In this monograph, the authors have brought the findings of the English and Romanian Adoptee (ERA) study up to age 15 years and, in so doing, have focused especially on the question of whether there are deprivation-specific psychological patterns (DSPs) that differ meaningfully from other forms of psychopathology. For this purpose, their main analytic strategy was to compare the subgroup of young people who had received institutional care in Romania that persisted up to at least the age of 6 months and a pooled comparison group that comprised the remainder of the sample. They conclude that the ERA findings have provided good evidence that institutional deprivation does truly cause DSPs. Contrary to the expectations at the time that the study started, it is striking that the DSPs constitute rather unusual patterns in contrast to the broad run of emotional disturbance and disruptive behavior. It is also very striking how remarkably persistent the effects of institutional deprivation have proved to be.