Deficits in error monitoring are associated with externalizing but not internalizing behaviors among children with a history of institutionalization
Open accessAbstract
Background: Children raised in institutions are at increased risk of developing internalizing and externalizing problems. However, not all children raised in institutions develop psychopathology. Deficits in error monitoring may be one risk pathway for children with a history of institutionalization given that these skills are related to both internalizing and externalizing psychiatric disorders. Error monitoring and the neural circuitry that supports it have a protracted developmental time course and are highly susceptible to the effects of adversity. As such, they may play an important moderating role between a history of institutional rearing and subsequent psychopathology. Methods: We investigated the impact of psychosocial deprivation on behavioral and neural responses (event‐related potentials: ERP s) to a Flanker task assessing error monitoring and the relations between these measures and psychopathology for 12‐year‐old children in the Bucharest Early Intervention Project ( BEIP ). The BEIP involves two groups of institutionalized children randomly assigned in infancy to receive either a foster care intervention ( FCG ) or care as usual ( CAUG ). Results: Children who experienced institutional care, particularly those in the CAUG , showed perturbed behavioral performance and ERP s on the Flanker task. Additionally, an ERP measure of error monitoring [error‐related negativity (ERN)] moderated the relations between time spent in institutions and externalizing and ADHD behaviors. When the amplitude of the ERN was smaller, time spent in institutional care was positively related to ADHD and externalizing behaviors, whereas time spent in institutions was unrelated to externalizing problems when children evidenced a larger ERN. Neural correlates of error monitoring did not moderate the relations between time spent in institutionalized care and internalizing behaviors. Conclusions: Exposure to institutional care early in life may affect brain circuitry associated with error monitoring. Perturbations in this neural circuitry in combination with psychosocial deprivation are possibly a risk pathway associated with the development of externalizing and ADHD problems.
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Effects of foster care on the ERN appear to be late-emerging, with no significant group differences between foster care and continued institutional care from middle childhood to age 12 years.
“Effects of foster care on the ERN appear to be late-emerging, with no significant group differences between foster care and continued institutional care from middle childhood to age 12 years (Loman et al., 2013; McDermott et al., 2013; TrollerRenfree et al., 2016).”
From Foster care intervention protects cognitive control skills in young adults exposed to institutional rearing (2026) · cites this paper as Troller-Renfree et al., 2016
The Results (ERP analyses; page unavailable) report no statistically significant difference in ΔERN between the foster-care and care-as-usual groups at about age 12 (p=.063). The Introduction describes findings at ages 8–11 as mixed, rather than establishing no group differences throughout middle childhood. The paper also does not show that foster-care effects emerge later. (LLM, conf=0.82)
Experimental — accuracy not yet measuredFindings from BEIP and other independent samples have revealed long-term error monitoring differences in previously institutionalized children that persist at least through adolescence.
“Findings both from BEIP and other independent samples have revealed long-term error monitoring differences in previously institutionalized children that persist at least through adolescence (Buzzell et al., 2020; Debnath et al., 2023; Frenkel et al., 2020; Loman et al., 2013; McDermott et al., 2013; Troller-Renfree et al., 2016).”
From Foster care intervention protects cognitive control skills in young adults exposed to institutional rearing (2026) · cites this paper as Troller-Renfree et al., 2016
The Discussion reports error-monitoring differences in the BEIP sample at age 12, supporting persistence from early institutionalization into early adolescence. This paper does not establish persistence through later adolescence; its Introduction describes findings from another sample at ages 8–11 as mixed. (LLM, conf=0.82)
Experimental — accuracy not yet measuredAcross multiple ages and even in the absence of intervention group differences, ERN amplitude has been associated with psychosocial functioning in the BEIP at age 8, 12, and 16 years.
“Nevertheless, across multiple ages and even in the absence of intervention group differences, ERN amplitude has been associated with psychosocial functioning in the BEIP at age 8, 12, and 16 years (Debnath et al., 2023; McDermott et al., 2013; Troller-Renfree et al., 2016), albeit sometimes in different directions, likely due to differences in analytic approach”
From Foster care intervention protects cognitive control skills in young adults exposed to institutional rearing (2026) · cites this paper as Troller-Renfree et al., 2016
At BEIP's age 12 follow-up, there was a marginally significant effect of intervention on the ΔERN, and greater time spent in institutional care predicted smaller (less negative) ΔERNs.
“However, at BEIP ' s age 12 follow-up, there was a marginally significant effect of intervention on the Δ ERN (the amplitude difference between the ERN and its correct-trial counterpart, the correct-related negativity or CRN), and greater time spent in institutional care predicted smaller (less negative) Δ ERNs, potentially signaling an emerging intervention effect (Troller-Renfree et al., 2016).”
From Foster care intervention protects cognitive control skills in young adults exposed to institutional rearing (2026) · cites this paper as Troller-Renfree et al., 2016
Prior work has linked cognitive control dysfunction to specific forms of psychopathology in the context of neglect.
“Prior work has linked cognitive control dysfunction to specific forms of psychopathology in the context of neglect (McDermott et al., 2013; Troller-Renfree et al., 2016).”
From Adolescent cognitive control and mediofrontal theta oscillations are disrupted by neglect: Associations with transdiagnostic risk for psychopathology in a randomized controlled trial (2020) · cites this paper as Troller-Renfree et al., 2016
In humans, prior work demonstrates that neglect leads to deficits in indirect markers of cognitive control function.
“indirect markers of cognitive control function (event-related potentials; McDermott et al., 2013; Troller-Renfree et al., 2016)”
From Adolescent cognitive control and mediofrontal theta oscillations are disrupted by neglect: Associations with transdiagnostic risk for psychopathology in a randomized controlled trial (2020) · cites this paper as Troller-Renfree et al., 2016
Aberrant processing of social and threatening cues from amygdala dysfunction is a hallmark of psychiatric sequelae following early-life abuse/neglect.
“Aberrant processing of social and threatening cues stemming from amygdala dysfunction is a hallmark of psychiatric sequelae following early-life abuse and neglect (Levin et al., 2015, Teicher et al., 2003, Troller-Renfree et al., 2016, Zeanah and Gleason, 2015).”
From Early life adversity during the infant sensitive period for attachment: Programming of behavioral neurobiology of threat processing and social behavior (2017) · cites this paper as Troller-Renfree et al., 2016
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- Authors
- Troller‐Renfree, S., Nelson, C. A., Zeanah, C. H., & Fox, N. A.
- Affiliations
- University of Maryland, College Park (US)
- Boston Children's Hospital (US)
- Tulane University (US)
- Corresponding author
- Troller‐Renfree, Sonya
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2016-08-29
- Volume
- 57
- Issue
- 10
- Pages
- 1145-1153
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC5047056
- OpenAlex
- W2510016857
- Cited by
- 47
- References
- 33
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 6 · 2023: 7 · 2022: 1 · 2021: 4 · 2020: 9 · 2019: 4 · 2018: 5 · 2017: 3 · 2016: 1
- FWCI
- 10.57
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH091363)
- National Science Foundation (DGE1322106)
- Topics
- Social Sciences › Safety Research › Child Welfare and Adoption
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- error monitoring, error-related negativity, institutionalization, psychosocial deprivation, externalizing problems, internalizing problems, attention deficit hyperactivity disorder, foster care, Bucharest Early Intervention Project, event-related potentials, flanker task, neural circuits, child psychopathology
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Child, Child Behavior Disorders, Child, Institutionalized, Evoked Potentials, Female, Humans, Male, Psychosocial Deprivation, Romania, Executive Function
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.
What counts as a claim ›How we measure confidence ›How we check this ›
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