Differential associations of threat and deprivation with emotion understanding in maltreated children in foster care

Differential Associations of Threat and Deprivation with Emotion Understanding in Maltreated Children in Foster Care Pablo Carrera *, , Jesús M. Jiménez-Morago, Román, M., & León E. Department of Developmental and Educational Psychology. Faculty of Psychology. Universidad de Sevilla. C/ Camilo José Cela, s/n, 41018 - Seville (Spain) Declaration of interest: none Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. * Corresponding author: Pablo Carrera; E-mail address: [email protected] ORCID ID: https://orcid.org/0000-0001-6580-2045 Maite Roman e-mail address: [email protected] Jesús M. Jiménez-Morago e-mail address: [email protected] Esperanza León e-mail address: [email protected] This is the peer reviewed version of the following article: Carrera, P, Jiménez-Morago, JM, Román, M, León, E. Differential associations of threat and deprivation with emotion understanding in maltreated children in foster care. Child & Family Social Work. 2020; 25: 973–982. , which has been published in final form at https://doi.org/10.1111/cfs.12783. This article may be used for noncommercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 1 Abstract Children in foster care are a remarkably heterogeneous group regarding their adaptation, and disrupted emotion understanding is one of the processes that may lead to differential outcomes in them. Previous research has found different effects for abused and for neglected children in emotion recognition. However, very few studies have analyzed more complex forms of emotion understanding in maltreated children while considering different adversity dimensions. The present study analyzed associations between threat and deprivation exposure and different facets of emotion understanding in a sample of maltreated children in foster care. The sample comprised 51 children from 4- to 9-years old (M = 7.07, SD = 1.63) in nonkin foster care in Spain. We used the Test of Emotional Comprehension to measure emotion understanding, and maltreatment reports to measure exposure to threat and deprivation. Threat exposure predicted enhanced external emotion understanding after controlling for age, vocabulary, and deprivation, particularly understanding emotions based on desires. Deprivation predicted worse external emotion understanding. Our findings reinforce the limits of cumulative risks models for understanding foster children’s developmental outcomes and the value of assessing separately adversity dimensions when possible, given the variable relations of threat and deprivation exposure with social cognitive development. Keywords: Emotion understanding; Early adversity; Dimensional model of adversity and psychopathology; Maltreatment; Foster care ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 2 Differential Associations of Threat and Deprivation with Emotion Understanding in Maltreated Children in Foster Care Children in foster care show are a remarkably heterogeneous group, in part due to their variable experiences of adversity previously to their entry into care and how key psychological mechanisms are affected by these experiences (Goemans, van Geel, & Vedder, 2018). A fruitful avenue for research is to focus on those psychological mechanisms that may partially explain poor adjustment in this population, or, conversely, may foster resilience (Rutter, 2000). One of such mechanisms is emotion understanding (EU; de Rosnay, Harris, & Pons, 2008; Denham et al., 2003). Despite its potential as an intervention target, studies on more advanced EU beyond emotion recognition and in older ages than preschool age are rare in children exposed to early adversity. Furthermore, there is evidence that different types of adversity may affect differentially EU-related dimensions (Luke & Banerjee, 2013; Pollak, Cicchetti, Hornung, & Reed, 2000). Following these lines of inquiry, the aim of our study was to analyze EU in a sample of children in foster care exposed to early adversity from 4 to 9 years-old, in particular the associations of threat and deprivation —two dimensions of adversity— with different facets of EU. Emotion Understanding EU is the area of social cognition devoted to understanding, predicting and explaining emotions in ourselves and others, in which emotions are treated as an object of knowledge (Denham, 1998; Pons, Harris, & de Rosnay, 2004). It includes several aspects that progress in childhood from less to more complexity. According to the model of Pons and colleagues (Pons et al., 2004), around five years old, children can recognize the basic emotions, understand their situational causes or understand how emotions are related to personal desires, which has been named the external component of EU. At age seven, most children ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 3 understand the mental nature of emotions, the relation of personal beliefs or memories with them, and how a person can hide his or her real emotion while displaying another one, also named the mental component of EU. From age eight or nine, they begin to grasp more complex aspects like the potential to experience ambivalent or mixed feelings, to selfregulate emotions, or the influence of morality on emotional reactions, also known as the reflective component of EU (Pons et al., 2004). The Test of Emotional Comprehension (TEC) was developed by Pons and colleagues to capture these different components of EU, and the studies carried out so far have confirmed this hierarchical and progressive nature of EU development across preschool-age and middle childhood (Pons et al., 2004; Tenenbaum, Visscher, Pons, & Harris, 2004). The development of EU is related to the quality of caregiving, including the security of attachment (Laible & Thompson, 1998) and the mental-state talking of the caregiver (Dunn, Brown, & Beardsall, 1991). Shaped by these early social influences, EU predicts later social competence with peers (Denham et al., 2003; Trentacosta & Fine, 2010). Given the relevance of early socialization for EU development, it is to be expected that neglect, abuse and other forms of inadequate caregiving impact the development of EU. Conceptualizing the Developmental Effects of Early Adversity for Foster Children Children in foster care have been typically exposed to various forms of early adversity, among them caregiver disruptions, prenatal exposure to drugs, or maltreatment (Fisher, 2015; Turney & Wildeman, 2017). Children in non-kin foster care (when the foster caregivers do not have a previous relationship with the child) seem to have experienced more cumulative adversity than children in other types of family placements as kinship care (when the foster caregivers are relatives or have a previous relationship with the child; Ehrle & Geen, 2002; Palacios & Jiménez, 2009). Consequently, this type of placement entails ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 4 challenges for foster caregivers who care for children exposed to severe adversity. Understanding the developmental consequences of early adversity, therefore, is key for developing adequate interventions and supporting foster caregivers (Fisher, 2015). One of the most dominant approaches to conceptualize the effects of early adversity on development has been the cumulative risk model, in one form or another (Felitti et al., 1998; McEwen, 2000). In this approach, different adverse childhood experiences (neglect, physical abuse, parental discord or caregiver mental health difficulties, among others) are treated as equivalent, and it is the accumulation of them which predicts maladaptive outcomes. The effects of cumulative stress are conceptualized as causing deficits and dysregulation in developmental systems (McEwen, 2000). More recently, some authors have gone further by taking a more nuanced approach, in which complex adverse childhood experiences can be divided by underlying dimensions. The Dimensional Model of Adversity and Psychopathology posits that the adversity dimensions of deprivation (lack of species-expected social and cognitive input) and threat (presence of atypical learning experiences related with traumatic violence) can be measured separately and have distinct consequences on emotion, cognitive, and neurobiological systems (Lambert et al., 2017; Machlin et al., 2019; McLaughlin & Sheridan, 2016; Milojevich et al., 2019). Deprivation results in reduced abilities for complex cognitive functions due to the lack of adequate scaffolding and interactions with caregivers, whereas threat involves changes in neural circuits related with fear learning, emotion regulation and reactivity to negative affective stimuli (Lambert et al., 2017; Machlin et al., 2019; Milojevich et al., 2019). Another recent advancement regarding the conceptualization of the developmental effects of early adversity is to consider early stressful rearing conditions as causing not merely cognitive deficits and dysregulation, but also as regulating and shaping developmental systems toward patterns of functioning that are adaptive in stressful environments —even though they may ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 5 come with long-term costs such as anxiety or aggression due to social information processing and attention biases (Ellis, Bianchi, Griskevicius, & Frankenhuis, 2017). Early Adversity and Emotion Understanding These two critiques of the cumulative risk model have been empirically illustrated by the research of Pollak and colleagues on the effect of maltreatment on emotion recognition. They found that physically abused children (but not neglected ones) showed an attentional bias toward detecting anger in facial expressions of emotion, which could be adaptive if growing up in a physically abusive environment, whereas neglected children showed a general deficit in emotion recognition (Pollak et al., 2000). The finding of enhanced detection of some emotions in children exposed to physical abuse and violence have been replicated in several other studies (Ardizzi et al., 2015; da Silva Ferreira, Crippa, & de Lima Osório, 2014), although some early studies did also find a general deficit in emotion recognition among abused children (Camras et al., 1988; During & McMahon, 1991). However, studies in which both neglect (as a form of deprivation exposure) and abuse (as a form of threat exposure) have been tested separately are rare. Furthermore, it was found in a large population-based study that adversity exposure did not predict emotion recognition deficits, although the measurement of adversity based on parent reports was a limitation in this study (Dunn et al., 2018). The line of research of emotion recognition by facial emotion processing is framed within an affective neuroscience tradition. Albeit not unrelated, more advanced forms of EU are typically tested through vignettes and hypothetical situations related to emotions (Pons et al., 2004). Using this kind of tasks, previous studies have found that preschool-aged, postinstitutionalized children showed deficits in EU, predominantly in aspects like understanding the external causes of emotion, emotion recognition, or affective perspective-taking (Barone ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 6 & Lionetti, 2012; Fries & Pollak, 2004; Tarullo et al., 2015). Research with children who suffered family neglect instead of institutionalization has also shown poorer external EU in neglected children than in community controls (Edwards, Shipman, & Brown, 2005), even after controlling for language skills (Sullivan, Bennett, Carpenter, & Lewis, 2008). Children exposed to multiple types of maltreatment beyond neglect —including physical maltreatment— have also been found to show poor EU (Luke & Banerjee, 2013; Pears & Fisher, 2005a; Shipman & Zeman, 1999; Smith & Walden, 2001). A recent study analyzed the associations between threat and deprivation adversity and social-cognitive dimensions (both theory of mind and EU) among children aged 8-16. Violence exposure predicted poorer EU, which was unrelated to poverty and emotional neglect as a form of deprivation (Heleniak & McLaughlin, 2019). These researchers remarked that future research in this area should focus on how specific aspects of adversity disrupt specific aspects of social cognition. Despite the advancements presented by the reviewed studies, there are still relevant issues that remain unanswered in this area. The studies on the EU development of children exposed to early adversity beyond preschool age are very limited, and few of them address more advanced forms of EU than the most basic, external aspects of EU. The absence of studies analyzing more advanced forms of EU in children exposed to early adversity raises other related questions, particularly if threat and deprivation exposure show distinct associations with different facets of EU beyond emotion recognition, as Heleniak and McLaughlin pointed out (2019). A study tackling these issues could be informative for several reasons: it would provide information on the possible socio-cognitive deficits of maltreated children in foster care beyond preschool age, which could inform interventions preventing social behavior difficulties. In fact, a qualitative study found that foster caregivers viewed socio-cognitive difficulties as a relevant mechanism for explaining foster children’s peer relationship ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 7 problems (Luke & Banerjee, 2012). The analysis of the distinct associations of the dimensions of threat and deprivation with different facets of EU could shed further light on the variable relations between different adversity dimensions and social-cognitive development. Aims Our aim in this study was to extend previous work on the EU of children in foster care exposed to maltreatment following these lines of inquiry. To this end, we analyzed EU in a sample of 4- to 9-years-old children in non-kin foster care. We also tested the associations of threat and deprivation with EU and its different facets, after controlling for language skills. We expected that deprivation would predict poorer EU, even after controlling for language. Regarding the effect of threat, the previous literature was not very consistent, so we did not have a specific prediction. Method Design The current study presents results from a broader project focused on foster children’s socio-emotional and cognitive development and family processes within non-kin foster families (placements in which the foster caregivers are not direct relatives of the foster children) in Andalusia (South of Spain). The eligibility criteria for recruitment was foster children aged between 4 and 9 years old, non-kin foster families, absence of a severe disability in the foster child, and at least five months having elapsed since the beginning of the current placement. Ethical Statement ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 8 The research project was reviewed and approved by an independent ethical board, the regional government’s Ethics in Biomedical Research Committee (guided by the Helsinki Declaration). Further approval was obtained from child protective services and local foster care agencies. Informed consent forms were signed by the main foster caregivers and verbal assent for participation in the study was obtained from the children (when applicable). Participants The final sample comprised 51 foster children between 4 and 9 years old (M = 7.07, SD = 1.63); 27 of them were girls (52.9%). Their age of entry into care ranged between 0 and 7 years and 9 months (M = 3.67 years, SD = 2.00), and they had been between 5 months and 8 years in their current foster placement at assessment (M = 2.24 years, SD = 2.06). Out of 65 potential participants meeting the study inclusion criteria, six were not able to participate because the foster care caseworkers declined participation due to other assessments or transitions going on. Another seven children did not participate because their foster caregivers refused to participate due to lack of time or stressful circumstances. Attrition analyses did not reveal any differences in available parameters (age of entry into care, age, and gender) between participating and non-participating children (n = 13). One foster child was excluded after participation due to not complying with the study inclusion criteria after examination of records. The foster children had antecedents of maltreatment and other kinds of early adversity, and came from birth families with multiple risk factors, as is usual in this population. Procedure The foster families received a two-hour home visit by two trained psychologists. While the main foster caregiver answered a semi-structured interview and a battery of questionnaires with one researcher, the child completed different socio-emotional and ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 15 The descriptive analyses showed that the foster children did not show differences at a group level with children from the measure’s standardization sample with a comparable mean age, nor did they show deficits in vocabulary skills. The lack of an appropriate control group, however, limits this comparison. Some studies with other early-adversity exposed children have shown that emotion recognition was not seriously delayed in the children, and it has been argued that the school context and the peer relations may partially compensate for poor caregiving in this domain (Moulson et al., 2015). Negative findings on the relation between adverse experiences and emotion recognition have also been reported in the large study by Dunn and colleagues (2018). Although they apparently did not show deficits in EU at a group level, our main interest was to determine within-group variability in EU outcomes, specifically how threat and deprivation adversity were related to various aspects of EU. Deprivation in the form of neglect was a significant predictor of worse external EU, which is composed by the components of accurately recognizing emotions, identifying situational causes of emotion (e.g., a person will feel happy if she receives a gift) and understanding that emotional reactions are related to personal desires (e.g., if a person likes lettuce, he will be happy if he has lettuce for lunch; Denham, 1998; Pons et al., 2004). It was noteworthy that this effect stood after controlling for the children’s language development, known to be delayed in neglected children (Pears & Fisher, 2005b). Neglecting caregivers have been found to provide less support to their children’s emotional displays, engage in less emotional discussion and report more negative emotion, undermining the children’s opportunities for learning about emotions and, consequently, their EU development (Edwards et al., 2005), as other previous studies have also found (Fries & Pollak, 2004; Sullivan et al., 2008). It is not clear why deprivation was related with external EU but not with mental and reflective EU, ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 16 although it may be related to the higher importance of language in more advanced forms of social cognition (Harris et al., 2013). The most intriguing finding was that, in contrast to what was found with deprivation, threat predicted better external EU. A speculative plausible explanation may be related to an adaptation to an abusive family context, following Pollak and colleagues’ finding of enhanced detection of anger in children exposed to physical maltreatment, but not in neglected ones (Pollak et al., 2000). The threat score comprised indicators of physical and emotional/verbal abuse such as bruises, using extreme punishments, threatening the child, chronic domestic violence, or putting the child in dangerous situations to create fear in him or her. Considering that the effect found was mainly based on the component of understanding the relations between a person’s desires and his or her emotional reaction, such hostile parenting behaviors may have enhanced the children’s cognitive appraisal of the emotional reactions of a person based on his or her desires. Although this explanation seems theoretically plausible, replication with larger samples and more complex study designs would be necessary to confirm this finding. Information on the valence of the emotions attributed by the children may add useful information for testing the proposed hypothesis. Limitations and Future Directions Certainly, the design of our study does not allow us to determine the direction of effects of our findings. It is possible that those children with poorer EU may elicit more deprivation in their caregivers; however, the extensive evidence on the role of parental socialization practices as predictors of EU and social cognition suggests a parent-to-child- effect as the preferred interpretation (Edwards et al., 2005; Luke & Banerjee, 2013). The small sample size is a general limitation of this study, especially when considering effect sizes of small magnitude. Another major limitation was that the lack of a control group ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 17 limited the comparison of the foster children’s level of EU with that of typically developing children. We measured maltreatment from child protection services administrative records, which is a well-established way of measuring maltreatment in research (Barnett, Manly, & Cicchetti, 1993). The availability of such a detailed third-party information, which is not retrospective but completed at the child’s entry in the child protection system, have allowed us to construct continuous scores of threat and deprivation exposure with the potential to capture differences along severity of exposure. Nevertheless, the information substantiated in child protection records may be that one most easily proved by social workers, rather than a full account of the children’s lived experience. For example, previous research has shown that substantiated and unsubstantiated cases for maltreatment in child protection services do not differentiate with regard to later health outcomes or risk for later reports of maltreatment (Kohl, Johnson-Reid, & Drake, 2009; Kugler et al., 2019). Therefore, some information relevant for understanding the children’s maltreatment experiences may have been missing. Other studies assessing older children have relied on interview or self-report measures such as the Violence Exposure Scale for Children or the Childhood Trauma Questionnaire (Heleniak & McLaughlin, 2019). It is possible that different methodologies in the measurement of maltreatment exposure are related with the variable findings regarding adversity exposure and social cognition in different studies. In future studies, it would be important to incorporate a control group, either a lowrisk, community sample or other group of children exposed to early adversity. Although our study included a broader age range than most previous studies focused on preschool-aged children, studies in later developmental stages would be interesting to follow on the consequences of early adversity on social cognition. An interesting venue for research is to study in more detail the hypothesis of how certain aspects of EU in children exposed to threat ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 18 may be related to the pattern of hypervigilance and bias to anger cues believed to be adaptations to a maltreating environment (McCrory, Gerin, & Viding, 2017). Conclusions and Implications for Practice In sum, although the foster children did not show apparent deficits at a group level in EU, our within-group analyses provided further evidence that early adversity experiences characterized by significant threat and those characterized by deprivation show different associations with EU skills. Our main findings have some relevance both for theory and for practice. Regarding theory, they highlight the limits of cumulative risk models in research with children exposed to early adversity. The opposite relation of the adversity dimensions of threat and deprivation with some aspects of EU reinforce the value of differentiating between different types of adverse experiences when possible, also in research on psychological mechanisms (Lambert et al., 2017; Milojevich et al., 2019). Although the variable effects of adversity dimensions on social cognition seem established, the specific role of adversity dimensions seems rather inconsistent. Future research could expand these research findings assessing the differential effects of threat and deprivation exposure on social cognition in larger samples of children in foster care or in other populations of children exposed to early adversity. Regarding practice implications, even though the co-morbidity between different kinds of adverse experience is the norm, our findings reinforce the idea that a one-size-fits-all approach for intervention with foster children exposed to early adversity is not adequate. Given the efficacy of different interventions in improving socio-cognitive skills (Sprung, Münch, Harris, Ebesutani, & Hofmann, 2015), preventive interventions informed by the children’s past experiences could be a meaningful way to help foster children exposed to early adversity develop the necessary skills to navigate social contexts. ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 19 References Ardizzi, M., Martini, F., Umiltà, M. A., Evangelista, V., Ravera, R., & Gallese, V. (2015). Impact of childhood maltreatment on the recognition of facial expressions of emotions. PLoS ONE, 10, 1–18. https://doi.org/10.1371/journal.pone.0141732 Barnett, D., Manly, J. T., & Cicchetti, D. (1993). Defining child maltreatment: The interface between policy and research. In D. Cicchetti & S. L. Toth (Eds.), Advances in applied developmental psychology: Child abuse, child development and social policy (pp. 7– 73). Norwood, NJ: Ablex. Barone, L., & Lionetti, F. (2012). Attachment and emotional understanding: A study on lateadopted pre-schoolers and their parents. Child: Care, Health and Development, 38, 690–696. https://doi.org/10.1111/j.1365-2214.2011.01296.x Camras, L. A., Ribordy, S., Hill, J., Martino, S., & et al. (1988). Recognition and posing of emotional expressions by abused children and their mothers. Developmental Psychology, 24, 776–781. https://doi.org/10.1037/0012-1649.24.6.776 Denham, S. A. (1998). Emotional development in young children. New York: Guildford Press. Dunn, E. C., Crawford, K. M., Soare, T. W., Button, K. S., Raffeld, M. R., Smith, A. D. A. C., … Munafò, M. R. (2018). Exposure to childhood adversity and deficits in emotion recognition: Results from a large, population-based sample. Journal of Child Psychology and Psychiatry and Allied Disciplines, 59, 845–854. https://doi.org/10.1111/jcpp.12881 ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 20 Dunn, J., Brown, J., & Beardsall, L. (1991). Family talk about feelings states and children's later understanding of others' emotions. Developmental Psychology, 27, 448–455. https://doi.org/10.1037/0012-1649.27.3.448 During, S. M., & McMahon, R. J. (1991). Recognition of emotional facial expressions by abusive mothers and their children. Journal of Clinical Child Psychology, 20(2), 132– 139. https://doi.org/10.1207/s15374424jccp2002_4 Edwards, A., Shipman, K., & Brown, A. (2005). The socialization of emotional understanding: A comparison of neglectful and nonneglectful mothers and their children. Child Maltreatment, 10, 293–304. https://doi.org/10.1177/1077559505278452 Ehrle, J., & Geen, R. (2002). Kin and non-kin foster care—Findings from a national survey. Children and Youth Services Review, 24, 15–35. https://doi.org/10.1016/S0190- 7409(01)00166-9 Ellis, B. J., Bianchi, J. M., Griskevicius, V., & Frankenhuis, W. E. (2017). Beyond risk and protective factors: An adaptation-based approach to resilience. Perspectives on Psychological Science, 12, 561–587. https://doi.org/10.1177/1745691617693054 Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14, 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8 Fidalgo, A. M., Tenenbaum, H. R., & Aznar, A. (2018). Are there gender differences in emotion comprehension? Analysis of the test of emotion comprehension. Journal of Child and Family Studies, 27, 1065–1074. https://doi.org/10.1007/s10826-017-0956-5 ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 21 Fisher, P. A. (2015). Review: Adoption, fostering, and the needs of looked-after and adopted children. Child and Adolescent Mental Health, 20(1), 5–12. https://doi.org/10.1111/camh.12084 Fries, A. B. W., & Pollak, S. D. (2004). Emotion understanding in postinstitutionalized Eastern European children. Development and Psychopathology, 16, 355–369. https://doi.org/10.1017/S0954579404044554 Goemans, A., van Geel, M., & Vedder, P. (2018). Variability in developmental outcomes of foster children: Implications for research and practice. Children Australia, 43, 116– 123. https://doi.org/10.1017/cha.2018.19 Harris, P. L., De Rosnay, M., & Pons, F. (2013). Language and children's understanding of mental states. Current Directions in Psychological Science, 14, 69–73. https://doi.org/10.1111/j.0963-7214.2005.00337.x Heleniak, C., & McLaughlin, K. A. (2019). Social-cognitive mechanisms in the cycle of violence: Cognitive and affective theory of mind, and externalizing psychopathology in children and adolescents. Development and Psychopathology, 32, 1–16. https://doi.org/10.1017/s0954579419000725 Kaufman, A. S., & Kaufman, N. L. (1990). The Kaufman brief intelligence test. Circle Pines, MN: American Guidance Service. Kohl, P. L., Jonson-Reid, M., & Drake, B. (2009). Time to leave substantiation behind. Child Maltreatment, 14, 17–26. https://doi.org/10.1177/1077559508326030 Kugler, K. C., Guastaferro, K., Shenk, C. E., Beal, S. J., Zadzora, K. M., & Noll, J. G. (2019). The effect of substantiated and unsubstantiated investigations of child ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 22 maltreatment and subsequent adolescent health. Child Abuse and Neglect, 87, 112– 119. https://doi.org/10.1016/j.chiabu.2018.06.005 Laible, D. J., & Thompson, R. A. (1998). Attachment and emotional understanding in preschool children. Developmental Psychology, 34, 1038–1045. https://doi.org/10.1037/0012-1649.34.5.1038 Lambert, H. K., King, K. M., Monahan, K. C., & McLaughlin, K. A. (2017). Differential associations of threat and deprivation with emotion regulation and cognitive control in adolescence. Development and Psychopathology, 29, 929–940. https://doi.org/10.1017/S0954579416000584 Lenhard, W. & Lenhard, A. (2014). Hypothesis tests for comparing correlations. Available: https://www.psychometrica.de/correlation.html. Bibergau (Germany): Psychometrica. https://doi.org/10.13140/RG.2.1.2954.1367 Luke, N., & Banerjee, R. (2012). Maltreated children's social understanding and empathy: a preliminary exploration of foster carers' perspectives. Journal of Child and Family Studies, 21, 237–246. https://doi.org/10.1007/s10826-011-9468-x Luke, N., & Banerjee, R. (2013). Differentiated associations between childhood maltreatment experiences and social understanding: A meta-analysis and systematic review. Developmental Review, 33, 1–28. https://doi.org/10.1016/j.dr.2012.10.001 McCrory, E. J., Gerin, M. I., & Viding, E. (2017). Annual research review: Childhood maltreatment, latent vulnerability and the shift to preventative psychiatry—The contribution of functional brain imaging. Journal of Child Psychology and Psychiatry and Allied Disciplines, 58, 338–357. https://doi.org/10.1111/jcpp.12713 ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 23 McEwen, B. S. (2000). Allostasis and allostatic load: Implications for neuropsychopharmacology. Neuropsychopharmacology, 22, 108–124. https://doi.org/10.1016/S0893-133X(99)00129-3 McLaughlin, K. A., & Sheridan, M. A. (2016). Beyond cumulative risk: A dimensional approach to childhood adversity. Current Directions in Psychological Science, 25, 239–245. https://doi.org/10.1177/0963721416655883 Milojevich, H. M., Norwalk, K. E., & Sheridan, M. A. (2019). Deprivation and threat, emotion dysregulation, and psychopathology: Concurrent and longitudinal associations. Development and Psychopathology, 31, 1–11. https://doi.org/10.1017/S0954579419000294 Moulson, M. C., Shutts, K., Fox, N. A., Zeanah, C. H., Spelke, E. S., & Nelson, C. A. (2015). Effects of early institutionalization on the development of emotion processing: A case for relative sparing? Developmental Science, 18, 298–313. https://doi.org/10.1111/desc.12217 Observatorio de la Infancia en Andalucía. (2011). Sistema de Información sobre Maltrato Infantil de Andalucía (SIMIA): Procedimiento de Actuación [System of Information about Child Maltreatment in Andalucia (SIMIA): action procedure]. Sevilla: Consejería para la Igualdad y Bienestar, Junta de Andalucía. (Retrieved from. https://www.juntadeandalucia.es/export/drupaljda/Infancia_Familia_archivos_PROC EDIMIENTO_SIMIA.pdf Osborne, J. W., & Overbay, A. (2008). Best practices in data cleaning. How outliers and “fringeliers” can increase error rates and decrease the quality and precision of your results. In J. W. Osborne (Ed.), Best Practices in Quantitative Methods (pp. 205–213). Thousand Oaks, CA: SAGE Publications, Inc. ASSOCIATIONS OF THREAT AND DEPRIVATION WITH EU 24 Palacios, J., & Jiménez, J. M. (2009). Kinship foster care: Protection or risk? Adoption and Fostering, 33, 64–75. https://doi.org/10.1177/030857590903300307 Pears, K., & Fisher, P. A. (2005b). Developmental, cognitive, and neuropsychological functioning in preschool-aged foster children: Associations with prior maltreatment and placement history. Journal of Developmental and Behavioral Pediatrics, 26, 112– 122. https://doi.org/10.1097/00004703-200504000-00006 Pears, K. C., & Fisher, P. A. (2005a). Emotion understanding and theory of mind among maltreated children in foster care: Evidence of deficits. Development and Psychopathology, 17, 47–65. https://doi.org/10.1017/S0954579405050030 Pollak, S. D., Cicchetti, D., Hornung, K., & Reed, A. (2000). Recognizing emotion in faces: Developmental effects of child abuse and neglect. Developmental Psychology, 36, 679–688. https://doi.org/10.1037//0012-1649.36.5.679 Pons, F., Harris, P. L., & de Rosnay, M. (2004). Emotion comprehension between 3 and 11 years: Developmental periods and hierarchical organization. European Journal of Developmental Psychology, 1, 127–152. https://doi.org/10.1080/17405620344000022 Román, M., Palacios, J., Moreno, C., & León, E. (2013, July). Comprehension and recognition of emotions in internationally adopted children. In Poster session presented at the Fourth International Conference on Adoption Research (ICAR4). Bilbao: Spain. de Rosnay, M., Harris, P. L., & Pons, F. (2008). Emotion understanding and developmental psychopathology in young children. In C. Sharp, P. Fonagy, & I. M. Goodyer (Eds.), Social cognition and developmental psychopathology (pp. 343–385). New York: Oxford University Press. https://doi.org/10.1093/med/9780198569183.003.0012