Is deprivation-related ADHD different from ADHD among children without histories of deprivation?

Abstract

Children reared in the deprived environments of institutions (e.g., orphanages) are at increased risk for problems with inattention and hyperactivity. Although these children have been reported to have higher rates of Attention Deficit/Hyperactivity Disorder (ADHD) diagnoses than would be expected in the general population, it is unclear if ADHD among post-institutionalized (PI) children is different from that among never institutionalized children. This study directly compared the clinical and symptom profile, executive function task and delay aversion task performances, and event-related potentials of 11- to 15-year-old internationally adopted PI children with ADHD (PI-A) to PI children without ADHD (PI-N) and non-adopted children with ADHD (NA-A). PI-As were found to be adopted primarily from Eastern European countries following longer periods of institutionalization than PI-Ns. They performed more poorly on most of the behavioral measures of executive function than PI-Ns; although the performance generally did not differ from NA-As. Relative to NA-As specifically, PI-As reported elevated disinhibited social behavior and, among males, demonstrated more aversion to delay, and had smaller overall N2 amplitude associated with a Go/No-go task. The results indicate that deprivation-related ADHD has an overlapping clinical profile with standard ADHD in addition to a few unique features. This profile associated with early deprived care could be considered a phenocopy of standard ADHD. A description of the deprivation-related ADHD profile has potential implications for identification and treatment of ADHD behaviors among PI youth.