Early adolescent outcomes for institutionally-deprived and non-deprived adoptees. I: disinhibited attachment.
BACKGROUND
Disinhibited attachment is an important sequel of an institutional rearing, but questions remain regarding its measurement, its persistence, the specificity of the association with institutional rearing and on whether or not it constitutes a meaningful disorder.


METHODS
Children initially reared in profoundly depriving institutions in Romania and subsequently adopted into UK families were compared with respect to findings at 11 years with children who had not experienced institutional deprivation and who had been adopted within the UK before the age of 6 months. Measures included parental reports, a Strange Situation procedure modified for use in the home and systematic standardised investigator ratings of the children's behaviour.


RESULTS
Disinhibited attachment, as reported by parents, showed a high degree of persistence from 6 to 11, but also a reduction over time in its frequency. Investigator ratings validated the parental reports but suggested that much of the fall in rate of disinhibited attachment was a function of the parental measure being less developmentally appropriate at 11 than it had been at 6. Disinhibited attachment was strongly associated with institutional rearing but there was not a significant increase in relation to duration of institutional deprivation beyond the age of 6 months. Mild, but not marked, disinhibited attachment was quite frequent in non-institutionalised adopted children but both the course and correlates indicated that its meaning was probably quite different. In the institution-reared children, disinhibited attachment was associated with a marked increase in service usage and associations with other forms of psychopathology.


CONCLUSIONS
Disinhibited attachment constitutes a valid, and handicapping, clinical pattern that is strongly associated with an institutional rearing.
Rutter
Michael
M
MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK.
Colvert
Emma
E
Kreppner
Jana
J
Beckett
Celia
C
Castle
Jenny
J
Groothues
Christine
C
Hawkins
Amanda
A
O'Connor
Thomas G
TG
Stevens
Suzanne E
SE
Sonuga-Barke
Edmund J S
EJ
D000293:Adolescent; D000300:Adoption; D000367:Age Factors; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D007326:Institutionalization; D008297:Male; D009769:Object Attachment; D011610:Psychosocial Deprivation; D012383:Romania / Q000208:ethnology; D012919:Social Behavior; D006113:United Kingdom