Adoptees' responses to separation from, and reunion with, their adoptive parent at age 4 years is associated with long-term persistence of autism symptoms following early severe institutional deprivation / Edmund J. S. SONUGA-BARKE in Development and Psychopathology, 32-2 (May 2020)  

Public ISBD [article]  inDevelopment and Psychopathology > 32-2 (May 2020) . - p.631-640 Titre : Adoptees' responses to separation from, and reunion with, their adoptive parent at age 4 years is associated with long-term persistence of autism symptoms following early severe institutional deprivation Type de document : Texte imprimé et/ou numérique Auteurs : Edmund J. S. SONUGA-BARKE, Auteur ; Mark KENNEDY, Auteur ; Dennis GOLM, Auteur ; Nicky KNIGHTS, Auteur ; Hanna KOVSHOFF, Auteur ; Jana KREPPNER, Auteur ; Robert KUMSTA, Auteur ; Barbara MAUGHAN, Auteur ; Thomas G. O'CONNOR, Auteur ; Wolff SCHLOTZ, Auteur Article en page(s) : p.631-640 Langues : Anglais (eng) Mots-clés : Romanian adoptees  adversity  insecure other  institutional deprivation  longitudinal Index. décimale : PER Périodiques Résumé : Institutionally deprived young children often display distinctive patterns of attachment, classified as insecure/other (INS/OTH), with their adoptive parents. The associations between INS/OTH and developmental trajectories of mental health and neurodevelopmental symptoms were examined. Age 4 attachment status was determined for 97 Romanian adoptees exposed to up to 24 months of deprivation in Romanian orphanages and 49 nondeprived UK adoptees. Autism, inattention/overactivity and disinhibited-social-engagement symptoms, emotional problems, and IQ were measured at 4, 6, 11, and 15 years and in young adulthood. Romanian adoptees with over 6 months deprivation (Rom>6) were more often classified as INS/OTH than UK and Romanian adoptees with less than 6 months deprivation combined. INS/OTH was associated with cognitive impairment at age 4 years. The interaction between deprivation, attachment status, and age for autism spectrum disorder assessment was significant, with greater symptom persistence in Rom>6 INS/OTH(+) than other groups. This effect was reduced when IQ at age 4 was controlled for. Age 4 INS/OTH in Rom>6 was associated with worse autism spectrum disorder outcomes up to two decades later. Its association with cognitive impairment at age 4 is consistent with INS/OTH being an early marker of this negative developmental trajectory, rather than its cause. En ligne : http://dx.doi.org/10.1017/s0954579419000506 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=426 [article] Adoptees' responses to separation from, and reunion with, their adoptive parent at age 4 years is associated with long-term persistence of autism symptoms following early severe institutional deprivation [Texte imprimé et/ou numérique] / Edmund J. S. SONUGA-BARKE, Auteur ; Mark KENNEDY, Auteur ; Dennis GOLM, Auteur ; Nicky KNIGHTS, Auteur ; Hanna KOVSHOFF, Auteur ; Jana KREPPNER, Auteur ; Robert KUMSTA, Auteur ; Barbara MAUGHAN, Auteur ; Thomas G. O'CONNOR, Auteur ; Wolff SCHLOTZ, Auteur . - p.631-640. Langues : Anglais (eng) in Development and Psychopathology > 32-2 (May 2020) . - p.631-640 Mots-clés : Romanian adoptees  adversity  insecure other  institutional deprivation  longitudinal Index. décimale : PER Périodiques Résumé : Institutionally deprived young children often display distinctive patterns of attachment, classified as insecure/other (INS/OTH), with their adoptive parents. The associations between INS/OTH and developmental trajectories of mental health and neurodevelopmental symptoms were examined. Age 4 attachment status was determined for 97 Romanian adoptees exposed to up to 24 months of deprivation in Romanian orphanages and 49 nondeprived UK adoptees. Autism, inattention/overactivity and disinhibited-social-engagement symptoms, emotional problems, and IQ were measured at 4, 6, 11, and 15 years and in young adulthood. Romanian adoptees with over 6 months deprivation (Rom>6) were more often classified as INS/OTH than UK and Romanian adoptees with less than 6 months deprivation combined. INS/OTH was associated with cognitive impairment at age 4 years. The interaction between deprivation, attachment status, and age for autism spectrum disorder assessment was significant, with greater symptom persistence in Rom>6 INS/OTH(+) than other groups. This effect was reduced when IQ at age 4 was controlled for. Age 4 INS/OTH in Rom>6 was associated with worse autism spectrum disorder outcomes up to two decades later. Its association with cognitive impairment at age 4 is consistent with INS/OTH being an early marker of this negative developmental trajectory, rather than its cause. En ligne : http://dx.doi.org/10.1017/s0954579419000506 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=426

Early severe institutional deprivation is associated with a persistent variant of adult attention-deficit/hyperactivity disorder: clinical presentation, developmental continuities and life circumstances in the English and Romanian Adoptees study / Mark KENNEDY in Journal of Child Psychology and Psychiatry, 57-10 (October 2016)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 57-10 (October 2016) . - p.1113-1125 Titre : Early severe institutional deprivation is associated with a persistent variant of adult attention-deficit/hyperactivity disorder: clinical presentation, developmental continuities and life circumstances in the English and Romanian Adoptees study Type de document : Texte imprimé et/ou numérique Auteurs : Mark KENNEDY, Auteur ; Jana KREPPNER, Auteur ; Nicky KNIGHTS, Auteur ; Robert KUMSTA, Auteur ; Barbara MAUGHAN, Auteur ; Dennis GOLM, Auteur ; Michael RUTTER, Auteur ; Wolff SCHLOTZ, Auteur ; Edmund J. S. SONUGA-BARKE, Auteur Article en page(s) : p.1113-1125 Langues : Anglais (eng) Mots-clés : Adult attention-deficit/hyperactivity disorder  institutional deprivation  Romanian adoptees  adult onset  longitudinal  adversity Index. décimale : PER Périodiques Résumé : Background Early-life institutional deprivation is associated with attention-deficit/hyperactivity disorder (ADHD) later in childhood and adolescence. In this article, we examine, for the first time, the persistence of deprivation-related ADHD into young adulthood in a sample of individuals adopted as young children by UK families after periods in extremely depriving Romanian orphanages. Methods We estimated rates of ADHD at age 15 years and in young adulthood (ages 22–25 years) in individuals at low (LoDep; nondeprived UK adoptees and Romanian adoptees with less than 6-month institutional exposure) and high deprivation-related risk (HiDep; Romanian adoptees with more than 6-month exposure). Estimates were based on parent report using DSM-5 childhood symptom and impairment criteria. At age 15, data were available for 108 LoDep and 86 HiDep cases, while in young adulthood, the numbers were 83 and 60, respectively. Data on education and employment status, IQ, co-occurring symptoms of young adult disinhibited social engagement (DSE), autism spectrum disorder (ASD), cognitive impairment, conduct disorder (CD), callous-unemotional (CU) traits, anxiety, depression and quality of life (QoL) were also collected. Results ADHD rates in the LoDep group were similar to the general population in adolescence (5.6%) and adulthood (3.8%). HiDep individuals were, respectively, nearly four (19%) and over seven (29.3%) times more likely to meet criteria, than LoDep. Nine ‘onset’ young adult cases emerged, but these had a prior childhood history of elevated ADHD behaviours at ages 6, 11 and 15 years. Young adult ADHD was equally common in males and females, was predominantly inattentive in presentation and co-occurred with high levels of ASD, DSE and CU features. ADHD was associated with high unemployment and low educational attainment. Conclusion We provide the first evidence of a strong persistence into adulthood of a distinctively complex and impairing deprivation-related variant of ADHD. Our results confirm the powerful association of early experience with later development in a way that suggests a role for deep-seated alterations to brain structure and function. En ligne : http://dx.doi.org/10.1111/jcpp.12576 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=295 [article] Early severe institutional deprivation is associated with a persistent variant of adult attention-deficit/hyperactivity disorder: clinical presentation, developmental continuities and life circumstances in the English and Romanian Adoptees study [Texte imprimé et/ou numérique] / Mark KENNEDY, Auteur ; Jana KREPPNER, Auteur ; Nicky KNIGHTS, Auteur ; Robert KUMSTA, Auteur ; Barbara MAUGHAN, Auteur ; Dennis GOLM, Auteur ; Michael RUTTER, Auteur ; Wolff SCHLOTZ, Auteur ; Edmund J. S. SONUGA-BARKE, Auteur . - p.1113-1125. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 57-10 (October 2016) . - p.1113-1125 Mots-clés : Adult attention-deficit/hyperactivity disorder  institutional deprivation  Romanian adoptees  adult onset  longitudinal  adversity Index. décimale : PER Périodiques Résumé : Background Early-life institutional deprivation is associated with attention-deficit/hyperactivity disorder (ADHD) later in childhood and adolescence. In this article, we examine, for the first time, the persistence of deprivation-related ADHD into young adulthood in a sample of individuals adopted as young children by UK families after periods in extremely depriving Romanian orphanages. Methods We estimated rates of ADHD at age 15 years and in young adulthood (ages 22–25 years) in individuals at low (LoDep; nondeprived UK adoptees and Romanian adoptees with less than 6-month institutional exposure) and high deprivation-related risk (HiDep; Romanian adoptees with more than 6-month exposure). Estimates were based on parent report using DSM-5 childhood symptom and impairment criteria. At age 15, data were available for 108 LoDep and 86 HiDep cases, while in young adulthood, the numbers were 83 and 60, respectively. Data on education and employment status, IQ, co-occurring symptoms of young adult disinhibited social engagement (DSE), autism spectrum disorder (ASD), cognitive impairment, conduct disorder (CD), callous-unemotional (CU) traits, anxiety, depression and quality of life (QoL) were also collected. Results ADHD rates in the LoDep group were similar to the general population in adolescence (5.6%) and adulthood (3.8%). HiDep individuals were, respectively, nearly four (19%) and over seven (29.3%) times more likely to meet criteria, than LoDep. Nine ‘onset’ young adult cases emerged, but these had a prior childhood history of elevated ADHD behaviours at ages 6, 11 and 15 years. Young adult ADHD was equally common in males and females, was predominantly inattentive in presentation and co-occurred with high levels of ASD, DSE and CU features. ADHD was associated with high unemployment and low educational attainment. Conclusion We provide the first evidence of a strong persistence into adulthood of a distinctively complex and impairing deprivation-related variant of ADHD. Our results confirm the powerful association of early experience with later development in a way that suggests a role for deep-seated alterations to brain structure and function. En ligne : http://dx.doi.org/10.1111/jcpp.12576 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=295

The adult outcome of childhood quasi-autism arising following extreme institutional deprivation / Maria RODRIGUEZ-PEREZ in Journal of Child Psychology and Psychiatry, 64-9 (September 2023)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 64-9 (September 2023) . - p.1292-1302 Titre : The adult outcome of childhood quasi-autism arising following extreme institutional deprivation Type de document : Texte imprimé et/ou numérique Auteurs : Maria RODRIGUEZ-PEREZ, Auteur ; Mark KENNEDY, Auteur ; Edward D. BARKER, Auteur ; Jana KREPPNER, Auteur ; Mireia SOLERDELCOLL, Auteur ; Edmund J.S. SONUGA-BARKE, Auteur Article en page(s) : p.1292-1302 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Background Rutter and colleagues' seminal observation that extended early life exposure to extreme institutional deprivation can result in what he termed quasi-autism (QA), informed both our understanding of the effects of adversity on development and the nature of autism. Here we provide the first detailed analysis of the adult outcomes of the group of institutionally deprived-then-adopted children identified as displaying QA. Methods Twenty-six adult adoptees identified with QA in childhood (Childhood QA+) were compared to 75 adoptees who experienced extended institutional deprivation (>6 months) but no QA (Childhood QA?), and 116 adoptees exposed to Low/No institutional deprivation. The outcomes were child-to-adult developmental trajectories of neuro-developmental symptoms (autism, attention-deficit/hyperactivity disorder (ADHD), disinhibited social engagement (DSE) and cognitive impairment), adult functioning, life satisfaction and mental health. Results Childhood QA+ was associated with elevated and persistent trajectories of broad-based autism-related difficulties, ADHD and DSE symptoms and low IQ, as well as adult mental health difficulties and functional impairment, including high rates of low educational attainment and unemployment. Life satisfaction and self-esteem were unaffected. Autism-related communication problems, in particular, predicted negative adult outcomes. Childhood QA+ was still associated with poor outcomes even when ADHD, DSE and IQ were controlled. Conclusions Early and time-limited institutional deprivation has a critical impact on adult functioning, in part via its association with an early established and persistent variant of autism, especially related to communication difficulties. Apparent similarities and differences to non-deprivation related autism are discussed. En ligne : https://doi.org/10.1111/jcpp.13767 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=512 [article] The adult outcome of childhood quasi-autism arising following extreme institutional deprivation [Texte imprimé et/ou numérique] / Maria RODRIGUEZ-PEREZ, Auteur ; Mark KENNEDY, Auteur ; Edward D. BARKER, Auteur ; Jana KREPPNER, Auteur ; Mireia SOLERDELCOLL, Auteur ; Edmund J.S. SONUGA-BARKE, Auteur . - p.1292-1302. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 64-9 (September 2023) . - p.1292-1302 Index. décimale : PER Périodiques Résumé : Background Rutter and colleagues' seminal observation that extended early life exposure to extreme institutional deprivation can result in what he termed quasi-autism (QA), informed both our understanding of the effects of adversity on development and the nature of autism. Here we provide the first detailed analysis of the adult outcomes of the group of institutionally deprived-then-adopted children identified as displaying QA. Methods Twenty-six adult adoptees identified with QA in childhood (Childhood QA+) were compared to 75 adoptees who experienced extended institutional deprivation (>6 months) but no QA (Childhood QA?), and 116 adoptees exposed to Low/No institutional deprivation. The outcomes were child-to-adult developmental trajectories of neuro-developmental symptoms (autism, attention-deficit/hyperactivity disorder (ADHD), disinhibited social engagement (DSE) and cognitive impairment), adult functioning, life satisfaction and mental health. Results Childhood QA+ was associated with elevated and persistent trajectories of broad-based autism-related difficulties, ADHD and DSE symptoms and low IQ, as well as adult mental health difficulties and functional impairment, including high rates of low educational attainment and unemployment. Life satisfaction and self-esteem were unaffected. Autism-related communication problems, in particular, predicted negative adult outcomes. Childhood QA+ was still associated with poor outcomes even when ADHD, DSE and IQ were controlled. Conclusions Early and time-limited institutional deprivation has a critical impact on adult functioning, in part via its association with an early established and persistent variant of autism, especially related to communication difficulties. Apparent similarities and differences to non-deprivation related autism are discussed. En ligne : https://doi.org/10.1111/jcpp.13767 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=512

Understanding the prospective associations between neuro-developmental problems, bullying victimization, and mental health: Lessons from a longitudinal study of institutional deprivation / Jala RIZEQ in Development and Psychopathology, 36-1 (February 2024)  

Public ISBD [article]  inDevelopment and Psychopathology > 36-1 (February 2024) . - p.40-49 Titre : Understanding the prospective associations between neuro-developmental problems, bullying victimization, and mental health: Lessons from a longitudinal study of institutional deprivation Type de document : Texte imprimé et/ou numérique Auteurs : Jala RIZEQ, Auteur ; Mark KENNEDY, Auteur ; Jana KREPPNER, Auteur ; Barbara MAUGHAN, Auteur ; Edmund SONUGA-BARKE, Auteur Article en page(s) : p.40-49 Langues : Anglais (eng) Mots-clés : bullying victimization  developmental cascades  institutional deprivation  mental health  neglect Index. décimale : PER Périodiques Résumé : Studies suggest that children who have experienced neglect are at risk for bullying which in turn increases the risk for poor mental health. Here we extend this research by examining whether this risk extends to the neglect associated with severe institutional deprivation and then testing the extent to which these effects are mediated by prior deprivation-related neuro-developmental problems such as symptoms of inattention, hyperactivity and autism. Data were collected at ages 6, 11, 15, and young adulthood (22-25 years) from 165 adoptees who experienced up to 43 months of deprivation in Romanian Orphanages in 1980s and 52 non-deprived UK adoptees (N = 217; 50.23% females). Deprivation was associated with elevated levels of bullying and neuro-developmental symptoms at ages 6 through 15 and young adult depression and anxiety. Paths from deprivation to poor adult mental health were mediated via cross-lagged effects from earlier neuro-developmental problems to later bullying. Findings evidence how deep-seated neuro-developmental impacts of institutional deprivation can cascade across development to impact social functioning and mental health. These results elucidate cascade timing and the association between early deprivation and later bullying victimization across childhood and adolescence. En ligne : https://dx.doi.org/10.1017/S095457942200089X Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=523 [article] Understanding the prospective associations between neuro-developmental problems, bullying victimization, and mental health: Lessons from a longitudinal study of institutional deprivation [Texte imprimé et/ou numérique] / Jala RIZEQ, Auteur ; Mark KENNEDY, Auteur ; Jana KREPPNER, Auteur ; Barbara MAUGHAN, Auteur ; Edmund SONUGA-BARKE, Auteur . - p.40-49. Langues : Anglais (eng) in Development and Psychopathology > 36-1 (February 2024) . - p.40-49 Mots-clés : bullying victimization  developmental cascades  institutional deprivation  mental health  neglect Index. décimale : PER Périodiques Résumé : Studies suggest that children who have experienced neglect are at risk for bullying which in turn increases the risk for poor mental health. Here we extend this research by examining whether this risk extends to the neglect associated with severe institutional deprivation and then testing the extent to which these effects are mediated by prior deprivation-related neuro-developmental problems such as symptoms of inattention, hyperactivity and autism. Data were collected at ages 6, 11, 15, and young adulthood (22-25 years) from 165 adoptees who experienced up to 43 months of deprivation in Romanian Orphanages in 1980s and 52 non-deprived UK adoptees (N = 217; 50.23% females). Deprivation was associated with elevated levels of bullying and neuro-developmental symptoms at ages 6 through 15 and young adult depression and anxiety. Paths from deprivation to poor adult mental health were mediated via cross-lagged effects from earlier neuro-developmental problems to later bullying. Findings evidence how deep-seated neuro-developmental impacts of institutional deprivation can cascade across development to impact social functioning and mental health. These results elucidate cascade timing and the association between early deprivation and later bullying victimization across childhood and adolescence. En ligne : https://dx.doi.org/10.1017/S095457942200089X Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=523

Why does early childhood deprivation increase the risk for depression and anxiety in adulthood? A developmental cascade model / Dennis GOLM in Journal of Child Psychology and Psychiatry, 61-9 (September 2020)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 61-9 (September 2020) . - p.1043-1053 Titre : Why does early childhood deprivation increase the risk for depression and anxiety in adulthood? A developmental cascade model Type de document : Texte imprimé et/ou numérique Auteurs : Dennis GOLM, Auteur ; Barbara MAUGHAN, Auteur ; Edward D. BARKER, Auteur ; Jonathan HILL, Auteur ; Mark KENNEDY, Auteur ; Nicky KNIGHTS, Auteur ; Jana KREPPNER, Auteur ; Robert KUMSTA, Auteur ; Wolff SCHLOTZ, Auteur ; Michael RUTTER, Auteur ; Edmund J. S. SONUGA-BARKE, Auteur Article en page(s) : p.1043-1053 Langues : Anglais (eng) Mots-clés : Institutional deprivation  anxiety  depression  developmental cascades  emotional problems  longitudinal  natural experiment  neurodevelopmental problems  prospective Index. décimale : PER Périodiques Résumé : BACKGROUND: Using data from the English & Romanian Adoptees (ERA) study, we recently reported that early time-limited exposure to severe institutional deprivation is associated with early-onset and persistent neurodevelopmental problems and later-onset emotional problems. Here, we examine possible reasons for the late emergence of emotional problems in this cohort. Our main focus is on testing a developmental cascade mediated via the functional impact of early-appearing neurodevelopmental problems on late adolescent functioning. We also explore a second putative pathway via sensitization to stress. METHODS: The ERA study includes 165 Romanian individuals who spent their early lives in grossly depriving institutions and were subsequently adopted into UK families, along with 52 UK adoptees with no history of deprivation. Age six years symptoms of neurodevelopmental problems and age 15 anxiety/depression symptoms were assessed via parental reports. Young adult symptoms of depression and anxiety were assessed by both parent and self-reports; young adults also completed measures of stress reactivity, exposure to adverse life events, and functioning in work and interpersonal relationships. RESULTS: The path between early institutional deprivation and adult emotional problems was mediated via the impact of early neurodevelopmental problems on unemployment and poor friendship functioning during the transition to adulthood. The findings with regard to early deprivation, later life stress reactivity, and emotional problems were inconclusive. CONCLUSIONS: Our analysis suggests that the risk for adult depression and anxiety following extreme institutional deprivation is explained through the effects of early neurodevelopmental problems on later social and vocational functioning. Future research should more fully examine the role of stress susceptibility in this model. En ligne : http://dx.doi.org/10.1111/jcpp.13205 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=430 [article] Why does early childhood deprivation increase the risk for depression and anxiety in adulthood? A developmental cascade model [Texte imprimé et/ou numérique] / Dennis GOLM, Auteur ; Barbara MAUGHAN, Auteur ; Edward D. BARKER, Auteur ; Jonathan HILL, Auteur ; Mark KENNEDY, Auteur ; Nicky KNIGHTS, Auteur ; Jana KREPPNER, Auteur ; Robert KUMSTA, Auteur ; Wolff SCHLOTZ, Auteur ; Michael RUTTER, Auteur ; Edmund J. S. SONUGA-BARKE, Auteur . - p.1043-1053. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 61-9 (September 2020) . - p.1043-1053 Mots-clés : Institutional deprivation  anxiety  depression  developmental cascades  emotional problems  longitudinal  natural experiment  neurodevelopmental problems  prospective Index. décimale : PER Périodiques Résumé : BACKGROUND: Using data from the English & Romanian Adoptees (ERA) study, we recently reported that early time-limited exposure to severe institutional deprivation is associated with early-onset and persistent neurodevelopmental problems and later-onset emotional problems. Here, we examine possible reasons for the late emergence of emotional problems in this cohort. Our main focus is on testing a developmental cascade mediated via the functional impact of early-appearing neurodevelopmental problems on late adolescent functioning. We also explore a second putative pathway via sensitization to stress. METHODS: The ERA study includes 165 Romanian individuals who spent their early lives in grossly depriving institutions and were subsequently adopted into UK families, along with 52 UK adoptees with no history of deprivation. Age six years symptoms of neurodevelopmental problems and age 15 anxiety/depression symptoms were assessed via parental reports. Young adult symptoms of depression and anxiety were assessed by both parent and self-reports; young adults also completed measures of stress reactivity, exposure to adverse life events, and functioning in work and interpersonal relationships. RESULTS: The path between early institutional deprivation and adult emotional problems was mediated via the impact of early neurodevelopmental problems on unemployment and poor friendship functioning during the transition to adulthood. The findings with regard to early deprivation, later life stress reactivity, and emotional problems were inconclusive. CONCLUSIONS: Our analysis suggests that the risk for adult depression and anxiety following extreme institutional deprivation is explained through the effects of early neurodevelopmental problems on later social and vocational functioning. Future research should more fully examine the role of stress susceptibility in this model. En ligne : http://dx.doi.org/10.1111/jcpp.13205 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=430

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