Poster #41 - Foster care is casually associated with reduced irritability among children who experienced severe psychosocial deprivation

• In Event: Poster Session 10

Abstract

Irritability is an individual difference in the propensity for frustration and anger (Vidal-Ribas et al., 2016), and is transdiagnostic with links to both concurrent and prospective symptoms of externalizing and internalizing psychopathology (Humphreys et al., 2019). While its developmental trajectories and outcomes have received substantial attention, less is known about its antecedents. Such research is critical for identifying targets for intervention and prevention. The early caregiving environment is arguably an important, but understudied factor, given links between early adversity and irritability as well as caregiving quality and emotion regulation of anger.

Towards this end, the current study examined irritability in a long-term follow-up of participants from the Bucharest Early Intervention Project (BEIP; Zeanah et al., 2003), a randomized controlled trial (RCT) of foster care as an alternative to institutional care for infants and young children residing in psychosocially depriving institutions in Bucharest, Romania. Children were randomized to one of two groups: 1) high-quality foster care (Foster Care Group; FCG), or 2) care as usual (Care as Usual Group; CAUG), which typically resulted in more prolonged institutional care exposure. Within this sample, we directly tested the intervention using a conservative intent-to-treat analysis to examine the causal effect of the quality of the early caregiving environment on children’s later irritability. Given the results from existing literature on non-experimental data (Kessel et al., 2021; Wiggins et al., 2014), we hypothesized that children with high-quality family placements (FCG) would have lower levels of irritability compared to children in CAUG.

Of the original 136 trial participants at baseline, the present analyses included 44 CAUG (20 females and 24 males) and 42 FCG (22 females and 20 males) still enrolled and capable of providing self-report of irritability using the Affective Reactivity Index (ARI; Stringaris et al., 2012) at age 16 years. The results showed that ARI scores in CAUG were moderately and statistically significantly higher than in FCG (t(84) = 2.454, p = .033, Cohen’s d = 0.529, 95% CI: 0.098 – 0.958). Thus, children randomized to CAUG tended to be higher in irritability than their counterparts randomized to high-quality foster care. This finding provides the first causal evidence of the role of the caregiving environment in preventing irritability; which may be particularly relevant in children who experienced early severe deprivation as a group with increased risk for difficulties in cognitive, behavioral, and social domains (Nelson, Fox, & Zeanah, 2014; Reeb-Sutherland, Fox, Nelson, & Zeanah, 2009). In addition to promoting early high-quality caregiving for abandoned and orphaned children; this work sets the stage for additional studies into the developmental mechanisms underlying the causal effect of caregiving on irritability.

Authors

• Yanbin Niu, Vanderbilt University
  Presenting Author

• Nathan A Fox, University of Maryland - College Park

• Charles A. Nelson, Harvard Medical School

• Charles H Zeanah, Tulane University

• George A Buzzell, Florida International University

• Kathryn L. Humphreys, Vanderbilt University