision-making quality and emotion recognition. ASD symptoms were not independently associated with neuropsychological deficits when accounting for their overlap with ADHD symptoms. Multiple regression analysis revealed that the link between childhood deprivation and adult ADHD symptoms was statistically explained by deprivation-related differences in adult IQ and prospective memory. Conclusions: These results represent some of the most compelling evidence to date of the enduring power of early, time-limited childhood adversity to impair neuropsychological functioning across the lifespan – effects that are linked specifically to deprivation-related adult ADHD symptoms.",

author = "Dennis Golm and Sagari Sarkar and Nuria Mackes and Graeme Fairchild and Mitul Mehta and Michael Rutter and Edmund Sonuga-Barke",

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AU - Rutter, Michael

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N2 - Background: Institutional deprivation in early childhood is associated with neuropsychological deficits in adolescence. Using 20-year follow-up data from a unique natural experiment – the large scale adoption of children exposed to extreme deprivation in Romanian institutions in the 1980s – we examined, for the first time, whether such deficits are still present in adulthood and whether they are associated with deprivation-related symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Methods: Adult neuropsychological functioning was assessed across five domains (inhibitory control, facial emotion recognition, decision-making, prospective memory and IQ) in 70 previously-institutionalized adoptees (mean age= 25.3, 50% female) and 22 non-deprived UK adoptees (comparison group, mean age= 24.6, 41% female). ADHD and ASD symptoms were assessed using parent-completed questionnaires. Results: Early institutionalization was associated with impaired performance on all tasks in adulthood. Prospective memory deficits persisted after controlling for IQ. ADHD and ASD symptoms were positively correlated. After controlling for ASD symptoms, ADHD symptoms remained associated with deficits in IQ, prospective memory, proactive inhibition, decision-making quality and emotion recognition. ASD symptoms were not independently associated with neuropsychological deficits when accounting for their overlap with ADHD symptoms. Multiple regression analysis revealed that the link between childhood deprivation and adult ADHD symptoms was statistically explained by deprivation-related differences in adult IQ and prospective memory. Conclusions: These results represent some of the most compelling evidence to date of the enduring power of early, time-limited childhood adversity to impair neuropsychological functioning across the lifespan – effects that are linked specifically to deprivation-related adult ADHD symptoms.

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The impact of childhood deprivation on adult neuropsychological functioning is associated with ADHD symptom persistence

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