Are adoptees at increased risk for attempting suicide?

What about trauma? Accounting for trauma exposure and symptoms in the risk of suicide among adolescents who have been adopted

BACKGROUND

Research suggests that individuals who have been adopted are at increased risk for suicidal behaviors, but this research does not account for the role of trauma.

OBJECTIVES

The study provided rates of trauma exposure among individuals who were adopted with child welfare involvement. The study also examined risk of suicidal ideation (SI) and behaviors (SB) based on adoption status, first as bivariate associations and then in context of trauma exposure and symptoms.

PARTICIPANTS AND SETTING

Participants in the LONGSCAN study were recruited at multiple US sites based on various risk factors for maltreatment. The current study included only those individuals with adequate information at key timepoints (n = 894), 106 (11.9%) of whom were adopted.

METHODS

Measures were collected at multiple timepoints, including caregiver-report, self-report, and review of child welfare records. Data were analyzed through logistic regression and descriptive statistics.

RESULTS

High rates of potentially traumatic experiences were found among individuals who were adopted (over 93%). The bivariate logistic regression replicated previous findings that adolescents who were adopted had increased likelihood of endorsing SI (OR 2.14, 95% CI 1.27-3.60, p = .004) and SB (OR 2.40, 95% CI 1.24-4.63, p = .009) compared to non-adopted peers. However, when polytrauma and traumatic stress symptoms were added to the model, adoption was no longer a significant predictor for SI (OR 1.35, 95% CI 0.70-2.60, p = .369) or SB (OR 1.46, 95% CI 0.68-3.13, p = .332).

CONCLUSIONS

Although much remains to be explored about the association between adoption and risk for suicidal thoughts and behaviors, the current study indicates that traumatic stress plays a critical role.

Developmental Change and Time-Specific Variation in Global and Specific Aspects of Self-Concept in Adolescence and Association with Depressive Symptoms

Previous research has demonstrated that adolescents make differential self-evaluations in multiple domains that include physical appearance, academic competence, and peer acceptance. We report growth curve analyses over a seven year period from age 9 to age 16 on the six domains of the Harter Self-Perception Profile for Children. In general, we find little change in self-concept, on average, but do find substantial individual differences in level, rate of change, and time-specific variation in these self- evaluations. The results suggest that sex differences and adoptive status were related to only certain aspects of the participants' self-concept. Depressive symptoms were found to have significant effects on individual differences in rate of change and on time-specific variation in general self-concept, as well as on some of the specific domains of self-concept.

Risk of suicide attempt in adopted and nonadopted offspring

OBJECTIVE

We asked whether adoption status represented a risk of suicide attempt for adopted and nonadopted offspring living in the United States. We also examined whether factors known to be associated with suicidal behavior would mediate the relationship between adoption status and suicide attempt.

METHODS

Participants were drawn from the Sibling Interaction and Behavior Study, which included 692 adopted and 540 nonadopted offspring and was conducted at the University of Minnesota from 1998 to 2008. Adoptees were systematically ascertained from records of 3 large Minnesota adoption agencies; nonadoptees were ascertained from Minnesota birth records. Outcome measures were attempted suicide, reported by parent or offspring, and factors known to be associated with suicidal behavior including psychiatric disorder symptoms, personality traits, family environment, and academic disengagement.

RESULTS

The odds of a reported suicide attempt were ~4 times greater in adoptees compared with nonadoptees (odds ratio: 4.23). After adjustment for factors associated with suicidal behavior, the odds of reporting a suicide attempt were reduced but remained significantly elevated (odds ratio: 3.70).

CONCLUSIONS

The odds for reported suicide attempt are elevated in individuals who are adopted relative to those who are not adopted. The relationship between adoption status and suicide attempt is partially mediated by factors known to be associated with suicidal behavior. Continued study of the risk of suicide attempt in adopted offspring may inform the larger investigation of suicidality in all adolescents and young adults.