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PubMed2005

Personal strengths and traumatic experiences among institutionalized children given up at birth (Les Enfants de Duplessis--Duplessis' children): I: Early experiences.

We examined childhood and early adult strengths and adverse experiences of a group of orphans given up at or near birth and raised in Quebec institutions into early adulthood. A follow-up interview of 81 adults (41 women, 40 men) at a mean age of 59.2 years included retrospective assessments of childhood experiences. Most participants reported multiple early adverse experiences, including, in descending order, unfair rules and excessive punishment, physical abuse, emotional neglect, witnessing violence, verbal abuse, physical neglect, sexual abuse, and serious illness. Adverse experiences were mainly due to lay caretakers, not peers or nuns. Twelve childhood strengths, such as self-protectiveness and athletic talent, were scored at each of four age periods, yielding a median score equivalent to one strength at each period. Over half had significant childhood attachments, but of limited intimacy. Childhood variables correlated with their respective variables in later adulthood. Overall, these older adults reported a high prevalence of adverse or traumatic childhood experiences, counterbalanced by modest levels of individual strengths and attachment relationships. Institutionalization of children--if unavoidable--must build in effective safeguards against adverse experiences.

Adaptation, Psychological↗
PubMed2004

Institutionalization and psychological suffering: notes on the mental health of institutionalized adolescents in Brazil.

This article examines the relationship between the institutionalization of needy children and adolescents and the resulting psychological suffering. Individuals who have been institutionalized for long periods suffer from increased fragility in psychological structure, becoming more vulnerable and at risk as a direct consequence of the treatment they receive in such institutions. The work described here is part of the Research Program on Adolescents, Mental Health and Culture, which is being conducted at the Child and Youth Care and Rehabilitation Center at the Institute of Psychiatry of the Federal University of Rio de Janeiro in Brazil (CARIM/IPUB/UFRJ).

Adaptation, Psychological↗
PubMed2002

Attachment disturbances in young children. II: Indiscriminate behavior and institutional care.

OBJECTIVE: To assess convergence among three different measures of indiscriminate behavior and to assess the relationship of indiscriminate behavior to having an attachment figure and to aggressive behavior among young children living in a Romanian institution. METHOD: Caregivers in the institution were interviewed with semistructured interviews regarding the behavior of 61 children with special emphasis on indiscriminate behavior. The study was conducted in Bucharest, Romania (1999). RESULTS: Substantial convergence among measures of indiscriminate behavior was demonstrated. Indiscriminate behavior was common whether or not these children had a preferred attachment figure. Indiscriminate behavior was independent of aggressive behavior. CONCLUSIONS: Differing explanations for indiscriminate behavior in young children derive from differing interpretations of similar findings rather than different findings with different measures. Indiscriminate behavior was largely independent of aggression in these institutionalized young children. Indiscriminate behavior may represent an independent problem rather than a type of reactive attachment disorder as suggested by DSM-IV criteria.

Aggression↗
PubMed1976

Responses to frustration: comparison of institutionalized and noninstitutionalized retarded adolescents and nonretarded children and adolescents.

Thirty adolescents (10 institutionalized retarded, 10 noninstitutionalized retarded, 10 nonretarded CA-matched) and 10 children (nonretarded MA-matched) were individually given the Rosenzweig Picture-Frustration Study (Children's Form). Responses were scored for direction of blame and reaction type, yielding nine frustration response categories. Three of the nine response categories showed significant group relationships. Retardation, institutionalization, and CA were all found to have an effect on responding, although analysis of response profiles showed all groups to be very similar in response pattern.

Adolescent↗
PubMed2004

Predictors of disruptive behavior, developmental delays, anxiety, and affective symptomatology among institutionally reared romanian children.

OBJECTIVE: To examine the associations between duration of institutionalization, age at abandonment, and mental and physical health outcomes of young institutionalized children in Romania and to examine patterns of associations between placement history, physical growth variables, and psychiatric symptoms. METHOD: Institutionalized children (ages 2-6 years) in a Romanian orphanage were studied through caregiver reports. Orphanage staff completed questionnaires on the children's psychiatric symptoms and physical growth measurements and placement histories on the children. RESULTS: Children showed high rates of developmental delays, anxiety/affective symptoms, and physical growth delays. Patterns of associations between history and growth variables (duration of institutionalization, age at abandonment, and physical stature) and psychiatric symptom clusters were examined using three sequential multiple regressions. Longer duration of institutionalization and shorter physical stature were significantly associated with anxiety/affective symptoms (F3,47=6.49, p <.01). Physical stature was significantly associated with developmental delays (F3,47=5.603, p <.01) and disruptive behaviors (F3,47=2.832, p <.05), with smaller stature being associated with greater developmental delays and fewer disruptive behavior problems. CONCLUSIONS: Institutionalized children demonstrate high rates of psychiatric symptoms. Duration of institutionalization, physical stature, and age at abandonment differentially relate to psychiatric symptoms. Findings are interpreted in light of implications for intervention and social policy.

Affect↗
PubMed2004

A comparison of the electroencephalogram between institutionalized and community children in Romania.

Electroencephalographic (EEG) data were collected from a sample of institutionalized infants and young children in Bucharest, Romania, and were compared with EEG data from age-matched children from the local community who had never been institutionalized and who were living with their families in the Bucharest area. Compared with the never-institutionalized group, the institutionalized group showed a pattern of increased low-frequency (theta) power in posterior scalp regions and decreased high-frequency (alpha and beta) power, particularly at frontal and temporal electrode sites. This finding is consistent with EEG studies of children facing environmental adversity and children with learning disorders. The institutionalized group also showed less marked hemispheric EEG asymmetries than the never-institutionalized group, particularly in the temporal region. The results are discussed in the context of two models: that the pattern of EEG in the institutionalized children reflects a maturational lag in nervous system development, or that it reflects tonic cortical hypoactivation.

Alpha Rhythm↗
PubMed1994

Institutionalizing children and adolescents in private psychiatric hospitals.

Admissions of children and adolescents to private psychiatric hospitals have been increasing more and more rapidly in recent years. However, the increasing use of inpatient treatment is not consistent with current theory and research about the mental health needs of children and adolescents; often inpatient treatment cannot be justified on the basis of the admitting diagnosis. Hospitalization has an array of negative effects and is less effective in terms of treatment outcome and cost when compared with community-based alternatives. High rates of admissions continue because of changes in the juvenile justice law, insurance practices, lack of legal protection for youths and children, inappropriate government policy, and the growth and practices of for-profit hospitals. Implications for social policy and social work practice are discussed.

Adolescent↗
PubMed2005

The discrimination of facial expressions by typically developing infants and toddlers and those experiencing early institutional care.

Early experience likely plays an important role in the development of the ability to discriminate facial expressions of emotion. We posited that compared to children reared with their biological families (n=72), abandoned children being reared in institutions (n=39) should demonstrate impairments in this ability. The visual paired comparison procedure was utilized to assess the abilities of 13- to 30-month-old children to discriminate among multiple pairs of photographs of facial expressions. Both groups exhibited a normative profile of discrimination, with no group differences evident. Such findings suggest that early institutionalization does not affect the ability of 1- to 3-year-olds to discriminate facial expressions of emotion, at least as inferred by the Visual Paired Comparison Procedure.

Child Development↗
PubMed2005

Personal strengths and traumatic experiences among institutionalized children given up at birth (Les Enfants de Duplessis--Duplessis' children): II: Adaptation in late adulthood.

In a companion article, we retrospectively examined the childhood strengths and adverse experiences of a group of orphans given up at or near birth and raised in Quebec institutions. This article examines the relationship of their early experiences to functioning and symptoms in later adulthood. The same follow-up interview of 81 adults (41 women, 40 men) at a mean age of 59.2 years included assessments of their current symptoms and functioning. The mean adult Social and Occupational Functioning Score (57.8; 95% CI, 54.7-61.0) indicated moderate difficulty. Psychiatric symptoms were significantly higher than in a matched population survey sample from Quebec. Mean overall defensive functioning indicated a neurotic (inhibited) level. Total trauma and childhood strengths predicted adult outcomes, but childhood strengths moderated the effects of trauma. Institutionalization of children--if unavoidable--must build in effective safeguards against adverse experiences, especially among children with few strengths, and foster children's strengths to avoid impaired adult outcomes.

Adaptation, Psychological↗
PubMed1976

Interpersonal interactions between institutionalized retarded children and their attendants.

An observational method was devised to enable detailed analysis of the behavioral and situational components of aide-resident interpersonal interactions in an institutional ward for retarded children. With this device we measured mode of communication, interpersonal affect, response to the initiator of an encounter, the context within which the interaction occurs, and a mand/tact dimension. In this article, the development and validation of the scale, including data on its reliablity, utiliy, and communicability in training novice observers, was reported. Interrater agreement in each dimension exceeded 80 percent, averaging 89 percent over all categories. Observations over a 7-week period indicated that the dormitory was consistently characterized by child-care and ward-management activities and a neutral affective atmosphere in which aides initiated most of the interactions. The observational method appears appropriate for evaluating interventions designed to improve the quality of residential treatment.

Adolescent↗
PubMedDate not supplied

[Mental and behavior disorders in children placed in long term care institutions in Hunedoara, Cluj and Timis, Romania].

This article originated from a descriptive study done in 1992-1993 in Romania. The study was initiated and coordinated by the French NGO "Médecins du Monde", was directed by three health organizations (the "Observatoire régional de la santé de Languedoc-Roussillon", the "Unité 265 INSERM", the Romanian League for Mental Health) and was granted by the Romanian government and the European Community Commission. There are many publications about children's mental and behavioural disorders. But there are few epidemiological studies concerning the prevalence of these disorders among children suffering from social difficulties. This article explores the prevalence of mental and behavioral disorders among Romanian children institutionalized and examines specifically the prevalence among children in homes for children ("Casa de Copii") to compare it with similar data published in other countries. First, this article explores the prevalence of mental and behavioral disorders among a population of 4.692 children institutionalized in three Romanian districts in 1992. Second, this article examines the prevalence of these disorders among a population of 1.610 children institutionalized in homes for children ("Casa de Copii"), i.e. 1,610 children ages ranging from 4 to 18 years and suffering from social difficulties. Homes for children are out of home care institutions which are specialised neither in physical deficiencies nor in mental disorders. From this population, a randomized sample of 508 children has been screened by physicians and psychologists based on an evaluation protocol. Then each disorder has been coded as a diagnosis, according to the Tenth International Disease Classification (WHO). Fifty-four percent (54%) of the children institutionalized in homes for children in three Romanian districts in 1992 had a main diagnosis of mental or behavioural disorder. Third, this article compares our results to the prevalence found in other studies. Only three studies could be selected for comparison because they were the only ones with the three following criteria: 1) a focus on a population of children or a randomized sample of children ages ranging from 4 to 18 years, 2) a focus on children suffering from social difficulties and living in out of home care, 3) disorders evaluated by health professionals or a validated methodology. Our results lies within the range of prevalence found in the literature (41-70%). A discussion follows regarding methodological matters and critiques that may be launched from such a comparative designs. Finally, the high frequency of institutionalization in Romania in 1992 illustrates how few solutions there were to social difficulties and how exaggerated institutionalization was. This was a very different situation compared to Western Europe and Northern America. This should not hide, however, the actual modifications that took place in Romania. This article concludes with a brief description of the modifications which have been generated by the evaluation protocol used here.

Adolescent↗