Background

A high incidence of Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) has been reported for children with experiences of trauma and other forms of adversity.

Objective

The present study aims to explore symptoms of RAD and DSED in children in two protection alternatives (international adoption and residential care) after experiences of early adversity.

Participants and setting

The participants were 146 children: 40 children adopted into Spanish families from Russia, 49 children in residential care in Spanish institutions (40.8% in long-term foster centers) and 57 community comparison children.

Methods

The Relationship Problems Questionnaire was used to explore both RAD and DSED. All adoptive parents and institutional caregivers retrospectively reported the problems at time of placement (Wave 0), as well as the symptoms observed at the time of the study, with children aged 4–8 years old (Wave 1). At this stage, the assessment of the community comparison group was added.

Results

Adopted and children in residential care presented high levels of RAD and DSED symptoms at placement. For adoptees, previous experiences of abuse and neglect were marginally associated with the initial presence of RAD symptoms and a significant recovery was observed after an average of three years in their families, with a certain level of longitudinal continuity between initial and later assessments. In children currently placed in long-term residential centers in Spain, DSED symptoms worsened from W0 to W1.

Conclusions

Adoption appears to be an effective intervention that promotes recovery of RAD and DSED symptomatology after early adversity, whereas institutionalization causes negative effects.

中文翻译：

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国际收养儿童和寄养儿童依恋障碍症状的变化

背景

据报道，有创伤和其他形式逆境经历的儿童发生反应性依恋障碍 (RAD) 和去抑制性社会参与障碍 (DSED) 的发病率很高。

客观的

本研究旨在探讨儿童在经历早期逆境后在两种保护选择（国际收养和寄宿照料）中的 RAD 和 DSED 症状。

参与者和设置

参与者为 146 名儿童：40 名从俄罗斯被西班牙家庭收养的儿童，49 名在西班牙机构接受寄养的儿童（40.8% 在长期寄养中心）和 57 名社区对照儿童。

方法

关系问题问卷用于探索 RAD 和 DSED。所有养父母和机构照顾者回顾性报告了安置时的问题（第 0 波），以及在研究时观察到的症状，儿童年龄为 4-8 岁（第 1 波）。在这个阶段，增加了社区对照组的评估。

结果

收养和寄宿照料的儿童在安置时表现出高水平的 RAD 和 DSED 症状。对于被收养者来说，以前的虐待和忽视经历与最初出现 RAD 症状的关系不大，在他们的家庭中平均三年后观察到显着的恢复，在初始评估和后来的评估之间具有一定程度的纵向连续性。在目前安置在西班牙长期居住中心的儿童中，DSED 症状从 W0 到 W1 恶化。

结论

收养似乎是一种有效的干预措施，可促进早期逆境后 RAD 和 DSED 症状的恢复，而制度化会产生负面影响。