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Child Maltreatment in Residential Care pp 129–148Cite as

Psychopathology Following Severe Deprivation: History, Research, and Implications of the Bucharest Early Intervention Project

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Abstract

The Bucharest Early Intervention Project (BEIP) is the only randomized controlled trial of foster care for children who were abandoned at or shortly after birth and placed into institutional care. The study conducted careful pre-randomization assessments at a mean age of 22 months and has included follow-ups through mid-adolescence. This longitudinal study has provided important insight into the effects of psychosocial deprivation on brain and behavioral development, the importance of sensitive periods, and the ability to recover from severe neglect through high-quality and stable caregiving environments. This chapter reviews the impetus behind the BEIP, as well as key findings related to psychopathology across the longitudinal study. Specifically, early deprivation history is associated with increased risk for psychopathology. In attachment disorder symptomatology, as well as internalizing, externalizing, and attention-deficit/hyperactivity disorder (ADHD) domains, those who had ever experienced institutional care had higher levels of symptoms and/or greater likelihood of meeting diagnostic criteria at the disorder level. Importantly, however, children assigned to the foster care intervention had more positive outcomes in all domains, with the exception of ADHD, in which there was no treatment effect. Secondary analyses indicated important mediators (e.g., attachment security; neural functioning) and moderators (e.g., age of placement; placement stability) of the interventions effect on psychopathology.

Policy makers may need a strong method of proof to be willing to accept a given intervention, especially when it conflicts with their biases. Even if some experts claim to know, based on observational evidence or experience, that a particular intervention is effective in producing a given outcome, or is better than an alternative intervention, positive results from a well-designed randomized trial may be necessary to persuade policy makers to change standard practice.

Franklin G. Miller (2009)

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Acknowledgments

Funding was provided by the National Institute of Mental Health (MH091363 and MH107129), the John D. and Catherine T. MacArthur Foundation, and the Brain & Behavior Research Foundation (formerly NARSAD) Young Investigator Award 23819. The authors thank the Bucharest Early Intervention Project staff in Romania and the children and caregivers who participated in this study.

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Authors and Affiliations

  1. Department of Psychology, Stanford University, Stanford, CA, 94305, USA

    Kathryn L. Humphreys

  2. Human Development and Quantitative Methodology (HDQM), University of Maryland, College Park, MD, USA

    Nathan A. Fox

  3. Boston Children’s Hospital/Harvard Medical School, Harvard Graduate School of Education, Boston, MA, USA

    Charles A. Nelson

  4. Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA, USA

    Charles H. Zeanah

Authors
  1. Kathryn L. Humphreys
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  2. Nathan A. Fox
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  3. Charles A. Nelson
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  4. Charles H. Zeanah
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Correspondence to Kathryn L. Humphreys .

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Editors and Affiliations

  1. Department of Social and Behavioral Science, Southwestern Christian University, Bethany, Oklahoma, USA

    Adrian V. Rus

  2. Texas Christian University, Fort Worth, Texas, USA

    Sheri R. Parris

  3. Social Pediatrics and Obstetrics Research Department, National Institute for Mother and Child Health “Alessandrescu-Rusescu”, Bucuresti, Romania

    Ecaterina Stativa

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Humphreys, K.L., Fox, N.A., Nelson, C.A., Zeanah, C.H. (2017). Psychopathology Following Severe Deprivation: History, Research, and Implications of the Bucharest Early Intervention Project. In: Rus, A., Parris, S., Stativa, E. (eds) Child Maltreatment in Residential Care. Springer, Cham. https://doi.org/10.1007/978-3-319-57990-0_6

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  • DOI: https://doi.org/10.1007/978-3-319-57990-0_6

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