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Prolonged institutional rearing is associated with atypically large amygdala volume and difficulties in emotion regulation
Open accessAbstract
Early adversity, for example poor caregiving, can have profound effects on emotional development. Orphanage rearing, even in the best circumstances, lies outside of the bounds of a species‐typical caregiving environment. The long‐term effects of this early adversity on the neurobiological development associated with socio‐emotional behaviors are not well understood. Seventy‐eight children, who include those who have experienced orphanage care and a comparison group, were assessed. Magnetic resonance imaging (MRI) was used to measure volumes of whole brain and limbic structures (e.g. amygdala, hippocampus). Emotion regulation was assessed with an emotional go‐nogo paradigm, and anxiety and internalizing behaviors were assessed using the Screen for Child Anxiety Related Emotional Disorders, the Child Behavior Checklist, and a structured clinical interview. Late adoption was associated with larger corrected amygdala volumes, poorer emotion regulation, and increased anxiety. Although more than 50% of the children who experienced orphanage rearing met criteria for a psychiatric disorder, with a third having an anxiety disorder, the group differences observed in amygdala volume were not driven by the presence of an anxiety disorder. The findings are consistent with previous reports describing negative effects of prolonged orphanage care on emotional behavior and with animal models that show long‐term changes in the amygdala and emotional behavior following early postnatal stress. These changes in limbic circuitry may underlie residual emotional and social problems experienced by children who have been internationally adopted.
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“In the same vein, it has been shown that maltreated children have higher amygdala volume (Lupien et al., 2011;Tottenham et al., 2010).”
From Physiological feelings (2019) · cites this paper as Tottenham et al., 2010
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Children deprived of a stable and responsive caregiver exhibit high levels of insecure and disorganized attachment and atypical affective development characterized by heightened emotional reactivity, accelerated functional development of the amygdala, poor emotion regulation, and atypical stress reactivity.(25, 32–37)”
From Neglect as a violation of species-expectant experience: neurodevelopmental consequences (2017) · cites this paper as [33]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“and recent data suggest that atypical presentations of these same systems have implications for understanding emotion dysregulation (Miller et al. 2017b, Tottenham et al. 2010) and a range of both internalizing and externalizing symptoms (Burghy et al. 2012, Chen et al. 2015, Nederhof et al. 2015, Slavich & Irwin 2014).”
From Adolescent Suicide as a Failure of Acute Stress-Response Systems. (2019) · cites this paper as Tottenham et al. 2010
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“children with histories of severe neglect show marked problems in many other domains, including psychopathology (34), social competence (35), emotional reactivity (36), and academic achievement (37)”
From Long-term effects of institutional rearing, foster care, and brain activity on memory and executive functioning (2019) · cites this paper as [36]
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In the citing paper
“Induced early life stress has been associated with amygdalar hypertrophy in primates (73), with increased volumes also found in children exposed to both neglect (74) and mild maternal disengagement (75).”
From Childhood Trauma, the HPA Axis and Psychiatric Illnesses: A Targeted Literature Synthesis (2022) · cites this paper as [74]
In the citing paper
“Longitudinal studies27 as well as studies of children raised in orphanages28 indicate that disorganized attachment during infancy predicts greater amygdala volume—a hypothesized biomarker of difficulty with emotion regulation28.”
From Psychobiological factors of resilience and depression in late life (2019) · cites this paper as [28]
In the citing paper
“The hippocampus is also highly stress susceptible, with sensitive periods in early childhood and during the pubertal period, but effects of stress are less persistent (15, 24, 47).”
From Disorganized attachment in infancy predicts greater amygdala volume in adulthood (2016) · cites this paper as [24]
In the citing paper
“Extreme deprivation dramatically alters neural architecture and functioning.”
From Normalization of EEG activity among previously institutionalized children placed into foster care: A 12-year follow-up of the Bucharest Early Intervention Project (2016) · cites this paper as Tottenham et al., 2010
In the citing paper
“Smaller left amygdala volume and larger right amygdala volume were reported in a small study of previously-institutionalized children,(128) but these patterns have not been replicated in larger studies.(33, 129)”
From Neglect as a violation of species-expectant experience: neurodevelopmental consequences (2017) · cites this paper as [33]
In the citing paper
“In contrast, stress-induced amygdala morphology and volume changes seem to persist (Vyas et al., 2002, Adamec et al., 2005, Tottenham et al., 2010).”
From The impact of developmental timing for stress and recovery (2015) · cites this paper as Tottenham et al., 2010
In the citing paper
“In studies of children reared in orphanages abroad and later adopted into stable families, the findings consistently suggest that earlier adoption is better (Rutter, 1998, Gunnar et al., 2000, Tottenham et al., 2010).”
From The impact of developmental timing for stress and recovery (2015) · cites this paper as Tottenham et al., 2010
In the citing paper
“Human studies of maternal deprivation early in life have shown atypical frontoamygdala development and function with greater amygdala volume, amygdala hyperactivity, and less prefrontal activity to emotional stimuli, as well as long-term impairments in anxiety and social behavior (Mehta et al., 2009, Zeanah et al., 2009, Tottenham et al., 2010, Tottenham et al., 2011).”
From The impact of developmental timing for stress and recovery (2015) · cites this paper as Tottenham et al., 2010, Tottenham et al., 2011
In the citing paper
“Human studies of maternal deprivation early in life have shown atypical frontoamygdala development and function with greater amygdala volume, amygdala hyperactivity, and less prefrontal activity to emotional stimuli, as well as long-term impairments in anxiety and social behavior (Mehta et al., 2009, Zeanah et al., 2009, Tottenham et al., 2010, Tottenham et al., 2011).”
From The impact of developmental timing for stress and recovery (2015) · cites this paper as Tottenham et al., 2010, Tottenham et al., 2011
In the citing paper
“The finding of reduced amygdala volume is counter to the enlarged amygdala volumes found in children with experiences of early deprivation (Tottenham et al, 2010).”
From Deviations from the expectable environment in early childhood and emerging psychopathology (2015) · cites this paper as Tottenham et al, 2010
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The Lifelong Effects of Early Childhood Adversity and Toxic Stress
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Inequality in early childhood: risk and protective factors for early child development
Walker, S. P., Wachs, T. D., Grantham-McGregor, S., Black, M. M., Nelson, C. A., Huffman, S. L., Baker-Henningham, H., Chang, S. M., Hamadani, J. D., Lozoff, B., et al. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60555-2 · Cited by 1,756
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Metadata
- Authors
- Tottenham, N., Hare, T. A., Quinn, B. T., McCarry, T. W., Nurse, M., Gilhooly, T., Millner, A., Galvan, A., Davidson, M. C., Eigsti, I., Thomas, K. M., Freed, P. J., Booma, E. S., Gunnar, M. R., Altemus, M., Aronson, J., & Casey, B. J.
- Affiliations
- Cornell University (US)
- California Institute of Technology (US)
- University of Massachusetts Amherst (US)
- University of Connecticut (US)
- University of Minnesota (US)
- Columbia University (US)
- Corresponding author
- Tottenham, Nim
- ORCID
- Venue
- Developmental Science
- Publisher
- Wiley
- Published
- 2009-12-09
- Volume
- 13
- Issue
- 1
- Pages
- 46-61
- ISSN
- 1363-755X (ISSN-L)
- 1467-7687
- PMC
- PMC2817950
- OpenAlex
- W1890675559
- Cited by
- 905
- References
- 87
- Citations by year
- 2026: 21 · 2025: 35 · 2024: 25 · 2023: 48 · 2022: 51 · 2021: 65 · 2020: 125 · 2019: 76 · 2018: 70 · 2017: 62 · 2016: 69 · 2015: 65 · 2014: 64 · 2013: 47 · 2012: 43
- FWCI
- 68.51
- Type
- journal article
- Language
- en
- Open access
- green
- www.zora.uzh.ch
- Licence
- Locations
- Developmental Science (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
- PubMed Central (acceptedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- National Institute of Mental Health (P50MH079513, R01MH073175, R01MH091864)
- Topics
- Social Sciences › Sociology and Political Science › Child Welfare and Adoption
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- institutional upbringing, amygdala volume, emotion regulation, childhood adversity, late adoption, anxiety disorders, internalizing problems, limbic system, hippocampus, emotional development, postpartum stress, social-emotional behavior
- MeSH terms
- Adaptation, Psychological, Adolescent, Adoption, Age Factors, Amygdala, Analysis of Variance, Brain Mapping, Child, Child Behavior Disorders, Emotions, Facial Expression, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Photic Stimulation, Surveys and Questionnaires, Orphanages, Checklist
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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