Risk of Post Traumatic Stress Disorder (PTSD) in Children Living in Foster Care and Institutionalised Settings

Abstract

There is a growing body of research on children living in foster care and other institutionalised settings. Impacted by early separation, neglect and abuse, these children often show symptoms of Post Traumatic Stress Disorder (PTSD). Early institutionalisation is known to alter brain development and disrupt patterns of attachment with subsequent decreases in ego-resilience and an inability to cope with trauma. This article aims to review papers on children living in institutionalised and foster care settings and its association of being at an increased risk of developing PTSD symptoms as compared to those who are raised in a family environment. The search was conducted on published literature between the years 1980 to 2013 (present). The databases searched ranged from Science Direct, Pub Med, ERIC, and the University of Edinburgh online library. All papers reviewed reflect a significant relationship between institutionalisation, abuse and neglect. Furthermore, some papers highlight a correlation between the above variables and risk of developing symptoms of PTSD in children. Results in most studies indicated that children raised in institutions were more likely to develop mental disorders as compared to those who were raised at home. However, at the same time most studies did not touch upon the direct association of PTSD and institutionalisation. Post-Traumatic Stress Disorder (PTSD) is associated with functional abnormalities of the hypothalamic-pituitary-adrenocortical (HPA) axis which plays a role in normal stress reactions. Evidence suggests that early abusive and neglectful care may disrupt the HPA axis in children, increasing stress responses and making them more susceptible to processing situations as threatening. This review highlights the need for future research to examine relationship between institutionalisation and symptoms of PTSD in such children.