Mental Health in Internationally Adopted Adolescents: A Meta-Analysis

The romantic relationships of adopted adolescents

INTRODUCTION

There is a gap in the literature on the romantic relationships of adopted adolescents. To address this issue, the present study has three aims: (1) to explore differences between adopted and non-adopted adolescents in terms of their involvement in and the length of their romantic relationships; (2) to explore the quality of these relationships; and (3) to analyze associations between affective relationships and well-being in both groups.

METHOD

The sample comprised 276 adopted (64.5% girls; mean age 16.3 years, 73.9% international adoptees) and 276 non-adopted (48.3% girls; mean age 16.3 years) adolescents, all of whom participated in the Spanish Health Behaviour in School-aged Children survey.

RESULTS

Similar romantic relationship rates and lengths were found among adoptees and non-adoptees, as well as between international and domestic adoptees. Adoptees reported more emotional support and conflicts in their romantic relationships than their non-adopted peers. Finally, associations between the quality of the romantic relationships and well-being were similar for both groups, with more conflicts being linked to lower levels of well-being, and more emotional support and affection correlating with higher levels of well-being.

DISCUSSION

The data suggest more similarities than differences between adopted and non-adopted adolescents. However, although this indicates that romantic relationships are yet another example of recovery for adopted boys and girls, further research is required, with larger and more diverse samples from multiple countries, to explore the differences observed in more detail.

A four-year multi-wave prospective study on the role of parental reflective functioning and parenting stress in the development of socio-emotional problems in internationally adopted children

Parental reflective functioning (PRF) plays a protective role in the development of children with histories of early adversity, including adopted children. This is the first study to investigate the developmental trajectories of PRF and children's socio-emotional problems in the first 4 years after international adoption (N = 48 families, mean age (T1) = 20.7 months) and to examine the mediating role of parenting stress in the relation between PRF and child socio-emotional problems. Multilevel modeling indicated that age at adoption and parent gender moderated the development of PRF and child socio-emotional problems. Moreover, decreases in PRF were associated with more socio-emotional problems in the children. These relations were mediated by parenting stress, and particularly feelings of incompetence and marital dissatisfaction.

School victimization and psychosocial adjustment among Eastern European adopted adolescents across Europe

BACKGROUND

Little is known about bullying experienced by internationally adopted teens residing in Europe.

OBJECTIVES

Within the framework of an international research effort involving several European countries, the main goal of this study was to explore the experiences of bullying victimization suffered by adopted adolescents, as well as its impact on their psychological adjustment.

METHODS

The sample consisted of 199 adolescents born in Eastern European countries and adopted in France (n = 50), Italy (n = 59), Norway (n = 25) and Spain (n = 65).

RESULTS

More than half of the adopted adolescents had been exposed to some form of peer victimization in the previous 2 months, with verbal harassment and social exclusion being the most common forms of victimization. Differences between receiving countries were not statistically significant, suggesting a common pattern for Eastern European adopted adolescents living in Western Europe. More frequent experiences of peer victimization were associated with more psychological difficulties among the adopted adolescents.

CONCLUSIONS

Findings highlight that adopted adolescents might have considerable difficulties in social integration with peers; these experiences of peer victimization might play an important role hindering their psychosocial adjustment. The socioemotional development of adopted people is not only linked to their pre-adoptive experiences; factors in their daily lives (i.e., peer relationships) may also be associated with their psychological adjustment later in life. Interventions are needed to promote the real inclusion of these groups of children in their social and educational contexts.

The Placement of Children in Need of Out-of-Home Care: Forms of Care and Differences in Attachment Security and Behavioral Problems in the Italian Context

The current paper investigated differences in secure attachment levels and behavioral problems among four groups of children in out-of-home care in Italy: closed adoption (child and birth parents not in contact following adoption), open adoption (child and birth parents still in contact after placement), foster care (child living temporarily with relatives or unrelated foster parents) and institutional care (child in residential care for large groups of children). One hundred and thirty children aged 10-19 were included in this study. The Attachment Interview for Childhood and Adolescence and the Achenbach Youth Self-Report were employed to measure participants' secure attachment levels and behavioral problems. Both a multivariate analysis of covariance and measured variable path analysis were performed. Age, gender and time elapsed between the request for child protection and placement on out-of-home care were used as covariates. The results showed that adolescents in closed adoption had higher secure attachment scores than those in foster care and institutional care, while adolescents in open adoption scored significantly higher on problem behaviors than those in the other out-of-home care groups. Findings were discussed in terms of limitations and implications for future research.

Attachment and alexithymia predict emotional-behavioural problems of institutionalized, late-adopted and community adolescents: An explorative multi-informant mixed-method study

OBJECTIVE

Compared to community adolescents (COM), adolescents placed in residential care (RC) or late adopted (LA) appear to show more emotional-behavioural problems. They also appear vulnerable in variables linked to emotional-behavioural problems, such as insecure-disorganized attachment and alexithymia. This study employs a mixed-method multi-informant approach to (1) compare adolescents placed in RC, LA and COM in emotional-behavioural problems, attachment and alexithymia and (2) investigate relationships and interplay of attachment and alexithymia concerning emotional-behavioural problems in these three groups.

METHOD

Participants were 174 adolescents (50 RC, 33 LA and 91 COM; Mage  = 15, 53% boys and 47% girls). Adolescents' internalizing and externalizing problems were assessed through both caregiver-reported and self-reported questionnaires, while attachment and alexithymia were assessed with a mixed method, using interviews and self-report questionnaires.

RESULTS

The results showed RC adolescents as more vulnerable in all variables, while LA and COM did not differ. Accounting for the group, attachment and alexithymia cumulatively predicted 25-43% of internalizing problems, and 19-43% of externalizing problems depending on the method of assessment or problems' informant (all p < 0.01). Alexithymia was both an independent predictor and interacted with preoccupied attachment in predicting internalizing problems, while no predictors were isolated for externalizing ones, and the group never indicate an effect on problems' rates.

CONCLUSIONS

The authors discuss the utility to maintain a research focus on attachment and alexithymia, also suggesting future directions of research. A need to determine potential distortions of results because of problems' informant and method of assessment is also highlighted.

Psychological wellbeing in adult adoptees: current age and developmental tasks

Introduction

Studies about adult adoptees are normally focused on the differences in adjustment difficulties between them and non-adoptees. However, there has been less research about adoptees' positive and developmental adjustment in adulthood. The aim of this study is to test a model of the mediating role of adoptees' achievement of adulthood tasks in the relationship between current age and psychological wellbeing.

Materials and methods

The sample consisted of 117 adults who were adopted as children by Spanish families. Their current mean age is 28.3 years. Participants underwent an interview and completed Ryff's Psychological WellBeing Scales.

Results

Findings show that current age is directly and negatively related to psychological wellbeing [c' = -0.039, 95% CI (-0.078, -0.001)], and the relationship between these variables is mediated by adoptees' achievement of adulthood tasks [indirect effect = 0.035, 95% CI (.014, 0.059)].

Discussion

The findings support traditional theories about transitioning to adulthood, and adds relevant information about this transition in adoptees. Moreover, this work indicates a new way of assessing adoption success, based on long-term measures and normative variables. Services providers should account for the importance of supporting young people on their life transitions and promoting their wellbeing, especially among those who started from disadvantaged contexts.

Personal Values and Substance Use in Adolescence and Young Adulthood: Risk or Protective Factors?

Background: Personal values are desirable trans-situational goals that serve as guiding principles in people's lives and have been widely found to be related to people's behavior. Objectives: This study aimed at investigating the relation between personal values and youth involvement in frequency of alcohol and cannabis use and problems related to substance use, comparing two groups of adolescents and young adults: 237 adolescents (age 14-19 years; 58.2% females) and 236 young adults (age 20-30 years; 78.8% females). Participants were asked to fill in an online self-report questionnaire aimed at assessing the constructs of interest. Results: The results showed that openness to change, despite being more prioritized by adolescents, was significantly positively related to frequency of cannabis use and problems related to substance use only for young adults. Conclusions: Implications for preventive interventions and further expansions of the study are discussed.

Do the Temperamental Characteristics of Both Mother and Child Influence the Well-Being of Adopted and Non-Adopted Children?

(1) Background: For decades, the temperaments of infants and small children have been a focus of studies in human development and been seen as a potential contributor to children’s developmental patterns. However, less is known about the interplay between the temperamental characteristics of mothers and their children in the context of explaining variations in developmental outcomes. The aim of our study was to explore the associations—with or without genetic links—of the temperaments and psychological distress of mothers and the temperaments of children with behavioral problems in a group of internationally adopted children and their adoptive mothers and in a group of non-adopted children and their mothers. (2) Methods: Data (n = 170) were derived from the ongoing Finnish Adoption (FinAdo) follow-up study. The children included were under the age of 7 years; 74 were adopted internationally through legal agencies between October 2010 and December 2016, and the remaining 96 were non-adopted children living with their birth parents (biological group) recruited from day-care centers. We used Mary Rothbart’s temperament questionnaires to assess temperament, the Child Behavior Checklist (CBCL) to obtain data on the children’s behavioral/emotional problems and competencies, and the General Health Questionnaire (GHQ) to assess parental psychological distress. The study was approved by the Ethics Committee of the Hospital District of Southwest Finland, and written informed consent was obtained from the parents and the children themselves. (3) Results: The negative affectivities of both mothers and children were associated with the total CBCL and with both internalizing and externalizing problem behaviors after adjusting for age, gender, and adoption status. Both relationships remained significant when tested simultaneously, suggesting additive effects. Maternal negative affect was associated with problem behavior irrespective of child extraversion/surgency. Child extraversion/surgency was associated with lower levels of all internalizing behavioral problems when adjusted for maternal sociability. Child negative affect was associated with all behavioral problem measures irrespective of maternal sociability or maternal psychological distress. Maternal distress was associated with child problem behaviors only in children with low extraversion/surgency. (4) Limitations: The sample size was relatively small, and the information was gathered solely with questionnaires. (5) Conclusions: The results of the study may be clinically significant. Child negative affect, maternal negative affect, and maternal experienced distress, combined with low child extraversion/surgency, may increase the risk of child problem behaviors in both adoptees and non-adoptees.

Adoption and trauma: Risks, recovery, and the lived experience of adoption

BACKGROUND

Although a very heterogeneous group, adopted persons may present developmental and mental health problems of varying severity. Pre-placement adversity and trauma have often been linked to these problems. It has been also suggested that adoption itself is a psychological trauma, predisposing the individual to emotional difficulties.

OBJECTIVES

This article examines the links between early adversity, trauma, and adoption. We begin by defining trauma and then describe the way in which pre-placement adversity can undermine neurobehavioral and interpersonal functioning, increasing the risk for long-term psychological difficulties. Next, we examine children's recovery when placed in a stable adoptive home. Finally, we explore adoption as a lived experience, highlighting contextual and developmental factors that facilitate the person's positive or negative attributions about being adopted, leading to varying patterns of emotional adjustment.

CONCLUSIONS

Although pre-placement adversity increases adopted individuals' risk for maladjustment, the human brain and behavior are malleable, and placement in a nurturing adoptive home often facilitates recovery from early adversity, with significant heterogeneity in the extent of recovery within and across domains of functioning. While there is no evidence that early adoption is a trauma for the individual, ongoing negative life circumstances, attachment difficulties, and developmentally-mediated attributions about adoption can undermine the person's self-esteem, identity, relationships, and sense of well-being. Conclusions and suggestions for future research are offered.

Emotional-behavioral problems, attachment and verbal skills in late-adopted adolescents: The role of pre-adoption adversities and adoption variables

BACKGROUND

There are few studies on late-adopted adolescents' outcomes -e.g., emotional-behavioral problems, attachment and cognitive status- and their possible predictive factors, none from Italy.

OBJECTIVE

This paper aimed to investigate emotional-behavioral problems, attachment representations, and verbal skills in late-adopted adolescents in Italy and to explore the predictive role of pre-adoption adversities and adoption variables for worse adoptees' outcomes.

PARTICIPANTS AND SETTING

The study included N = 79 late-adopted (mean age at adoption = 6 years) adolescents, between 11 and 18 years, placed via both intercountry and domestic adoption.

METHODS

Parents provided information about pre-adoption and adoption history and filled the Children's Behavior Checklist 6-18 for measuring participants' emotional-behavioral problems. Attachment representations were assessed through the Friend and Family Interview administered directly to adolescents, like the verbal comprehension index of the Wechsler Intelligence Scale for Children (4th edition) for measuring participants' verbal IQ.

RESULTS

Maltreatment and its interaction with multiple placements were the main predictors of other problems-i.e., social, thought, and identity difficulties (respectively, p = .007 and p = .029)-while intercountry adoption was the unique predictor of both externalizing and total problems (respectively, p = .047 and p = .015). However, domestic adoption was the most important predictor both for higher insecurity and disorganized attachment representations and lower verbal skills (all p < .044); even stronger if domestic adoption interacted with pre-adoptive institutionalization.

CONCLUSIONS

Pre-adoption adversities as well as domestic vs. intercountry adoption, but not the age at placement, contributed to adolescent adoptees' developmental outcomes.

Advocating the need for neuro-informed working with intercountry adoptees

BACKGROUND

Intercountry adoption is declining and many adoptees at any point of their life are in search of therapeutic services. Specialized care is scare and regular services seem to be missing the point. Regular therapeutic services do not cater to the specific needs of adoptees because they often forget to take the early adversity into account. Adoption specific therapeutic services are called for worldwide, this needs not be very difficult. Affective neurobiology, trauma and attachment research next to adoption studies have given practitioners many tools to design a sustainable therapeutical practice for both adoption aware assessment as well as adoption aware treatment.

OBJECTIVE

Advocating a neuro-informed approach to treatment when intercountry adoptees present developmental or other mental health problems. This approach is based on a combination of professional reflection as well as on theory and the idea is that it can be used broadly by clinicians, even when not specifically trained or focused on intercountry adoptions.

PARTICIPANTS AND SETTING

Theoretical insights are combined with clinical experience in De Adoptiepraktijk, a private, specialized mental health practice, making the argument for embracing a neuro informed approach in working with intercountry adoptees in the Netherlands.

METHODS

Theoretical evaluation, argumentation and personal reflection illustrated by a small case study. Results Overview of problems, models and methods to be used in clinical work with intercountry adoptees.

CONCLUSIONS

Proposition to use theoretical and practical insights from the neurosequential network, dyadic developmental psychotherapy, sensorimotor psychotherapy¹ and the polyvagal theory to help clinicians assess the problems adopted clients encounter and plan interventions accordingly.

Intervening With Attachment and Biobehavioral Catch-Up to Reduce Behavior Problems Among Children Adopted Internationally: Evidence From a Randomized Controlled Trial

Children who have been adopted internationally often exhibit persistent behavior problems. The current study assessed the efficacy of the Attachment and Biobehavioral Catch-up intervention (ABC; Dozier & Bernard, 2019) for reducing behavior problems in 122 children adopted internationally. Behavior problems were measured via parent-report using the Brief Infant Toddler Social Emotional Assessment at a pre-intervention visit and after the intervention when children were between 18 and 36 months. Children's behavior problems were also observed using the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS) after the intervention when children were 48 and 60 months. Parents who received ABC reported fewer child behavior problems than parents who received the control intervention immediately after the intervention through 1.5 years post-intervention. Additionally, children whose parents received ABC exhibited fewer behavior problems within the parent context of the DB-DOS when they were 48 months old (2 years post-intervention) than children whose parents received the control intervention. There were no significant intervention effects on children's observed behavior problems within the examiner contexts. These results support the efficacy of ABC in reducing behavior problems among children adopted internationally. Trial registration: ClinicalTrials.gov NCT00816621.

Comparing Childhood Characteristics of Adopted and Non-adopted Individuals Deceased by Suicide

OBJECTIVE

Across the globe more than 35,000 children a year are adopted by non-relatives, and some studies suggest that adopted individuals may be more vulnerable to developing mental disorders. To map the differences in suicide risk factors in adopted and non-adopted individuals, this study will compare the development of mental disorders as well as life events occurring before the age of 18 for both adopted and non-adopted individuals deceased by suicide.

METHODS

This study included 13 adopted and 26 non-adopted individuals deceased by suicide as well as 26 non-adopted living control individuals. Cases were taken from a data bank created over the last decade by researchers of [our institution] comprising a mixture of 700 suicide cases and living control individuals aged from 14 to 84. Adopted and non-adopted individuals deceased by suicide; adopted individuals deceased by suicide and non-adopted living control individuals were each compared on Axis I and II disorders, early life events, and burdens of adversity.

RESULTS

Results show significant differences, with a higher rate of Attention Deficit Hyperactivity Disorder, mental health comorbidity and Cluster C personality disorders among adopted individuals. Furthermore, adopted individuals have higher adversity scores prior to the age of 15.

CONCLUSION

This study underlines the fact that adoptive families need to be supported throughout adoption. Health care professionals need specialized training on this matter, and the psychological challenges adopted individuals face need to be treated at the earliest juncture.

The effects of maternal depression on their perception of emotional and behavioral problems of their internationally adopted children

BACKGROUND

Even though child psychopathology assessment guidelines emphasize comprehensive multi-method, multimodal, and multi-informant methodologies, maternal-report symptom-rating scales often serve as the predominant source of information. Research has shown that parental mood symptomatology affects their reports of their offspring's psychopathology. For example, the depression-distortion hypothesis suggests that maternal depression promotes a negative bias in mothers' perceptions of their children's behavioral and emotional problems. We investigated this difference of perception between adoptive mothers and internationally adopted children. Most previous studies suffer from the potential bias caused by the fact that parents and children share genetic risks.

METHODS

Data were derived from the Finnish Adoption (FinAdo) survey study (a subsample of adopted children aged between 9 and 12 years, n = 222). The Child Behavior Checklist (CBCL) was used to assess emotional and behavioral problems and competences of the adopted children. The CBCL was filled in by the adopted children and the adoptive mothers, respectively. Maternal depressive symptoms were measured using the short version of the General Health Questionnaire.

RESULTS

On average, mothers reported less total CBCL symptoms in their children than the children themselves (0.25 vs 0.38, p-value < 0.01 for difference). Mothers' depressive symptoms moderated the discrepancy in reporting internalizing symptoms (β = - 0.14 and p-value 0.01 for interaction) and the total symptoms scores (β = - 0.22 and p-value < 0.001 for interaction) and externalizing symptoms in girls in the CBCL.

LIMITATIONS

The major limitation of our study is its cross-sectional design and the fact that we only collected data in the form of questionnaires.

CONCLUSIONS

The results of our research support the depression-distortion hypothesis concerning the association of maternal depressive symptoms and child internalizing symptoms and externalizing symptoms in girls in a sample without genetic bias.

The quiet migration of adopted adolescents in Italy: Ethnic identity, reflected minority categorization, and ethnic discrimination

Internationally adopted adolescents face the crucial developmental task of shaping their ethnic identity by balancing their dual belongingness to the current cultural background and the birth country's ethnic background. This process does not depend exclusively on individual variables, but it is embedded within the social context. The present study was aimed at exploring the role of ethnic discrimination in moderating the association between reflected minority categorization, on the one hand, and ethnic identity, on the other. A self-report questionnaire was administrated to 180 internationally adopted adolescents. Results showed that at high levels of ethnic discrimination the relation between reflected minority categorization and ethnic identity in terms of commitment was negative and stronger. When considering instead ethnic identity in terms of exploration, it is possible to note that higher levels of reflected minority categorization were associated with higher levels of exploration. Findings are discussed in light of post-adoption intervention for adoptees.

Aggressiveness in Adopted and Non-Adopted Teens: The Role of Parenting, Attachment Security, and Gender

The aim of this study was to examine the relationship among aggressiveness, parenting practices, and attachment security in adolescents, assessing maternal and paternal effects separately. Two different subsamples of adolescents between 12 and 16 years old participated in the study (n = 157): 67 adopted adolescents (61.2% girls) and 90 non-adopted adolescents (56.7% girls). Partial and full mediation models were analyzed in multi-group structural equation models (using maximum likelihood estimates), allocating non-adoptive and adoptive adolescents into two different groups. Results showed that whereas acceptance/involvement of each parent predicted attachment security towards the corresponding parental figure, only the father's coercion/imposition predicted aggressiveness, and only attachment security to the mother was a (negative) predictor of adolescent's aggressiveness. The partial mediation model provided the most parsimonious explanation for the data, showing no differences between adopted and non-adopted subsamples and supporting a good model fit for both boys and girls in a multi-group invariance analysis. The implications of these results are discussed in light of the protective effects of care relationships in early adolescence (vs. late adolescence) as well as the differential role of parent figures.

Adoptive Gay Father Families: A Longitudinal Study of Children's Adjustment at Early Adolescence

Findings are presented from the second phase of a UK longitudinal study of 33 gay father, 35 lesbian mother, and 43 heterosexual parent families when their adopted children reached early adolescence. Participants predominantly lived in urban/suburban areas and were mostly white and well-educated. Standardized interviews, observations, and questionnaires of parental mental health, parent-child relationships, and adolescent adjustment were administered to parents, children, and teachers between 2016 and 2018. There were few differences between family types. However, adjustment problems had increased in all family types, with better parenting quality and parental mental health associated with fewer adjustment problems. The findings contribute to adoption policy and practice, and to theoretical understanding of the role of parental gender in child development.

Behavioral symptoms of eating disorders among adopted adolescents and young adults in the United States: Findings from the Add Health survey

OBJECTIVE

More adopted individuals report experiencing general psychopathology, poor parental attachment, and early childhood eating difficulties than nonadopted individuals, yet little is known about disordered eating in this population. This study sought to describe the relationship between adoption status and behavioral eating-disorder (ED) symptoms, and to examine potential correlates of ED symptoms that are unique to adopted individuals.

METHOD

We examined data from adolescents and young adults from Waves 1 (n adopted = 561, nonadopted = 20,184), 2 (n adopted = 211, nonadopted = 14,525), and 3 (n adopted = 416, nonadopted = 14,754) of the National Longitudinal Study of Adolescent to Adult Health. ED symptom items included dieting, breakfast skipping, binge eating, extreme weight loss behaviors (EWLBs; i.e., self-induced vomiting, laxative use, diet pill use) and lifetime ED diagnosis.

RESULTS

Compared to nonadopted individuals, adopted individuals were more likely to report EWLBs at Wave 2 and binge eating and lifetime ED diagnosis at Wave 3 (ps < .05). Among adopted individuals, contact with a biological parent was associated with higher rates of binge eating and lifetime ED diagnosis at Wave 3 (ps < .05), whereas age at adoption and having ever been in foster care were not associated with rates of ED symptoms.

DISCUSSION

This study provides preliminary evidence that being adopted may be a risk factor for certain behavioral symptoms of EDs. Given the benefits of early detection and treatment of ED symptoms, mental health professionals working with adopted individuals should assess for disordered eating.

Risk of eating disorders in international adoptees: a cohort study using Swedish national population registers

AIMS

Compared to the general population, adoptees are more often referred to specialist psychiatric treatment, exhibit increased risk of suicide and display more symptoms of attention-deficit/hyperactivity-disorder. However, little is known about the impact of being an adoptee on the risk of developing an eating disorder. The aim of the present study was to assess whether international adoptees have a higher risk for eating disorders than native Swedes.

METHODS

In the present retrospective cohort study, data from the Swedish total population registers on individuals born between 1979 and 2005 were used to assess whether international adoptees residing in Sweden (n = 25 287) have a higher risk for anorexia nervosa (AN) and other eating disorders (OED) than non-adoptees with Swedish-born parents from the general population (n = 2 046 835). The patterns of these results were compared to those for major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and anxiety disorders to determine whether any observed effects were unique to eating disorders or reflected a more general impact on mental health outcomes.

RESULTS

A survival analysis adjusting for relevant demographic covariates revealed an elevated risk of all examined psychiatric disorders in international adoptees: hazard ratios (95% confidence intervals) are 1.21 (1.04-1.41) for AN, 1.60 (1.44-1.79) for OED, 1.90 (1.81-2.00) for MDD, 1.25 (1.09-1.44) for OCD, and 1.69 (1.60-1.78) for anxiety disorders.

CONCLUSIONS

Elevated risk of eating disorders as well as of MDD, OCD, and anxiety disorders was found in international adoptees. A parallel pattern between AN and OCD was observed, which both display less elevated rates than the other diagnoses. A considerable number of biological, environmental, and societal factors have been suggested to explain the observed differences in mental health between adoptees and non-adoptees, but they remain primarily theoretical.

Sleep patterns and insomnia among internationally adopted adolescents

OBJECTIVE

Sleep is essential for adolescent development. We aimed to investigate sleep patterns and insomnia among internationally adopted adolescents compared with their nonadopted peers.

DESIGN

Cross-sectional.

SETTING

Data stem from the population-based youth@hordaland-survey, conducted during winter/spring 2012, in Hordaland, Norway.

PARTICIPANTS

Of the 9846 adolescents who responded to the sleep measures in the youth@hordaland-survey, 44 were identified as international adoptees by linkage to the Central Adoption Registry.

MEASURES

The adolescents provided self-report information on demographic characteristics, mental health problems, and a range of sleep measures.

RESULTS

There were no significant differences between the adoptees and nonadopted peers regarding how much time they spent in bed, but the internationally adopted adolescents reported significantly shorter sleep duration, both on weekdays (d=0.37, P = .014) and weekends (d=0.37, P = .015). The difference was due to the adoptees spending longer time awake after sleep onset (d=0.78, P > .001). Furthermore, 32% of the adopted adolescents fulfilled the DMS-5 criteria for insomnia, compared with 18% of their nonadopted peers (odds ratio 2.06, 95% CI: 1.09-3.90). However, this association was no longer significant after adjusting for symptoms of depression. Adolescents adopted after 12 months of age reported more sleep problems than those who were adopted earlier.

CONCLUSION

The short sleep duration and high occurrence of insomnia among the internationally adopted adolescents suggest both a problem area that should receive more focus and a potential avenue for intervention. The results further suggest that assessing both mental health problems and sleep problems among internationally adopted adolescents who are experiencing difficulties could help target interventions.

Influence of Communicative Openness on the Psychological Adjustment of Internationally Adopted Adolescents

This study evaluated the predictive relationship between the communicative openness and psychological adjustment of adopted adolescents, controlling for preplacement risk factors. One hundred Spanish international adoptees aged 12-18 took part in the study. Data were gathered with a structured interview, the Youth Self Report and the Adoption Communication Scale. A history of maltreatment prior to the adoption was associated with more closed communication between parents and children. Prenatal drug exposure shows a relationship with the presence of externalizing behaviors and attention problems in adolescents. Finally, a lower degree of communicative openness regarding the child's origins was significantly associated with the presence of all the adolescent behavioral problems studied.

Adoption-related feelings, loss, and curiosity about origins in adopted adolescents

Adoption involves strong emotions. From the adoptee's point of view, adoption means not only the gain of a new family but also inevitable losses. This study aims at analyzing adoption-related feelings, which include the feelings of loss and the ensuing curiosity about the birth family and pre-adoption life. A total of 81 adopted adolescents, aged 12-22, adopted at 4 years of age, on average, participated in this study. The data were collected using the Questionnaire of Adoption-related Feelings and the Adopted Adolescents Interview, which allowed for the identification of the experiences, feelings, and attitudes of the adopted adolescents regarding their story before and after adoption, and their feelings towards their birth family. The results showed that most participants did not identify adoption-related losses. Nevertheless, they acknowledged the existence of some aspects of their adoption story that made them feel sad and angry and could identify several difficulties associated with their adoptive status. Participants showed low levels of curiosity even if they were mostly curious about the reasons why they had been placed up for adoption. The adoptees' feelings when thinking about their birth parents, the curiosity regarding their past, and their adoption-related losses predicted their feelings related to the adoption experience. Several implications for the psychological practice with adopted adolescents will be presented.

Parental depressive symptoms as a risk factor for child depressive symptoms; testing the social mediators in internationally adopted children

Parental depressive symptoms have shown to be associated with offspring depression but much of the research has been focused on maternal depression. The aim of our study was to investigate the extent to which depressive symptoms of both parents associate with offspring depressive symptoms and whether social factors mediate these associations using data from adopted children with no shared genetic background. Data were derived from the Finnish Adoption survey study (a subsample of adopted children aged between 9 and 12 years, n = 548). Parental depressive symptoms were measured using short version of the General Health Questionnaire and Children's Depression Inventory (CDI) was used to measure depressive symptoms in adoptees. Paternal depressive symptoms were related to the total CDI (B = 0.33, p = 0.05) and two dimensions of offspring depressive symptoms: negative mood (B = 0.10, p = 0.03) and interpersonal problems (B = 0.06, p = 0.009). These associations remained significant even when adjusted for child's age and gender, age at adoption, type of placement before adoption, continent of birth and adoptive family's SES. No associations were found between maternal and any dimensions of offspring depressive symptoms. No information about the mental health of biological parents was available. We interpret the results as demonstrating that intergenerational transmission of depressive symptoms is not solely related to shared genes. Also, the results highlight the association of paternal depression with offspring depressive symptoms.