scholarly journals The prospective association between stressful life events and inflammation among adolescents with a history of early institutional rearing

2020 ◽  
Vol 32 (5) ◽  
pp. 1715-1724
Author(s):  
Alva Tang ◽  
Mark Wade ◽  
Nathan A. Fox ◽  
Charles A. Nelson ◽  
Charles H. Zeanah ◽  
...  
Keyword(s):  
Foster Care ◽  
Stressful Life Events ◽  
Institutional Care ◽  
Family Care ◽  
Stressful Events ◽  
Low Grade ◽  
Institutionalized Children ◽  
Reactive Protein ◽  
History Of ◽  
Prospective Association

AbstractEarly adversity has been shown to sensitize individuals to the effects of later stress and enhance risk of psychopathology. Using a longitudinal randomized trial of foster care as an alternative to institutional care, we extend the stress sensitization hypothesis to examine whether early institutional rearing sensitizes individuals to stressful events in adolescence engendering chronic low-grade inflammation. At baseline, institutionalized children in Romania (ages 6–31 months) were randomly assigned to foster care or to remain in usual care within institutions. A group of never-institutionalized children was recruited as an in-country comparison sample. At ages 12 and 16, participants reported stressful events. At age 16, Interleukin-6 (IL-6) and C-reactive protein (CRP) were derived from blood spots. Among children assigned to care as usual, more stressful events at age 12, but not age 16, were associated with higher IL-6. In the same group, stressful events at age 16 were associated with higher CRP, though these effects attenuated after adjusting for covariates. These associations were not observed in the foster care or never-institutionalized groups. The findings suggest that heightened inflammation following stress exposure is one pathway through which early neglect could compromise physical health. In contrast, early family care might buffer against these risks.

scholarly journals Effects of early intervention on EEG power and coherence in previously institutionalized children in Romania

2008 ◽  
Vol 20 (3) ◽  
pp. 861-880 ◽  
Author(s):  
Peter J. Marshall ◽  
Bethany C. Reeb ◽  
Nathan A. Fox ◽  
Charles A. Nelson ◽  
Charles H. Zeanah
Keyword(s):  
Foster Care ◽  
Spectral Power ◽  
Institutional Care ◽  
Family Care ◽  
Care Group ◽  
Alpha Power ◽  
Eeg Coherence ◽  
Institutionalized Children ◽  
Eeg Power ◽  
Foster Care Placement

AbstractTwo groups of Romanian children were compared on spectral power and coherence in the electroencephalogram (EEG) in early childhood. One group consisted of previously institutionalized children who had been randomly assigned to a foster care intervention at a mean age of 23 months. The second group had been randomized to remain in institutional care. Because of a policy of noninterference, a number of these children also experienced placement into alternative family care environments. There were minimal group differences between the foster care and institutionalized groups in EEG power and coherence across all measured frequency bands at 42 months of age. However, age at foster care placement within the foster care group was correlated with certain measures of EEG power and coherence. Earlier age at foster care placement was associated with increased alpha power and decreased short-distance EEG coherence. Further analyses separating age at placement from duration of intervention suggest that this effect may be more robust for EEG coherence than EEG band power. Supplementary analyses examined whether the EEG measures mediated changes in intellectual abilities within the foster care children, but no clear evidence of mediation was observed.

scholarly journals Environmental determinants of physiological reactivity to stress: The interacting effects of early life deprivation, caregiving quality, and stressful life events

2020 ◽  
Vol 32 (5) ◽  
pp. 1732-1742
Author(s):  
Mark Wade ◽  
Margaret A. Sheridan ◽  
Charles H. Zeanah ◽  
Nathan A. Fox ◽  
Charles A. Nelson ◽  
...  
Keyword(s):  
Foster Care ◽  
Stress Response ◽  
Life Events ◽  
Early Life ◽  
Stressful Life Events ◽  
Controlled Trial ◽  
Institutional Care ◽  
Stressful Life ◽  
Institutionalized Children ◽  
Caregiving Quality

AbstractChildren who spend their early lives in institutions experience profound psychosocial deprivation that is associated with altered stress response system development. Here, we used data from a longitudinal randomized controlled trial of foster care for institutionally reared children to examine whether caregiving quality and stressful life events (SLEs) in early adolescence (age 12) influence patterns of hypothalamic–pituitary–adrenal (HPA) axis and sympathetic nervous system (SNS) reactivity. Controlling for the effect of institutional care, higher caregiving quality at age 12 was associated with heightened cortisol and SNS reactivity. However, moderation analysis revealed that the latter effect was only observed among never-institutionalized children, whereas ever-institutionalized children demonstrated a persistently blunted SNS response regardless of recent caregiving quality. Among institutionally reared children, SLEs interacted with prior random assignment to foster care, such that those placed in foster care early in development had a SNS response that approximated never-institutionalized children when SLEs at age 12 were low. In contrast, SNS reactivity was persistently blunted among those with prolonged deprivation, regardless of recent SLEs. Early-life deprivation is associated with persistent blunting of stress response systems, but normalization may be achievable if SLEs are limited following placement into enriched family-based care.

scholarly journals A study of clinico-demographic profile of patients with dissociative disorder

2013 ◽  
Vol 8 (3) ◽  
pp. 30-35 ◽  
Author(s):  
SK Shah
Keyword(s):  
Personality Disorder ◽  
Stressful Life Events ◽  
Educational Status ◽  
Young Female ◽  
Stressful Events ◽  
Sensory Loss ◽  
Dissociative Disorder ◽  
Medical Sciences ◽  
Demographic Profile ◽  
History Of

Objectives To study the clinical and socio demographic profile of patients with dissociative disorder and their comorbid mental illness. Materials and methods Fifty-one patients of dissociative disorder presenting to emergency and outpatient department of Psychiatry at College of Medical Sciences Teaching Hospital during the period from Jan to March 2012 were included. International statistical classification of diseases and related health problems tenth edition, diagnostic criteria for research (ICD-10, DCR) was used. Results Out of 51 patients, the majority 24 (47.1%), were in the age group 15-29. However the age of presentation ranged from 9-45 years. The females were more, 44 (86.3%) as compared to males 7 (13.7%). The majority of patients had low level of education with none of the patients having education above intermediate level. The majority of patients, 27(52.9%) belonged to lower middle class. 49% of the patients presented with dissociative convulsions, 15.7% with dissociative motor disorders, 15.7% with dissociative stupor, 11.8% with dissociative anesthesia and sensory loss and 7.8% with trance and possession disorder. Depressive illness was found co-morbid with dissociative disorder in 33.3%, borderline personality disorder in 9.8% and histrionic personality disorder in 7.8%. There was history of immediate stressful events that supposedly precipitated the event in 76.5%. Conclusion Dissociative disorder mainly affects young female of lower socio-economic and educational status with history of immediate stressful life events precipitating the illness. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-3, 30-35 DOI: http://dx.doi.org/10.3126/jcmsn.v8i3.8683

scholarly journals Tuberculous spondylitis after vertebral augmentation: A case report with a literature review

2017 ◽  
Vol 46 (2) ◽  
pp. 916-924 ◽  
Author(s):  
Sun Jia-Jia ◽  
Sun Zhi-Yong ◽  
Qian Zhong-Lai ◽  
Yang Hui-Lin ◽  
Zhu Xiao-Yu
Keyword(s):  
Back Pain ◽  
Low Grade ◽  
Dramatic Improvement ◽  
Vertebral Augmentation ◽  
Tuberculous Spondylitis ◽  
Protein Levels ◽  
Reactive Protein ◽  
Paravertebral Abscess ◽  
Bony Destruction ◽  
History Of

Tuberculous spondylitis of vertebral augmentation following percutaneous vertebroplasty or kyphoplasty is rare. We report an unusual case of tuberculous spondylitis diagnosed after percutaneous kyphoplasty (PKP). A 54-year-old woman presented to hospital complaining of back pain following a fall 20 days prior. Radiology showed an acute osteoporotic compression (L3 fracture). The patient denied a history of pulmonary tuberculosis and there were no signs of infection. The patient was discharged from hospital 2 days after undergoing L3 PKP with a dramatic improvement in her back pain. The patient was readmitted 10 months later with a history of recurrent back pain and low-grade fever for 3 months. Imaging examinations showed severe spondylitis at the L2–L3 level, with paravertebral abscess formation and bony destruction of L2 and L3. A positive result of the T-SPOT test preliminarily confirmed the diagnosis of tuberculous spondylitis. The tuberculosis test was positive, and serum C-reactive protein levels and erythrocyte sedimentation were relatively high. Treatment for tuberculous spondylitis was started. She underwent posterior fusion and instrumentation from T12–L5 after markers for infection returned to normal. After surgery, the patient continued antituberculous and anti-osteoporosis treatments. Her low back pain was relieved and low-grade fever and sweating disappeared.

scholarly journals Mental health indicators among pregnant Aboriginal women in Canada: results from the Maternity Experiences Survey

2018 ◽  
Vol 38 (7/8) ◽  
pp. 269-276 ◽  
Author(s):  
Chantal Nelson ◽  
Karen M. Lawford ◽  
Victoria Otterman ◽  
Elizabeth K. Darling
Keyword(s):  
Mental Health ◽  
First Nations ◽  
Stressful Life Events ◽  
Previous History ◽  
Health Indicators ◽  
Correction Method ◽  
Stressful Events ◽  
Aboriginal Women ◽  
Maternity Experiences Survey ◽  
History Of

Introduction There is little research done on mental health among pregnant Aboriginal women. Therefore, the purpose of the study was to examine the prevalence of postpartum depression (PPD) and its determinants, including pre-existing depression among non-Aboriginal and Aboriginal women in Canada. Methods The Maternity Experiences Survey (MES) is a national survey of Canadian women’s experiences and practices before conception, up to the early months of parenthood. Predictors of PPD were calculated using the Mantel-Haenszel correction method relative to the risk estimates based on the odds ratio from adjusted regression analysis. The analysis was conducted among women who self-identified as Aboriginal (Inuit, Métis or First Nations living off-reserve) and those who identified as non-Aboriginal. Results The prevalence of pre-existing depression was higher among self-reported First Nations off-reserve and Métis women than non-Aboriginal women. Inuit women had the lowest prevalence of self-reported pre-existing depression, and Aboriginal women reported a higher prevalence of PPD than non-Aboriginal women. Pre-existing depression was not a predictor for PPD for Inuit or Métis women in this study but was a positive predictor among First Nations off-reserve and non-Aboriginal women. A disproportionally higher number of Aboriginal women reported experiencing abuse, as compared to non-Aboriginal women. Conclusion Our study demonstrated that common predictors of PPD including anxiety, experiencing stressful life events during pregnancy, having low levels of social support, and a previous history of depression were consistent among non-Aboriginal women. However, with the exception of the number of stressful events among First Nations offreserve, these were not associated with PPD among Aboriginal women. This information can be used to further increase awareness of mental health indicators among Aboriginal women.

scholarly journals Potential Consequences of Abandonment in Preschool-Age: Neuropsychological Findings in Institutionalized Children

2012 ◽  
Vol 25 (4) ◽  
pp. 291-301 ◽  
Author(s):  
Juan F. Cardona ◽  
Facundo Manes ◽  
Josefina Escobar ◽  
Jéssica López ◽  
Agustín Ibáñez
Keyword(s):  
Cognitive Impairment ◽  
Executive Functions ◽  
Institutional Care ◽  
Preschool Age ◽  
Early Deprivation ◽  
Institutionalized Children ◽  
Preschool Period ◽  
History Of ◽  
Preliminary Study ◽  
Attention Memory

Objective:Several longitudinal studies had shown that early deprivation and institutionalization during the first six months of life affects the emotional, cognitive, social and neurophysiologic development. Nevertheless, our understanding of possible similar effects of delayed institutionalization, in preschool-age remains unclear to this day. The goal of this study is to evaluate the cognitive performance of institutionalized children with history of preschool-age physical abandonment.Method:18 male institutionalized children with history of abandonment during the preschool-age (2–5 years old) and comparison group matched by age, handedness, gender, educational and socioeconomic level were tested on multiple tasks of attention, memory and executive functions.Results:We found a cognitive impairment in the institutionalized children in several measures of attention, memory and executive functions. This is the first report of cognitive impairment related to late abandonment and institutionalization effects (after 2 years old), extending the already known effects on early institutionalization.Conclusions:This preliminary study suggests that environmental factors including abandonment and institutional care, can affect not only the infancy period, but also the preschool period providing new insights into our understanding of neurocognitive development.

scholarly journals Stress sensitization among severely neglected children and protection by social enrichment

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Mark Wade ◽  
Charles H. Zeanah ◽  
Nathan A. Fox ◽  
Florin Tibu ◽  
Laura E. Ciolan ◽  
...  
Keyword(s):  
Foster Care ◽  
Life Events ◽  
Externalizing Problems ◽  
Stressful Life Events ◽  
Controlled Trial ◽  
Childhood Adversity ◽  
Stressful Life ◽  
Childhood Neglect ◽  
Institutionalized Children ◽  
Positive Caregiving

AbstractChildhood adversity may sensitize certain individuals to later stress which triggers or amplifies psychopathology. The current study uses data from a longitudinal randomized controlled trial to examine whether severe early neglect among children reared in institutions increases vulnerability to the effects of later stressful life events on externalizing problems in adolescence, and whether social enrichment in the form of high-quality foster care buffers this risk. Children abandoned to Romanian institutions were randomly assigned to a foster care intervention or care-as-usual during early childhood. A sample of never-institutionalized children served as a comparison group. Here we report that, among those with prolonged institutional rearing, more stressful life events in preadolescence predicted higher externalizing problems in adolescence. This effect was not observed for never-institutionalized children or those in foster care, thus providing experimental evidence that positive caregiving experiences protect against the stress-sensitizing effects of childhood neglect on externalizing problems in adolescence.

Isolated lateral meniscus tear masquerading as a potential septic arthritis in a 7 year old

2020 ◽  
Vol 13 (11) ◽  
pp. e236150
Author(s):  
Evelyn Patricia Murphy ◽  
Patrick J O'Toole
Keyword(s):  
Meniscal Tear ◽  
Lateral Meniscus ◽  
Meniscus Tear ◽  
Low Grade ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Meniscus Tears ◽  
History Of ◽  
Biochemical Testing ◽  
Unexpected Findings

A 7-year-old boy presented with a 1-week history of a limp, low grade temperature and mildly elevated inflammatory markers. He sustained a fall 2 weeks ago but was relatively symptom free for a week. The inital physical exam demonstrated a knee effusion clinically, radiographs did not demonstrate any overt pathology and biochemical testing demonstrated an elevated C reactive protein of 8 mg/L. An arthroscopy was conducted, with a plan for synovial biopsies to investigate for infective versus inflammatory arthritis as a cause for the effusion. An isolated lateral meniscal tear was discovered. This was repaired using all inside technique with Smith and Nephew’s FastFix 360 (R) suture anchors. It is quite uncommon to find isolated lateral meniscus tears in this population, but the learning point demonstrates it is important to arthroscopically examine the whole knee, even while performing synovial biopsies as there may be unexpected findings.

scholarly journals Growth in Self-Regulation Over the Course of Adolescence Mediates the Effects of Foster Care on Psychopathology in Previously Institutionalized Children: A Randomized Clinical Trial

2021 ◽  
pp. 216770262199388
Author(s):  
Cora E. Mukerji ◽  
Mark Wade ◽  
Nathan A. Fox ◽  
Charles H. Zeanah ◽  
Charles A. Nelson
Keyword(s):  
Foster Care ◽  
Self Regulation ◽  
Institutional Care ◽  
Care Group ◽  
Social And Emotional Development ◽  
General Psychopathology ◽  
Institutionalized Children ◽  
Social And Emotional ◽  
Peer Difficulties ◽  
The Impact

Children reared in institutions experience severe psychosocial deprivation, resulting in lasting consequences for social and emotional development. This study evaluated growth trajectories of self-regulation from ages 8 to 16 among previously institutionalized children randomized to foster care (foster-care group; FCG) or to remain in institutional care (care-as-usual group; CAUG) compared with a never-institutionalized group (NIG). We then tested a developmental pathway by which growth in self-regulation reduces general psychopathology at age 16 for the FCG relative to the CAUG. The FCG experienced modest growth in self-regulation over adolescence and “caught up” to the NIG by age 16. The beneficial effect of foster care on psychopathology operated through growth in self-regulation; part of this effect was further mediated by reduced peer difficulties for the FCG. Findings reveal that the effects of foster care on self-regulation emerge over adolescence and that growth in self-regulation is a mechanism by which foster care mitigates the impact of institutionalization on psychopathology.

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