The DOI matches its Crossref record; 37 of the 38 references it cites were found in a registry or an index; 7 of the 46 sources its claims cite were checked for support.
A Randomized Controlled Trial Comparing Foster Care and Institutional Care for Children With Signs of Reactive Attachment Disorder
Open accessAbstract
OBJECTIVE: The authors examined signs of emotionally withdrawn (inhibited type) and indiscriminately social (disinhibited type) reactive attachment disorder in Romanian children enrolled in a randomized trial of foster care compared with institutional care and in a comparison group of never-institutionalized children. METHOD: At baseline and when children were ages 30, 42, and 54 months and 8 years, caregivers were interviewed with the Disturbances of Attachment Interview to assess changes in signs of reactive attachment disorder in three groups of children: those receiving care as usual (including continued institutional care) (N=68); those placed in foster care after institutional care (N=68); and those who were never institutionalized (N=72). The impact of gender, ethnicity, and baseline cognitive ability was also examined. RESULTS: On the Disturbances of Attachment Interview, signs of the inhibited type of reactive attachment disorder decreased after placement in foster care, and scores were indistinguishable from those of never-institutionalized children after 30 months. Signs of the disinhibited type were highest in the usual care group, lower in the foster care group, and lowest in the never-institutionalized group. Early placement in foster care (before age 24 months) was associated with fewer signs of the disinhibited type. Lower baseline cognitive ability was associated with more signs of the inhibited type in the usual care group and more signs of the disinhibited type in both groups. CONCLUSIONS: Signs of the inhibited type of reactive attachment disorder responded quickly to placement in foster care; signs of the disinhibited type showed less robust resolution with foster placement. Lower baseline cognitive ability was linked to signs of reactive attachment disorder.
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Claims the paper makes
25 Own result · 14 No full text of the sources · 11 Own interpretation · 9 Own method · 4 Partly supported · 4 No basis given · 2 Supported · 2 Not checked yet · 1 Sources not found · accuracy not yet measured
Every source the paper cites for this claim was checked and supports it.
In the paper
“Nevertheless, our confidence in caregiver reports for this sample is high because they converge with observer ratings (29).”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Discussion
What the sources say
- Supportedcites [29] source
The Discussion states that convergence between interviews and observational measures for both types of RAD increased confidence in the caregiver-report measures used. This supports the cited rationale for confidence in caregiver reports. (LLM, conf=0.92)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Results from this investigation have implications not only for young children raised in institutions but also for those who have experienced maltreatment (29, 37, 38) and other forms of neglect.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Discussion
What the sources say
- Partly supportedcites [29] sourceExperimental — accuracy not yet measured
The paper discusses attachment disorders in children who experienced maltreatment, so it provides some context for the proposed implications. But the Discussion (page not provided) says this study examined institutionalization only and its findings may not generalize to children exposed to other adverse caregiving, including other forms of neglect. (LLM, conf=0.84)
- Not checked — no full text of the sourcecites [37] source
- Not checked — no full text of the sourcecites [38] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“scores were indistinguishable from those of never-institutionalized children after 30 months”
- Also stated in: § Discussion · plain
“signs were indistinguishable between children in the foster care group and those in the never-institutionalized group after age 30 months”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“more signs of the disinhibited type in both groups”
- Also stated in: § Factors impacting change in signs of reactive attachment disorder · plain
“children with better cognitive abilities at baseline had fewer signs of this type of reactive attachment disorder across the entire intervention period.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Factors impacting change in signs of reactive attachment disorder · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Lower baseline cognitive ability was associated with more signs of the inhibited type in the usual care group”
- Also stated in: § Factors impacting change in signs of reactive attachment disorder · plain
“Post hoc comparisons revealed more signs of this type of reactive attachment disorder among children in the usual care group with lower baseline cognitive abilities, across the entire intervention period, compared with children in this group with higher baseline cognitive abilities (t=4.24, df=127, p<.0.001).”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Factors impacting change in signs of reactive attachment disorder · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Early placement in foster care (before age 24 months) was associated with fewer signs of the disinhibited type.”
- Also stated in: § Timing of intervention · plain
“children placed in foster care before age 24 months had fewer signs of disinhibited reactive attachment disorder at ages 30 months (t=3.11, df=239, p<0.01) and 54 months (t=2.62, df=239, p<0.01) than did those placed after age 24 months.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Timing of intervention · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“signs of the inhibited type of reactive attachment disorder decreased after placement in foster care”
- Also stated in: § Discussion · boosted
“placement of young institutionalized children in quality foster care resulted in marked reduction of signs of inhibited reactive attachment disorder”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Results
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Discussion · boosted
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Differences between the foster care group and the never-institutionalized group were evident at baseline and at ages 30 months and 8 years.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Results > Signs of Inhibited Reactive Attachment Disorder
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Post hoc comparisons at ages 30 months (t=4.51, df=475, p<0.001), 42 months (t=4.58, df=475, p<0.001), 54 months (t=4.07, df=475, p<0.001), and 8 years (t=2.70, df=475, p<0.01) all indicated fewer signs of inhibited reactive attachment disorder for children in the foster care group compared with those in the usual care group.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Results > Signs of Inhibited Reactive Attachment Disorder
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“repeated-measures ANOVA revealed a main effect for baseline cognitive ability (F=18.14, df=1, 127, p<0.001), suggesting that children with better cognitive abilities at baseline had fewer signs of this type of reactive attachment disorder across the entire intervention period.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Results > Factors impacting change in signs of reactive attachment disorder
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 14
- It may state two separate claims as one. 22
- The quote only partly states this claim. 1
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Both types of the disorder, emotionally withdrawn (inhibited) and the indiscriminately social (disinhibited), have been described in young children who have been maltreated or raised in conditions of deprivation (2–4).”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Conclusions
What the sources say
- Partly supportedcites [2] Bowlby J, 1951 sourceExperimental — accuracy not yet measured
The Abstract describes two possible outcomes of early maternal deprivation: an affectionless character or profound emotional and physical apathy. This supports the broader point that deprived young children may show different patterns, but it does not identify them as inhibited and disinhibited RAD, describe indiscriminate sociability, or address maltreatment separately. (LLM, conf=0.82)
- Not checked — no full text of the sourcecites [3] source
- Not checked — no full text of the sourcecites [4] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The association of institutional deprivation and reactive attachment disorder has been noted in the literature since the mid-20th century (1–4).”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Conclusions
What the sources say
- Not checked — no full text of the sourcecites [1] source
- Partly supportedcites [2] Bowlby J, 1951 sourceExperimental — accuracy not yet measured
The 1952 paper’s Abstract links early deprivation of a mother-figure to impaired emotional development and describes studies of deprived children’s behaviour. It does not specifically identify institutional deprivation or reactive attachment disorder, so it supports the historical connection only at a broader level. (LLM, conf=0.84)
- Not checked — no full text of the sourcecites [3] source
- Not checked — no full text of the sourcecites [4] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The instrument has shown strong convergent (9, 30) and discriminant (29) validity.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Methods > Measures
What the sources say
- Not checked — no full text of the sourcecites [9] source
- Could not verifycites [30] sourceExperimental — accuracy not yet measured
In Part II, ‘PTSD and Secure Base Distortions’ (page unavailable), the paper describes the DAI and reports internal consistency for its secure-base-distortion items and an association between DAI scores and maternal PTSD severity. Neither that passage nor searches for ‘convergent validity’ and ‘discriminant validity’ establish that the DAI has strong validity of either kind. (LLM, conf=0.72)
- Partly supportedcites [29] sourceExperimental — accuracy not yet measured
The Results (page unavailable) examine discriminant validity and find no statistical association between disinhibited RAD and ADHD diagnoses. But the tests concern RAD diagnoses rather than the DAI instrument as a whole; the paper also reports an association between withdrawn RAD signs and depressive symptoms. Its findings therefore do not establish the DAI’s broadly ‘strong’ discriminant validity. (LLM, conf=0.82)
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“When placed with families, children form new attachments (21) and signs of inhibited reactive attachment disorder disappear.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Discussion
What the sources say
- Supportedcites [21] source
The citation is attached to the claim that children placed with families form new attachments, not to the subsequent statement about inhibited reactive attachment disorder. The Discussion says that children placed in foster care after early institutional rearing show recovery in attachment and a strong disposition to form attachments. (LLM, conf=0.92)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All children under age 31 months (N=187) at study initiation (April 2001) who were cared for in the six institutions in Bucharest were assessed for participation in the study.”
- Also stated in: § Sample · plain
“Fifty-one children met exclusion criteria, resulting in an initial study population of 136 children.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Methods > Sample
plainn = 136- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one. The quote only partly states this claim.
- Also stated in: § Sample · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Signs of the disinhibited type were highest in the usual care group, lower in the foster care group, and lowest in the never-institutionalized group.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“One child in the foster care group was subsequently found to meet exclusion criteria and was excluded from further analyses.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Methods > Sample
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The repeated-measures analysis showed significant main effects for change over time (F=12.72, df=4, 475, p<0.001) and for group (F=15.42, df=1, 133, p<0.001), but not for the group-by-time interaction, suggesting that scores did not decrease differentially for the usual care and foster care groups (Figure 1).”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Results > Signs of Disinhibited Reactive Attachment Disorder
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results of repeated-measures ANOVA revealed a baseline cognitive ability-by-group interaction (F=5.89, df=1, 127, p<0.05), indicating a differential effect of baseline cognitive ability on signs of inhibited reactive attachment disorder.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Results > Factors impacting change in signs of reactive attachment disorder
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Preliminary analyses revealed no significant effect of gender or ethnicity and these variables were excluded from further analyses.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“repeated-measures analysis showed a significant interaction of age at placement by time (f=3.39, df=4, 239, p<0.05), indicating that scores decreased differentially for the children placed in foster care before age 24 months compared with those placed after that age.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Results > Timing of intervention
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“By including assessments of reactive attachment disorder prior to removal from institutions and by using well-validated measures administered longitudinally, this randomized controlled trial reduces selection bias and directly addresses questions about the responsiveness of children with reactive attachment disorder to enhanced caregiving.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Conclusions
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Third, the comparison groups for two recent studies (11, 15) were Canadian and British children, respectively, rather than ethnically matched children, introducing the possibility that cultural differences may affect outcomes.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Conclusions
What the sources say
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Children in the study had been abandoned at or soon after birth and placed in institutional care in the custody of the government.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Conclusions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Interest in the effects of institutional care persists to the present day because many children throughout the world are raised in institutions as a result of abuse or neglect, abandonment, or parental incapacity or death (5–7).”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Conclusions
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We did, however, ensure that no child, once placed in foster care through the Bucharest Early Intervention Project, would be returned to an institutional setting, either during or after the study.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Methods > Sample
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Similarly, Rutter and colleagues (4, 14–16) found no signs of the inhibited type of reactive attachment disorder in children adopted before age 4, but a minority of children showed signs of indiscriminate behavior.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Conclusions
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“For children adopted from institutions, rates of attachment disorders are elevated but lower than those for children living in institutions (11).”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Conclusions
What the sources say
- Not checked — no full text of the sourcecites [11] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We followed an intent to treat approach in all analyses so that original group assignment was maintained.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Methods > Sample
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“They were assessed comprehensively at baseline and then randomly assigned to care as usual (including continued institutional care) or to placement in foster care, which was created as part of the project.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Conclusions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Since studies of children currently living in institutions have demonstrated that both types of the disorder are readily identifiable (9, 13), the absence of the inhibited type, and the persistence of the disinhibited type in children after they are placed in more favorable caregiving environments are notable.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Conclusions
What the sources say
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Often, these institutions are large group settings with multiple caregivers whose rotating schedules do not support the development of a focused attachment relationship between a child and a given caregiver (8, 9).”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Conclusions
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Of those who had been returned to their parents or been adopted, none exhibited signs of the inhibited type, and a minority continued to exhibit signs of the disinhibited type (13).”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Conclusions
What the sources say
- Not checked — no full text of the sourcecites [13] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The Bucharest Early Intervention Project, which was designed as a randomized controlled trial of foster care as an alternative to care as usual among institutionalized young children, addressed many of the limitations of previous studies (17).”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Conclusions
What the sources say
- Not checked — no full text of the sourcecites [17] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Each child was given a number (siblings were placed together) and numbers were drawn from a hat and alternately assigned to the two groups.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Methods > Procedure
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The lack of a timing effect suggests that children raised in institutional settings retain a capacity for forming attachments, with no obvious sensitive period.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Two Romanian-speaking research assistants who were trained to reliability on the interview (10) coded each interview. Discrepancies were resolved by conferencing, and a consensus code was obtained for each item.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Methods > Measures
What the sources say
- Not checked — no full text of the sourcecites [10] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The timing of placement in foster care has been shown to have an impact on cognitive recovery for children who experienced institutional care (20)”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Discussion
What the sources say
- Not checked — no full text of the sourcecites [20] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This effect was not evident among children in the foster care group, suggesting that the intervention of foster care was beneficial to children regardless of their cognitive abilities.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Discussion
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“On average, children in the never-institutionalized group were younger at the baseline assessment than children in the study groups (data not shown).”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These findings indicate that placement in families clearly eliminates signs of the inhibited type of reactive attachment disorder, as measured by the Disturbances of Attachment Interview, among young children raised in institutions, but it has a more attenuated effect on the disinhibited type.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Discussion
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Before this study, no planned intervention studies of attachment disorders had been conducted.
“To our knowledge, there have been no previous planned intervention studies of attachment disorders, although some natural experiments have provided valuable data.”
The paper relies on this without support.
No previous studies had examined the impact of the intervention on attachment disorders.
“No previous studies have examined the impact of the intervention on attachment disorders.”
The paper relies on this without support.
No randomized trial comparing foster care and institutional care had been conducted until the BEIP was initiated in 2001.
“Despite 60 years of research comparing young children in foster care and those in institutional care, no randomized trial had been conducted until the Bucharest Early Intervention Project was initiated in 2001.”
The authors state this as an assumption.
The repeated-measures analyses assume data are missing at random.
“repeated-measures analysis of variance (ANOVA; likelihood model, data missing at random, SAS PROC MIXED, two groups and 5 assessments)”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“fewer attachment disorder symptoms (Guyon-Harris et al., 2018, 2019;Humphreys et al., 2017;King et al., 2023;Smyke et al., 2012)”
From Resilience following severe early life neglect: A review of longitudinal evidence from the Bucharest Early Intervention Project (2026) · cites this paper as Smyke et al., 2012
The cited source says what the claim attributes to it.
In the citing paper
“Strong improvements in attachment disorder symptoms; moderate improvements in externalizing symptoms and adaptive functioning; weak improvements in internalizing symptoms for boys (strong for girls)”
From Resilience following severe early life neglect: A review of longitudinal evidence from the Bucharest Early Intervention Project (2026) · cites this paper as Smyke et al., 2012
In the citing paper
“To date, investigators have reported that children placed in foster care had significantly fewer symptoms of internalizing disorders, 6 attachment disorders, 21 and stereotyped movement disorders 22 compared to children receiving continued institutional care.”
From Recovering from early deprivation: attachment mediates effects of caregiving on psychopathology (2012) · cites this paper as [21]
In the citing paper
“Externalizing signs, CU traits and attachment disorder behaviors at 12 years all were reduced for children living in foster care [34–37].”
From Alternatives for abandoned children: Insights from the Bucharest Early Intervention Project (2017) · cites this paper as [36]
In the citing paper
“Externalizing signs, CU traits and attachment disorder behaviors at 12 years all were reduced for children living in foster care [34–37].”
From Alternatives for abandoned children: Insights from the Bucharest Early Intervention Project (2017) · cites this paper as [34]
In the citing paper
“At age 12 years, children who had remained in a stable foster placement since original randomization were less likely to display signs of internalizing and externalizing disorders [34]”
From Alternatives for abandoned children: Insights from the Bucharest Early Intervention Project (2017) · cites this paper as [34]
In the citing paper
“Second, there were substantial IQ differences between the groups, with the RAD group showing a lower FSIQ compared with the TD group, which has been reported elsewhere.8,51”
From Ventral striatum dysfunction in children and adolescents with reactive attachment disorder: functional MRI study (2015) · cites this paper as [51]
In the citing paper
“While prior studies in the BEIP have specifically examined attachment,15, 23, 24 teacher-rated social skills,16 and stereotypies,17 these findings are not always specific to ASD.”
From Social communication difficulties and autism in previously institutionalized children (2015) · cites this paper as [15]
In the citing paper
“Other studies, while not looking specifically at ASD, suggest that post-institutionalized children demonstrate behaviors often seen in ASD, including abnormalities in social approach, difficulties adjusting behavior to suit social context, and difficulties with peer relationships.4, 9–16”
From Social communication difficulties and autism in previously institutionalized children (2015) · cites this paper as [15]
In the citing paper
“this adds to the growing list of developmental domains that are altered in children with a history of institutionalization and can be improved by foster care, including attachment,15, 23, 24 stereotypies,17 language,38–40 cognition,31, 41 depression, anxiety,42, 43 and growth.44”
From Social communication difficulties and autism in previously institutionalized children (2015) · cites this paper as [15]
In the citing paper
“Studies in this cohort have shown that although multiple areas of development are impaired among ever-institutionalized children, foster care placement leads to improvement in some areas (e.g. cognition,2,3 attachment,5,6,40, language7–9, depression, anxiety,10,12 stereotypies,11 and growth41) but not in other areas”
From Motor outcomes in children exposed to early psychosocial deprivation (2014) · cites this paper as [6]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Abstract > Results
“scores were indistinguishable from those of never-institutionalized children after 30 months.”
§ A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder > Results > Signs of Inhibited Reactive Attachment Disorder
“Differences between the foster care group and the never-institutionalized group were evident at baseline and at ages 30 months and 8 years.”
Citations
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Zeanah, C. H., Smyke, A. T., Koga, S. F., Carlson, E., & The Bucharest Early Intervention Project Core Group (2005) · Child Development · doi:10.1111/j.1467-8624.2005.00894.x · Cited by 516 · cited 3×
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BackgroundSelf-citationO'CONNOR, T. G., & RUTTER, M. (2000) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200006000-00008 · Cited by 482
ZEANAH, C. H., NELSON, C. A., FOX, N. A., SMYKE, A. T., MARSHALL, P., PARKER, S. W., & KOGA, S. (2003) · Development and Psychopathology · doi:10.1017/s0954579403000452 · Cited by 447 · cited 2×
“Study subjects were three groups of young Romanian children enrolled in the Bucharest Early Intervention Project and repeatedly assessed over time; assessments were conducted at baseline (6–30 months) and at ages 30, 42, and 54 months and 8 years (17, 20).”
BackgroundMethodSelf-citationInstitutional rearing and psychiatric disorders in Romanian preschool children
Zeanah, C. H., Egger, H. L., Smyke, A. T., Nelson, C. A., Fox, N. A., Marshall, P. J., & Guthrie, D. (2009) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2009.08091438 · Cited by 365
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Cited by
Sorted by citations
Zeanah, C. H., & Gleason, M. M. (2015) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12347 · Cited by 265
“In the BEIP, there was a modest, but statistically significant decline in signs of DSED with the foster care intervention, although rates were significantly lower in the never institutionalized group (Smyke et al., 2012).”
BackgroundInfluentialSelf-citationMental disorders in foster children: a study of prevalence, comorbidity and risk factors
Lehmann, S., Havik, O. E., Havik, T., & Heiervang, E. R. (2013) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/1753-2000-7-39 · Cited by 236
“Some longitudinal studies have continued to use the Strange Situation Procedure up until school age, in combination with parental reports and standardised investigator ratings of child behaviour [19,20], while others have developed their own semi-structured interviews and rating scales [21].”
BackgroundHow Early Experience Shapes Human Development: The Case of Psychosocial Deprivation
Nelson, C. A., Zeanah, C. H., & Fox, N. A. (2019) · Neural Plasticity · doi:10.1155/2019/1676285 · Cited by 211
“…[100], more mature patterns of brain electrical activity at age 8 [90], more secure attachments to their adult care-givers at 42 months of age [101], less indiscriminate behavior through 8 years [102], and healthier stress responsivity in both sympathetic and cortisol reactivity at 12 years [41].”
Self-citationAttachment goes to court: child protection and custody issues
Forslund, T., Granqvist, P., van IJzendoorn, M. H., Sagi-Schwartz, A., Glaser, D., Steele, M., Hammarlund, M., Schuengel, C., Bakermans‐Kranenburg, M. J., Steele, H., et al. (2021) · Attachment & Human Development · doi:10.1080/14616734.2020.1840762 · Cited by 202
Self-citationRecovering from early deprivation: attachment mediates effects of caregiving on psychopathology
McGoron, L., Gleason, M. M., Smyke, A. T., Drury, S. S., Nelson, C. A., Gregas, M. C., Fox, N. A., & Zeanah, C. H. (2012) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2012.05.004 · Cited by 133
Self-citationComparing Long-Term Placement Outcomes of Residential and Family Foster Care: A Meta-Analysis
Li, D., Chng, G. S., & Chu, C. M. (2017) · Trauma Violence & Abuse · doi:10.1177/1524838017726427 · Cited by 159
“On the one hand, research has indicated that there are both short- and long-term benefits in placing children under family foster care as compared to residential care (Dregan & Gulliford, 2012; Smyke et al., 2012).”
BackgroundZeanah, C. H., Chesher, T. L., Boris, N. W., Walter, H. J., Bukstein, O. G., Bellonci, C., Benson, R. S., Bussing, R., Chrisman, A. K., Hamilton, J. D., et al. (2016) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2016.08.004 · Cited by 144
“On the other hand, children with RAD may show continuing impairment in family and social relationships, even after signs of the disorder diminish in adequate caregiving environments.(41) This suggests that careful evaluation of all aspects of the child’s functioning is necessary, even after the child is in an adequate…”
BackgroundMethodResultInfluentialSelf-citationAge at Adoption from Institutional Care as a Window into the Lasting Effects of Early Experiences
Julian, M. M. (2013) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-013-0130-6 · Cited by 135
“Furthermore, the BEIP demonstrated that age at adoption is related to the disinhibited, but not inhibited, type of RAD (Smyke et al., 2012).”
BackgroundInfluentialAlternatives for abandoned children: Insights from the Bucharest Early Intervention Project
Zeanah, C. H., Humphreys, K. L., Fox, N. A., & Nelson, C. A. (2017) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2017.02.024 · Cited by 115
Self-citationAlmas, A. N., Degnan, K. A., Radulescu, A., Nelson, C. A., Zeanah, C. H., & Fox, N. A. (2012) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1121256109 · Cited by 115
Self-citationMechanisms of neuroplasticity linking early adversity to depression: developmental considerations
Ho, T. C., & King, L. S. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01639-6 · Cited by 117
“In humans, institutionalized children who are deprived of individualized input from caregivers often fail to develop organized—let alone secure—attachment styles and are more likely to develop disorders of social relatedness that persist across childhood [88, 139, 140].”
BackgroundMental Disorders in Early Childhood
von Klitzing, K., Döhnert, M., Kröll, M., & Grube, M. (2015) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2015.0375 · Cited by 81
Oxytocin receptor DNA methylation and alterations of brain volumes in maltreated children
Fujisawa, T. X., Nishitani, S., Takiguchi, S., Shimada, K., Smith, A. K., & Tomoda, A. (2019) · Neuropsychopharmacology · doi:10.1038/s41386-019-0414-8 · Cited by 85
Humphreys, K. L., Nelson, C. A., Fox, N. A., & Zeanah, C. H. (2017) · Development and Psychopathology · doi:10.1017/s0954579417000256 · Cited by 74
“At each assessment during the RCT (ages 30, 42, and 54 months) the children in foster care had fewer signs of reactive attachment disorder than children in care as usual (Smyke et al., 2012).”
BackgroundResultInfluentialSelf-citationIndiscriminate Behaviors in Previously Institutionalized Young Children
Gleason, M. M., Fox, N. A., Drury, S. S., Smyke, A. T., Nelson, C. A., & Zeanah, C. H. (2014) · PEDIATRICS · doi:10.1542/peds.2013-0212 · Cited by 77
Self-citationSocial communication difficulties and autism in previously institutionalized children
Levin, A. R., Fox, N. A., Zeanah, C. H., & Nelson, C. A. (2015) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2014.11.011 · Cited by 68
Self-citationLeloux-Opmeer, H., Kuiper, C. H. Z., Swaab, H., & SCHOLTE, E. M. (2017) · Children and Youth Services Review · doi:10.1016/j.childyouth.2017.03.018 · Cited by 67
Orphanage caregivers' perceptions of children's emotional needs
Bettmann, J. E., Mortensen, J. M., & Akuoko, K. O. (2015) · Children and Youth Services Review · doi:10.1016/j.childyouth.2015.01.003 · Cited by 70
“These deficits are likely associated with children's emotional adjustment and attachment relationships, which depend considerably on the quality of their early attachment relationships (McLaughlin, Zeanah, Fox, & Nelson, 2012; Muhamedrahimov, Palmov, Nikiforova, Groark, & McCall, 2004; Smyke et al., 2014).”
BackgroundTakiguchi, S., Fujisawa, T. X., Mizushima, S., Saito, D. N., Okamoto, Y., Shimada, K., Koizumi, M., Kumazaki, H., Jung, M., Kosaka, H., et al. (2015) · BJPsych Open · doi:10.1192/bjpo.bp.115.001586 · Cited by 63
RetractedAttachment and Trauma in Early Childhood: A Review
Breidenstine, A. S., Bailey, L. O., Zeanah, C. H., & Larrieu, J. A. (2011) · Journal of Child & Adolescent Trauma · doi:10.1080/19361521.2011.609155 · Cited by 73
Self-citationPsychological Consequences of Early Global Deprivation
Kumsta, R., Kreppner, J., Kennedy, M., Knights, N., Rutter, M. L., & Sonuga-Barke, E. J. S. (2015) · European Psychologist · doi:10.1027/1016-9040/a000227 · Cited by 66
“, 2007; van Ijzendoorn, Juffer, & Poelhuis, 2005; van Ijzendoorn, Luijk, & Juffer, 2008; Zeanah & Smyke, 2008; Zeanah, Smyke, Koga, & Carlson, 2005), Specifically, considerable agreement exists across studies that a pattern of disinhibited social engagement constitutes a sequela of prolonged institutional rearing and…”
BackgroundMotor outcomes in children exposed to early psychosocial deprivation
Levin, A. R., Zeanah, C. H., Fox, N. A., & Nelson, C. A. (2014) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2013.09.026 · Cited by 55
Self-citationDisturbances in attachment: inhibited and disinhibited symptoms in foster children
Jonkman, C., Oosterman, M., Schuengel, C., Bolle, E. A., Boer, F., & Lindauer, R. (2014) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/1753-2000-8-21 · Cited by 49
“This assumption is supported by previous findings of others that reported decreasing inhibited symptoms in improved caregiving environments [25].”
BackgroundResultReactive Attachment Disorder in the General Population: A Hidden ESSENCE Disorder
Pritchett, R., Pritchett, J., Marshall, E., Davidson, C., & Minnis, H. (2013) · The Scientific World JOURNAL · doi:10.1155/2013/818157 · Cited by 55
“They have found high levels of Reactive Attachment Disorder symptoms in the sample and associations between RAD and lower cognitive ability [7].”
BackgroundKay, C., & Green, J. (2015) · Development and Psychopathology · doi:10.1017/s0954579415000292 · Cited by 52
“…brings to the fore the need for a more detailed understanding of the pervasive social impairments underlying symptoms of DAD, which is important not only forconceptualization of the disorder but also for the development of new approaches to assessment and intervention (Smyke et al., 2012).”
Background(2013) · PubMed · Cited by 43
Shimada, K., Takiguchi, S., Mizushima, S. G., Fujisawa, T. X., Saito, D. N., Kosaka, H., Okazawa, H., & Tomoda, A. (2015) · NeuroImage Clinical · doi:10.1016/j.nicl.2015.07.001 · Cited by 44
Differential Plasticity in the Recovery of Adopted Children After Early Adversity
Palacios, J., Román, M., Moreno, C., Manso, E. L., & Peñarrubia, M. (2014) · Child Development Perspectives · doi:10.1111/cdep.12083 · Cited by 62
“quicker and more effective changes in the inhibited than in the disinhibited type of disturbance (Smyke et al., 2012).”
BackgroundHornor, G. (2019) · Journal of Pediatric Health Care · doi:10.1016/j.pedhc.2019.04.017 · Cited by 59
“DSED is predictive of functional impairment, difficulties forming close relationships, and more need for special education services due to the social, cognitive, and behavioral abnormalities of the disorder (Smyke et al., 2012).”
BackgroundInfluentialReactive Attachment Disorder in maltreated young children in foster care
Bruce, M., Young, D., Turnbull, S. D., Rooksby, M., Chadwick, G., Oates, C., Nelson, R., Young‐Southward, G., Haig, C. E., & Minnis, H. (2018) · Attachment & Human Development · doi:10.1080/14616734.2018.1499211 · Cited by 39
“Smyke et al. (2012) found similar findings in an institutionalised population and it is interesting to see that this appears also to be the case in this family-reared population.”
BackgroundResultDisorders of attachment and social engagement related to deprivation
Zeanah, C. H., & Smyke, A. T. (2015) · Rutter's Child and Adolescent Psychiatry · doi:10.1002/9781118381953.ch58 · Cited by 39
Self-citationMcLuckie, A., Landers, A. L., Curran, J., Cann, R., Carrese, D. H., Nolan, A., Corrigan, K., & CARREY, N. J. (2019) · Systematic Reviews · doi:10.1186/s13643-019-1043-3 · Cited by 45
Guyon‐Harris, K. L., Humphreys, K. L., Degnan, K. A., Fox, N. A., Nelson, C. A., & Zeanah, C. H. (2018) · Attachment & Human Development · doi:10.1080/14616734.2018.1499208 · Cited by 38
“Further, we have shown that removal from institutions and placement in foster care leads to reductions in signs of RAD at various points in early and middle childhood (Smyke et al., 2012) and in early adolescence (Humphreys et al.”
InfluentialSelf-citationCourse of Disinhibited Social Engagement Disorder From Early Childhood to Early Adolescence
Guyon-Harris, K. L., Humphreys, K. L., Fox, N. A., Nelson, C. A., & Zeanah, C. H. (2018) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2018.02.009 · Cited by 37
Self-citationLehmann, S., Monette, S., EGGER, H. L., Breivik, K., Young, D., Davidson, C., & Minnis, H. (2018) · Assessment · doi:10.1177/1073191118797422 · Cited by 45
“The Bucharest Early Intervention Project continued to use the semistructured Disturbances of Attachment Interview (Smyke et al., 2002) to assess 8-year-old children (Smyke et al., 2012) and at follow-up when they were 12 years old.”
BackgroundMethodLawler, J. M., Hostinar, C. E., Mliner, S. B., & Gunnar, M. R. (2014) · Development and Psychopathology · doi:10.1017/s0954579414000054 · Cited by 38
“A recent study by Smyke et al. (2012) found that this behavior was associated with cognitive ability, with children with lower developmental quotients demonstrating more DSE behaviors.”
BackgroundKennedy, M., Kreppner, J., Knights, N., Kumsta, R., Maughan, B., Golm, D., Hill, J., Rutter, M. L., Schlotz, W., & Sonuga-Barke, E. J. S. (2017) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.117.200618 · Cited by 36
Allen, B. (2016) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2016.1172945 · Cited by 31
Sim, F., Li, D., & Chu, C. M. (2015) · Children and Youth Services Review · doi:10.1016/j.childyouth.2015.11.012 · Cited by 33
A Bibliography of Randomized Controlled Experiments in Social Work (1949–2013)
Thyer, B. A. (2015) · Research on Social Work Practice · doi:10.1177/1049731515599174 · Cited by 31
King, L. S., Guyon-Harris, K. L., Valadez, E. A., Radulescu, A., Fox, N. A., Nelson, C. A., Zeanah, C. H., & Humphreys, K. L. (2023) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20220672 · Cited by 29
Self-citationWade, M., Parsons, J., Humphreys, K. L., McLaughlin, K. A., Sheridan, M. A., Zeanah, C. H., Nelson, C. A., & Fox, N. A. (2022) · Child Development Perspectives · doi:10.1111/cdep.12462 · Cited by 42
“…risk and recovery from early deprivation in relation to common mental health problems (i.e., anxiety, depression, ADHD) during adolescence (for a discussion of attachment-specific problems, see Guyon-Harris et al., 2018, 2019; Humphreys et al., 2017; Rutter et al., 2007; Smyke et al., 2012).”
BackgroundSelf-citationTrauma- and Stressor-Related Disorders
(2022) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9780890425787.x07_trauma_and_stressor_related_disorders · Cited by 37
Children in care or in need: educational progress at home and in care
Sinclair, I., Luke, N., & Berridge, D. (2019) · Oxford Review of Education · doi:10.1080/03054985.2019.1600488 · Cited by 28
“…of Romanian orphans CONTACT Ian Sinclair ian.sinclair@york.ac.uk © 2019 Informa UK Limited, trading as Taylor & Francis Group (Rutter et al., 2007; Smyke et al., 2012) have suggested that cognitive deficits acquired during early extreme deprivation can be ameliorated if children are moved into…”
BackgroundAttachment disorders diagnosed by community practitioners: a replication and extension
Allen, B., & Schuengel, C. (2019) · Child and Adolescent Mental Health · doi:10.1111/camh.12338 · Cited by 30
“In-clinic diagnosis did not identify any case with RAD, which is consistent with the notion that RAD symptoms usually recede once children are placed in a caregiving environment of any reasonable quality and no longer exposed to extremes of inadequate care (Jonkman et al., 2014; Smyke et al., 2012).”
BackgroundInfluentialThe course of early disinhibited social engagement among post‐institutionalized adopted children
Lawler, J. M., Koss, K. J., Doyle, C., & Gunnar, M. R. (2016) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12606 · Cited by 26
“RAD is tied closely to attachment and dissipates when children exit conditions of social deprivation (Smyke et al., 2012).”
BackgroundZimmermann, P., & Iwanski, A. (2018) · Attachment & Human Development · doi:10.1080/14616734.2018.1499212 · Cited by 28
“…to this research, main signs of RAD in older children still are the poor discrimination of attachment figures, problems with social regulation of negative emotions (i.e. not seeking or accepting of comfort), poor social reciprocity, and problems with emotion regulation (Smyke et al., 2012).”
BackgroundResultInfluentialSeim, A. R., Jozefiak, T., Wichstrøm, L., Lydersen, S., & Kayed, N. S. (2021) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2021.105141 · Cited by 25
Attachment disorder and attachment theory – Two sides of one medal or two different coins?
Schröder, M., Lüdtke, J., Fux, E., İzat, Y., Bolten, M. I., Gloger-Tippelt, G., Suess, G. J., & Schmid, M. (2019) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2019.152139 · Cited by 19
Raaska, H. K., Elovainio, M. J., Sinkkonen, J., Stolt, S., Jalonen, I., Matomäki, J., Mäkipää, S., & Lapinleimu, H. (2013) · Journal of Applied Developmental Psychology · doi:10.1016/j.appdev.2012.12.003 · Cited by 20
“…Bucharest Early Intervention Study among children from Romania indicated that signs of inhibited RAD diminished markedly during an average of eight months in foster care with special support, whereas the reduction in signs of indiscriminate behaviour was less straightforward (Smyke et al., 2012).”
BackgroundResultInfluentialChanges in Attachment Disorder symptoms in children internationally adopted and in residential care
Román, M., Palacios, J., & Minnis, H. (2021) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2021.105308 · Cited by 19
Corval, R., Belsky, J., Baptista, J., Oliveira, P., Mesquita, A. R., & Soares, I. (2017) · Attachment & Human Development · doi:10.1080/14616734.2017.1342172 · Cited by 23
“1, similar to scores found in previous studies (Smyke et al., 2012; Zeanah et al., 2005).”
ResultMayes, S. D., Calhoun, S. L., Waschbusch, D. A., Breaux, R., & Baweja, R. K. (2017) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2017.02.012 · Cited by 19
Psychiatric Assessment of Social Impairment Across the Lifespan
Thom, R. P., Keary, C. J., Kramer, G., Nowinski, L. A., & McDougle, C. J. (2020) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000257 · Cited by 22
Giltaij, H. P., Sterkenburg, P. S., & Schuengel, C. (2017) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104517709049 · Cited by 18
“…results for interventions that focus on secure attachment in high-risk families (Bernard et al., 2012; Moss et al., 2011), with the exception of placement from institutional care to foster care (Smyke et al., 2012), little is known about the potential of treatment to reduce disordered attachment.”
BackgroundTurner, F., Venturini, E., Kainth, G., Crawford, K., O’Connor, R. C., Balestrieri, M., Macdonald, S., & Minnis, H. (2022) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2022.105585 · Cited by 18
“…the Bucharest Early Intervention Project, which was the first ever Randomised Controlled Trial of foster care as an alternative to institutional care, showed improvements in AD symptoms in foster care (Smyke et al., 2012) that were sustained through until adolescence (Guyon-Harris et al., 2019).”
BackgroundResultAdverse caregiving in early life: The trauma and deprivation distinction in young children
Guyon‐Harris, K. L., Humphreys, K. L., & Zeanah, C. H. (2020) · Infant Mental Health Journal · doi:10.1002/imhj.21892 · Cited by 19
“…to foster care had significantly fewer signs of RAD than those who experienced more prolonged institutional exposure at every assessment during the trial, and these differences persisted into adolescence (Guyon-Harris et al., 2019; Humphreys, Nelson, Fox, & Zeanah, 2017; Smyke et al., 2012).”
BackgroundSelf-citationThe biological bases of attachment
Oliveira, P., & Fearon, P. R. M. (2019) · Adoption & Fostering · doi:10.1177/0308575919867770 · Cited by 18
Schröder, M., Pérez, T., Buderer, C., & Schmid, M. (2017) · Kindheit und Entwicklung · doi:10.1026/0942-5403/a000223 · Cited by 18
Jung, M., Takiguchi, S., Hamamura, S., Mizuno, Y., Kosaka, H., & Tomoda, A. (2020) · Cerebral Cortex · doi:10.1093/cercor/bhaa051 · Cited by 15
The feasibility of a randomised controlled trial of Dyadic Developmental Psychotherapy
Turner‐Halliday, F., Watson, N., Boyer, N. R., Boyd, K., & Minnis, H. (2014) · BMC Psychiatry · doi:10.1186/s12888-014-0347-z · Cited by 18
“Background Children who have experienced maltreatment through abuse and neglect in early life are at greatly increased risk of significant mental health problems [1,2] which are complex, difficult to classify and can include Reactive Attachment Disorder (RAD), conduct problems and Attention-Deficit Hyperactivity Disor…”
BackgroundInfluentialSória, I. N., Servera, M., & Burns, G. L. (2019) · Journal of Child and Family Studies · doi:10.1007/s10826-019-01596-1 · Cited by 18
“…2012; Fries et al. 2008, Gunnar and Van Dülmen 2007; Kjelsberg and Nygren 2004; Li et al. 2017; Martín et al. 2008; Shechory and Sommerfeld 2007; Smyke et al. 2012), our findings are more unique in the outcome that children with longer stays in foster care did not differ from the nonfoster care…”
BackgroundResultDevelopment and validation of an observational measure of symptoms of Reactive Attachment Disorder
Corval, R., Belsky, J., Baptista, J., Mesquita, A. R., & Soares, I. (2018) · Attachment & Human Development · doi:10.1080/14616734.2018.1499209 · Cited by 16
“…a role in the prevention of RAD (Smyke, Dumitrescu, & Zeanah, 2002; Zeanah et al., 2005) and the remission of the disorder (Chisholm, Carter, Ames, & Morison, 1995; O´Connor, Bredenkamp, Rutter, & the ERA Study Team, O’Connor, Bredenkamp, & Rutter, 1999; Smyke et al., 2012; Tizard & Rees, 1975).”
BackgroundVervoort, E., Bosmans, G., Doumen, S., Minnis, H., & Verschueren, K. (2014) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2014.07.004 · Cited by 14
“For instance, studies found that, in contrast with inhibited behaviors, indiscriminately friendly behaviors persisted in children of 6 years and older, even when the caregiving environment improved after adoption or foster care (e.g., Smyke et al., 2012).”
BackgroundResultMosier, W. A. (2013) · Springer eBooks · doi:10.1007/978-94-007-6671-6_6 · Cited by 17
Humphreys, K. L., Fox, N. A., Nelson, C. A., & Zeanah, C. H. (2017) · Springer eBooks · doi:10.1007/978-3-319-57990-0_6 · Cited by 16
Self-citationAger, A., Zimmerman, C., Unlu, K., Rinehart, R., Nyberg, B. J., Zeanah, C. H., Hunleth, J. M., Bastiaens, I., Weldy, A., Bachman, G. L., et al. (2012) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2012.09.006 · Cited by 17
Self-citationJonkman, C., Bolle, E. A., Lindeboom, R., Schuengel, C., Oosterman, M., Boer, F., & Lindauer, R. (2012) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/1753-2000-6-38 · Cited by 14
“compared to children in foster care institutionalized children show more cognitive delays (Nelson, Zeanah, Fox, Marshall, Smyke & Guthrie [9]), attachment disturbances (Smyke, Zeanah, Gleason, Drury, Fox, Nelson, Guthrie [10]) and developmental delays (Curtis, Alexander & Lunghofer [11]).”
ResultVacaru, S. V., Sterkenburg, P. S., & Schuengel, C. (2017) · Child Care Health and Development · doi:10.1111/cch.12521 · Cited by 17
“Methods: Thirty‐three institutionalized children, aged 4–12, participated in a multimethod and multi‐informant assessment of disturbed attachment behaviours (i.e., Disturbances of Attachment Interview and Behavioral Signs of Disturbed Attachment in Young Children), self‐ concept (i.e., Pictorial Scale of Perceived Com…”
BackgroundMethodInfluentialTurner, F., Kainth, G., Macdonald, S., O’Connor, R. C., Crawford, K., & Minnis, H. (2022) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2022.105983 · Cited by 13
“Seminal studies have shown that children who were moved from large institutions into foster care very quickly started to thrive (Smyke et al., 2012) and improvements in mental health were sustained over time (Guyon-Harris et al., 2019).”
BackgroundJiménez-Etcheverría, P., & Palacios, J. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.105102 · Cited by 12
Assessment of attachment disorder symptoms in foster children: comparing diagnostic assessment tools
Kliewer-Neumann, J. D., Zimmermann, J., Bovenschen, I., Gabler, S., Lang, K., Spangler, G., & Nowacki, K. (2018) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-018-0250-3 · Cited by 12
Guyon‐Harris, K. L., Humphreys, K. L., Miron, D., Gleason, M. M., Nelson, C. A., Fox, N. A., & Zeanah, C. H. (2019) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-019-00547-0 · Cited by 16
“…suggesting that DSED, as opposed to reactive attachment disorder (RAD), can cooccur with secure caregiver–child attachment and is less responsive (again, as opposed to RAD) to placement in a loving, supportive family setting (Bakermans-Kranenburg et al. 2011; Rutter et al. 2007; Smyke et al. 2012).”
BackgroundSelf-citationScheper, F. Y., Groot, C. R. M., de Vries, A. L. C., DORELEIJERS, T. A. H., Jansen, L. M. C., & Schuengel, C. (2018) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12994 · Cited by 13
“…of this behavior (Chisholm, 1998; Gleason et al., 2011; GuyonHarris, Humphreys, Fox, Nelson, & Zeanah, 2018; Lawler, Koss, Doyle, & Gunnar, 2016; Rutter et al., 2007; Smyke et al., 2012), unless children received early and stable family placement (Guyon-Harris et al., 2018; Smyke et al., 2012).”
BackgroundInhibited symptoms of Attachment Disorder in children from institutional and foster care samples
Spangler, G., Bovenschen, I., Jorjadze, N., Zimmermann, J., Werner, A., Riedel, N., Gabler, S., Kliewer-Neumann, J. D., & Nowacki, K. (2018) · Attachment & Human Development · doi:10.1080/14616734.2018.1499210 · Cited by 14
“Longitudinal findings from the Bucharest Early Intervention Project (e.g. Smyke et al., 2012; ; Zeanah & Smyke, 2009) showed that early institutionalized children showed a decrease of inhibited symptoms to a nonclinical level after placement in foster families, in contrast to children remaining in…”
BackgroundInfluentialSchechter, D. S. (2012) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2012.12020174 · Cited by 11
Latent subtypes of youth in psychiatric residential care
Boel-Studt, S. M. (2017) · Children and Youth Services Review · doi:10.1016/j.childyouth.2017.04.005 · Cited by 10
Challenges of Assessing Maltreated Children Coming into Foster Care
Pritchett, R., Hockaday, H., Anderson, B., Davidson, C., Gillberg, C., & Minnis, H. (2016) · The Scientific World JOURNAL · doi:10.1155/2016/5986835 · Cited by 11
“[8] found higher rates of Reactive Attachment Disorder (RAD) in institutionalised children compared with those who had never been institutionalised.”
BackgroundKliewer-Neumann, J. D., Bovenschen, I., Lang, K., Spangler, G., Nowacki, K., & Roland, I. (2015) · Praxis der Kinderpsychologie und Kinderpsychiatrie · doi:10.13109/prkk.2015.64.10.759 · Cited by 10
Çavuş, F., & Çalış, N. (2021) · Toplum ve sosyal hizmet(Online)/Toplum ve sosyal hizmet · doi:10.33417/tsh.900655 · Cited by 9
Perinatal risk factors and reactive attachment disorder: A nationwide population‐based study
Upadhyaya, S., Chudal, R., Luntamo, T., Hinkka‐Yli‐Salomäki, S., Sucksdorff, M., Lehtonen, L., & Sourander, A. (2020) · Acta Paediatrica · doi:10.1111/apa.15156 · Cited by 9
Stability and change of attachment disorder symptoms and interpersonal problems in foster children
Symanzik, T., Lohaus, A., Job, A., Chodura, S., Konrad, K., Heinrichs, N., & Reindl, V. (2018) · Mental Health & Prevention · doi:10.1016/j.mhp.2018.12.001 · Cited by 9
Bosmans, G., Spilt, J. L., Vervoort, E., & Verschueren, K. (2018) · Attachment & Human Development · doi:10.1080/14616734.2018.1499213 · Cited by 7
“The DAI is a semi-structured interview that was originally developed for 1- to 5-year-old children, and later adapted for use with school-aged children (Smyke et al., 2012; Zeanah & Smyke, n. d.).”
MethodDickmann, C. R., & Allen, B. (2017) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2017.1286959 · Cited by 10
“Indeed, some evidence suggests that DSED symptoms improve when children are placed with a foster/adoptive caregiver and that improved attachment security is a mediating factor (McGoron et al., 2012; Smyke et al., 2012).”
BackgroundA Developmental Psychopathology Perspective on Foster Care Research
Fisher, P. A., Leve, L. D., Delker, B. C., Roos, L. E., & Cooper, B. (2016) · Wiley eBooks · doi:10.1002/9781119125556.devpsy312 · Cited by 10
Kliewer-Neumann, J. D., Zimmermann, J., Bovenschen, I., Gabler, S., Lang, K., Spangler, G., & Nowacki, K. (2023) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-023-00636-5 · Cited by 14
“It has been shown repeatedly that inhibited symptoms tend to decrease after moving to a stable family placement [6, 14, 30].”
BackgroundResultInfluentialJulian, M. M., McCall, R. B., Groark, C. J., Muhamedrahimov, R. J., Palmov, O. I., & Nikiforova, N. V. (2018) · Applied Developmental Science · doi:10.1080/10888691.2017.1420480 · Cited by 12
“…children generally demonstrate better developmental outcomes in family care than in institutions (Julian & McCall, 2011; Nelson et al., 2007; Smyke et al., 2012), quality of care may be a more meaningful criterion than placement type (Braitstein, 2015; Hermenau, Goessmann, Rygaard, Landolt,…”
BackgroundGorter, B. G., Helder, E. J., Oh, Y. I., & Gunnoe, M. L. (2017) · Adoption Quarterly · doi:10.1080/10926755.2017.1349699 · Cited by 8
“Persistent caregiver-reported DSB despite improved attachment relationships was also documented in a sample of previously institutionalized Romanian children placed in foster care (Smyke et al., 2012).”
BackgroundPractice and Policy Regarding Child Neglect: Lessons from Studies of Institutional Deprivation
Zeanah, C. H., & King, L. S. (2022) · Annual Review of Developmental Psychology · doi:10.1146/annurev-devpsych-121020-031658 · Cited by 8
Self-citationJorjadze, N., Bovenschen, I., & Spangler, G. (2023) · Developmental Child Welfare · doi:10.1177/25161032231193168 · Cited by 7
“Symptoms of RAD include inhibited, emotionally withdrawn behaviour and social and emotional disturbance and symptoms seem to decrease significantly when the conditions of care improve (Nelson et al., 2020; Smyke et al., 2012).”
BackgroundInfluentialBoyer, N. R., Boyd, K., Turner‐Halliday, F., Watson, N., & Minnis, H. (2014) · BMC Psychiatry · doi:10.1186/s12888-014-0346-0 · Cited by 6
“include: conduct disorder, attention deficit hyperactivity disorder and reactive attachment disorder [1-3].”
BackgroundZimmermann, J., Kliewer-Neumann, J. D., Bovenschen, I., Lang, K., Gabler, S., Nowacki, K., & Spangler, G. (2024) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.106872 · Cited by 4
Foster care in Portugal: outcomes, needs, and challenges for deinstitutionalization
Delgado, P. (2023) · Pedagogia Social Revista Interuniversitaria · doi:10.7179/psri_2023.43.07 · Cited by 5
“The debate about the solutions provided by family foster care and residential care is extensive and several studies have demonstrated more benefits in placing children in family foster care (Dregan & Gulliford, 2012; Lee et all, 2011; Smyke et al., 2012).”
BackgroundSinclair, I., Fletcher, J., O’Higgins, A., et al. (2021) · Oxford Review of Education · doi:10.1080/03054985.2021.1967118 · Cited by 5
“Evidence that the children in care might catch up comes from the progress of young children from Romanian institutions (Rutter et al., 2007; Smyke et al., 2012).”
BackgroundNelson, R., Chadwick, G., Bruce, M., Young‐Southward, G., & Minnis, H. (2020) · Developmental Child Welfare · doi:10.1177/2516103220940326 · Cited by 5
“Individual factors included male gender (Lehmann et al., 2016); reduced gray matter volume (Fujisawa et al., 2018; Shimada et al., 2015; Smyke et al., 2012); lower cognitive ability (Hong et al., 2018; Takiguchi et al., 2015); dopaminergic dysfunction (Gleason et al., 2011; Tomoda, 2016); and…”
BackgroundVitté, L.-O. A. D. T., Belloncle, V., & Gérardin, P. (2017) · Neuropsychiatrie de l Enfance et de l Adolescence · doi:10.1016/j.neurenf.2017.08.001 · Cited by 5
Early Deprivation and Developmental Psychopathology
Esposito, E. A., & Gunnar, M. R. (2014) · Springer eBooks · doi:10.1007/978-1-4614-9608-3_19 · Cited by 6
Woolgar, M., Bengo, C., & Scott, S. (2013) · Adoption Quarterly · doi:10.1080/10926755.2013.790864 · Cited by 6
“Indeed there is accumulating evidence that the inhibited type of RAD responds well to enhancements in carer sensitivity that follow from adoption and fostering (Rutter et al., 2009; Zeanah et al., 2011; Smyke et al., 2012).”
BackgroundBaptista, J., Camilo, C., Magalhães, E., Feher, A., Ramos, C., & Alves, S. (2025) · Infant Behavior and Development · doi:10.1016/j.infbeh.2025.102079 · Cited by 4
Schröder, M., Seker, S., d’Huart, D., İzat, Y., Bolten, M. I., Schmeck, K., & Schmid, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192315458 · Cited by 4
Metadata
- Authors
- Smyke, A. T., Zeanah, C. H., Gleason, M. M., Drury, S. S., Fox, N. A., Nelson, C. A., & Guthrie, D.
- Affiliations
- Tulane University (US)
- Venue
- American Journal of Psychiatry
- Published
- 2012-05
- Volume
- 169
- Issue
- 5
- Pages
- 508-514
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC4158103
- OpenAlex
- W2096000669
- Cited by
- 181
- References
- 38
- Citations by year
- 2026: 10 · 2025: 8 · 2024: 10 · 2023: 8 · 2022: 11 · 2021: 11 · 2020: 13 · 2019: 14 · 2018: 20 · 2017: 18 · 2016: 14 · 2015: 15 · 2014: 13 · 2013: 8 · 2012: 6
- FWCI
- 34.91
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH091363)
- Topics
- Social Sciences › Sociology and Political Science › Child Welfare and Adoption
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- reactive attachment disorder, foster care, institutional care, Romanian orphans
- MeSH terms
- Child, Child, Preschool, Female, Foster Home Care, Humans, Institutionalization, Interview, Psychological, Male, Neuropsychological Tests, Romania, Reactive Attachment Disorder, Early Diagnosis
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