title: Early adolescent outcomes for institutionally-deprived and non-deprived adoptees. I: disinhibited attachment.
abstract: 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.
authors.affiliation: MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Rutter
authors.forename: Emma
authors.initials: E
authors.lastname: Colvert
authors.forename: Jana
authors.initials: J
authors.lastname: Kreppner
authors.forename: Celia
authors.initials: C
authors.lastname: Beckett
authors.forename: Jenny
authors.initials: J
authors.lastname: Castle
authors.forename: Christine
authors.initials: C
authors.lastname: Groothues
authors.forename: Amanda
authors.initials: A
authors.lastname: Hawkins
authors.forename: Thomas G
authors.initials: TG
authors.lastname: O'Connor
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Stevens
authors.forename: Edmund J S
authors.initials: EJ
authors.lastname: Sonuga-Barke
mesh_terms: 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