185 - Early Institutional Care is Associated with Elevated Allostatic Load in Adolescents

Poster Number: 185
Publication Number: 185.1225

Background: Allostatic Load (AL), the “wear and tear” of the body due to repeated or chronic physiological responses to stress, is a salient predictor of long-term health. There has been limited understanding of how early institutional (e.g., orphanage) care, arguably one of the most severe forms of early life stress, impacts allostatic load in adolescents.

Objective: To examine the effect of early institutional care on allostatic load (AL) in adolescents.

Design/Methods: Participants were 97 previously institutionalized youth who were adopted internationally by 2-3 years of age from orphanage-like institutions (PI; % of female= 63; age range 12.02 to 21.39 years; Age Mean = 16.31 (SD=2.4); See Table 1; See Table 2 for % of cases reported for pre-adoption neglect and abuse) and 96 youth born and raised by birth families of comparable education and incomes to the adoptive families (Non-adopted, NA; % of female = 52; age range 12.11 to 21.82 years; Age mean = 15.24 (SD =2.35)). Participants completed online questionnaires and on-site physical exams. AL was calculated using a sum score of the number of biomarkers that fell within a high-risk percentile from the measurement of hair cortisol, high-sensitivity C-reactive protein, interleukin-6, Tumor Necrosis Factor-alpha, high- and low-density lipoprotein cholesterol, triglyceride, insulin, glucose, systolic and diastolic blood pressure, waist-to-hip ratio, and body mass index.

An ANCOVA was performed with the independent variable of early institutional care (dummy coded: PI, 1; NA, 0) and the dependent variable of the AL sum score, controlling for youth’s race (White, 1; non-White, 0), age, sex (male, 1; female, 0), and current life stress (i.e., total count of stress in the past 12 months) collected via the Stress and Adversity Inventory. To further explore whether the effect of early institutional care on AL would differ by age, sex, and current life stress, I examined the interaction of early institutional care with age, sex, and current life stress, respectively, in ANCOVA.

Results: PI youth had higher AL scores than NA youth (p <.05). Males had higher AL scores than females (p <.05). Age and current life stress were positively associated with AL scores (ps <.05) (Table 3). However, none of the interaction effects was significant.

Conclusion(s): Our findings underscore the impact of early institutional care on youth’s long-term health. In practice, clinicians should pay special attention to youth (especially boys), who experienced early adverse rearing that involves neglect and abuse, to better detect early health risks.