Growth in Self-Regulation Over the Course of Adolescence Mediates the Effects of Foster Care on Psychopathology in Previously Institutionalized Children: A Randomized Clinical Trial

Abstract

Children reared in institutions experience severe psychosocial deprivation, resulting in lasting consequences for social and emotional development. This study evaluated growth trajectories of self-regulation from ages 8 to 16 among previously institutionalized children randomized to foster care (foster-care group; FCG) or to remain in institutional care (care-as-usual group; CAUG) compared with a never-institutionalized group (NIG). We then tested a developmental pathway by which growth in self-regulation reduces general psychopathology at age 16 for the FCG relative to the CAUG. The FCG experienced modest growth in self-regulation over adolescence and “caught up” to the NIG by age 16. The beneficial effect of foster care on psychopathology operated through growth in self-regulation; part of this effect was further mediated by reduced peer difficulties for the FCG. Findings reveal that the effects of foster care on self-regulation emerge over adolescence and that growth in self-regulation is a mechanism by which foster care mitigates the impact of institutionalization on psychopathology.