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Journal Article

Why does early childhood deprivation increase the risk for depression and anxiety in adulthood? A developmental cascade model


Schlotz,  Wolff
Scientific Services, Max Planck Institute for Empirical Aesthetics, Max Planck Society;

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Golm, D., Maughan, B., Barker, E. D., Hill, J., Kennedy, M., Knights, N., et al. (2020). Why does early childhood deprivation increase the risk for depression and anxiety in adulthood? A developmental cascade model. The Journal of Child Psychology and Psychiatry, 61(9), 1043-1053. doi:10.1111/jcpp.13205.

Cite as: https://hdl.handle.net/21.11116/0000-0005-BCA3-F
Background: Using data from the English & Romanian Adoptees (ERA) study, we recently reported that early timelimited

exposure to severe institutional deprivation is associated with early-onset and persistent neurodevelopmental

problems and later-onset emotional problems. Here, we examine possible reasons for the late emergence of emotional

problems in this cohort. Our main focus is on testing a developmental cascade mediated via the functional impact of

early-appearing neurodevelopmental problems on late adolescent functioning. We also explore a second putative

pathway via sensitization to stress. Methods: The ERA study includes 165 Romanian individuals who spent their

early lives in grossly depriving institutions and were subsequently adopted into UK families, along with 52 UK

adoptees with no history of deprivation. Age six years symptoms of neurodevelopmental problems and age 15

anxiety/depression symptoms were assessed via parental reports. Young adult symptoms of depression and anxiety

were assessed by both parent and self-reports; young adults also completed measures of stress reactivity, exposure

to adverse life events, and functioning in work and interpersonal relationships. Results: The path between early

institutional deprivation and adult emotional problems was mediated via the impact of early neurodevelopmental

problems on unemployment and poor friendship functioning during the transition to adulthood. The findings with

regard to early deprivation, later life stress reactivity, and emotional problems were inconclusive. Conclusions: Our

analysis suggests that the risk for adult depression and anxiety following extreme institutional deprivation is

explained through the effects of early neurodevelopmental problems on later social and vocational functioning.

Future research should more fully examine the role of stress susceptibility in this model. Keywords: Institutional

deprivation; depression; anxiety; emotional problems; developmental cascades; neurodevelopmental problems;

longitudinal; prospective; natural experiment.