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Malcorps S, Vliegen N, Fonagy P, Luyten P. 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. Dev Psychopathol 2024; 36:266-279. [PMID: 36382423 DOI: 10.1017/s0954579422001171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Saskia Malcorps
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Nicole Vliegen
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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2
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Ferrari L, Canzi E, Barni D, Ranieri S, Danioni FV, La Fico G, Rosnati R. COVID-19-Related Stress and Resilience Resources: A Comparison Between Adoptive and non-Adoptive Mothers. Fam J Alex Va 2023; 31:454-463. [PMID: 38603286 PMCID: PMC9465058 DOI: 10.1177/10664807221124251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Despite an increasing interest in how adoptive parents deal with situations appraised as stressful, there is a lack of research regarding adoptive parents' adjustment to the challenges posed by the prolonged COVID-19 pandemic. The current study explores similarities and differences between adoptive and non-adoptive mothers in terms of risks (i.e., COVID-19-related stress) and individual (i.e., sense of coherence [SOC]), couple (i.e., partner's support), parent-child (i.e., parent-child relationship satisfaction), and social (i.e., friends' support) resources in the face of the prolonged COVID-19 pandemic. Specifically, the present study was aimed at predicting which variables discriminate more effectively between the two groups. Participants were 445 Italian mothers (40.9% adoptive mothers), who were asked to fill in an anonymous online survey between May 2021 and October 2021. Results showed that adoptive and non-adoptive mothers reported different resilience resources to face the stressors posed by the health emergency. Specifically, COVID-19 traumatic stress symptoms, parent-child relationship satisfaction, and SOC were found to contribute most in discriminating between the two groups. Findings are discussed in relation to future research developments and practical implications.
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Affiliation(s)
- Laura Ferrari
- Department of Psychology, Family Studies and Research University Centre, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Elena Canzi
- Department of Psychology, Family Studies and Research University Centre, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Daniela Barni
- Department of Human and Social Sciences, Università degli Studi di Bergamo, Bergamo, Italy
| | - Sonia Ranieri
- Department of Psychology, Family Studies and Research University Centre, Università Cattolica del Sacro Cuore, Piacenza, Italy
| | | | - Giuliana La Fico
- Family Studies and Research University Centre, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Rosa Rosnati
- Department of Psychology, Family Studies and Research University Centre, Università Cattolica del Sacro Cuore, Milan, Italy
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3
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Abstract
Children adopted from public care are more likely to experience emotional and behavioural problems. We investigated two aspects of emotion recognition that may be associated with these outcomes, including discrimination accuracy of emotions and response bias, in a mixed-method, multi-informant study of 4-to-8-year old children adopted from local authority care in the UK (N = 42). We compared adopted children's emotion recognition performance to that of a comparison group of children living with their birth families, who were matched by age, sex, and teacher-rated total difficulties on the Strengths and Difficulties Questionnaire (SDQ, N = 42). We also examined relationships between adopted children's emotion recognition skills and their pre-adoptive histories of early adversity (indexed by cumulative adverse childhood experiences), their parent- and teacher-rated emotional and behavioural problems, and their parents' coded warmth during a Five Minute Speech Sample. Adopted children showed significantly worse facial emotion discrimination accuracy of sad and angry faces than non-adopted children. Adopted children's discrimination accuracy of scared and neutral faces was negatively associated with parent-reported behavioural problems, and discrimination accuracy of angry and scared faces was associated with parent- and teacher-reported emotional problems. Contrary to expectations, children who experienced more recorded pre-adoptive early adversity were more accurate in identifying negative emotions. Warm adoptive parenting was associated with fewer behavioural problems, and a lower tendency for children to incorrectly identify faces as angry. Study limitations and implications for intervention strategies to support adopted children's emotion recognition and psychological adjustment are discussed.
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Affiliation(s)
- Amy L Paine
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.
| | | | - Daniel T Burley
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK
| | - Rebecca Anthony
- Wolfson Centre for Young People's Mental Health, Cardiff University; Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences , Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
| | - Katherine H Shelton
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK
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Ligier F, Body Lawson F, Lamourette M, Giguère CE, Lesage A, Séguin M. Comparing Childhood Characteristics of Adopted and Non-adopted Individuals Deceased by Suicide. Front Psychiatry 2022; 13:756306. [PMID: 35722592 PMCID: PMC9203736 DOI: 10.3389/fpsyt.2022.756306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Fabienne Ligier
- McGill Group on Suicide Studies, Montréal, QC, Canada.,Psychiatry Department, Montréal University, Montréal, QC, Canada.,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.,EA 4360 APEMAC, Université de Lorraine, Nancy, France.,PUPEA, Centre Psychothérapique de Nancy, Laxou, France
| | | | | | - Charles-Edouard Giguère
- Banque Signature, Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Alain Lesage
- McGill Group on Suicide Studies, Montréal, QC, Canada.,Psychiatry Department, Montréal University, Montréal, QC, Canada.,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.,Québec Network on Suicide Research, Québec, QC, Canada
| | - Monique Séguin
- McGill Group on Suicide Studies, Montréal, QC, Canada.,Québec Network on Suicide Research, Québec, QC, Canada.,Department of Psychoeducation and Psychology, Québec University, Québec, QC, Canada.,Centre Intégré de Santé et Service Social de l'Outaouais (CISSSO), Gatineau, QC, Canada
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5
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Skandrani S, Moro MR, Harf A. The Search for Origin of Young Adoptees-A Clinical Study. Front Psychol 2021; 12:624681. [PMID: 34366954 PMCID: PMC8346243 DOI: 10.3389/fpsyg.2021.624681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 06/28/2021] [Indexed: 11/13/2022] Open
Abstract
In the current area of social media propagation, the adoptees' search for the birth family is increasingly reversed: more and more adopted adolescents are contacted directly by their birth parents, even if they did not search for them. This study explores the impact of these new forms of contact between adoptive family members and birth family members, through the qualitative analysis of clinical protocols of five adoptive families that sought counseling in a clinical setting devoted to international adoption. The interpretative phenomenological analysis revealed three themes. Two of them shared by the parents and their children: the feelings of anxiety and intrusion, as well as the feelings of guilt and debt. The last theme concerns only the parents: feelings of endangered family relations and can be divided into two sub-themes: feelings of threat by the birth family, feelings of an undermined parental role. Nevertheless, these new kinds of confrontations with the children's origins bear a potential of renegotiating adoptive family relationships and positive effects on mutual feeling of filiation. Exploring the impact of the search of adoptees by the birth family enables professionals involved in adoption to improve preventive and supportive work in the adoption process.
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Affiliation(s)
- Sara Skandrani
- EA 4430, Université Paris Nanterre, Nanterre, France.,Hôpital Cochin, Paris, France
| | - Marie-Rose Moro
- Hôpital Cochin, Paris, France.,Université Paris Descartes, Paris, France.,Université Paris-Saclay, Saint Aubin, France
| | - Aurelie Harf
- Hôpital Cochin, Paris, France.,Université Paris-Saclay, Saint Aubin, France
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6
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Rossman SM, Eddy KT, Franko DL, Rose J, DuBois R, Weissman RS, Dierker LC, Thomas JJ. Behavioral symptoms of eating disorders among adopted adolescents and young adults in the United States: Findings from the Add Health survey. Int J Eat Disord 2020; 53:1515-1525. [PMID: 32701179 DOI: 10.1002/eat.23334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 12/16/2022]
Abstract
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.
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Affiliation(s)
- Setareh M Rossman
- Department of Psychology, Clark University, Worcester, Massachusetts, USA
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Debra L Franko
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Jennifer Rose
- Department of Psychology, Wesleyan University, Middletown, Connecticut, USA
| | - Russell DuBois
- Department of Clinical Research, Blueprint Health, Chicago, Illinois, USA
| | | | - Lisa C Dierker
- Department of Psychology, Wesleyan University, Middletown, Connecticut, USA
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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7
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Harris KM, Halpern CT, Whitsel EA, Hussey JM, Killeya-Jones LA, Tabor J, Dean SC. Cohort Profile: The National Longitudinal Study of Adolescent to Adult Health (Add Health). Int J Epidemiol 2020; 48:1415-1415k. [PMID: 31257425 DOI: 10.1093/ije/dyz115] [Citation(s) in RCA: 192] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2019] [Indexed: 01/17/2023] Open
Affiliation(s)
- Kathleen Mullan Harris
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carolyn Tucker Halpern
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Maternal and Child Health, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eric A Whitsel
- Department of Epidemiology and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jon M Hussey
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Maternal and Child Health, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ley A Killeya-Jones
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Epidemiology Research Team, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joyce Tabor
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah C Dean
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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8
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Aramburu Alegret I, Pérez-Testor C, Mercadal Rotger J, Salamero Baró M, Davins Pujols M, Mirabent Junyent V, Aznar Martínez B, Brodzinsky D. Influence of Communicative Openness on the Psychological Adjustment of Internationally Adopted Adolescents. J Res Adolesc 2020; 30 Suppl 1:226-237. [PMID: 30367705 DOI: 10.1111/jora.12464] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
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.
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Abstract
This study examined the risks and protective factors for experiencing bullying and especially racist bullying among internationally adopted children in Finland. Factors examined were related to children's background, adoptive family, children's social problems and social skills, and their associations with bullying experiences. About 56.9% of children reported bullying victimization and 24.2% racist bullying victimization. Boys were at bigger risk of becoming bullied (B = 0.14, p < .05), as were children with disability (B = 0.11; p < .05). The continent of birth (European; B = 0.51; p < .001) and adoptive family's lower socioeconomic status (SES; B = 0.16; p < .05) were associated with increased victimization. Child's social problems increased the likelihood of victimization for both general (B = 0.59, p < .001) and racist bullying (B = 0.10, p < .001). Child's social skills appeared as a protective factor against general bullying (B = 3.87; p > .001). This study shows that interventions for tackling children's social problems and improving their social skills may reduce children's risk for bullying involvement.
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Affiliation(s)
- Eveliina Holmgren
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
- Metropolia University of Applied Sciences, Finland
| | - Hanna Raaska
- Helsinki University Central Hospital, Department of Child Psychiatry, Finland
| | - Helena Lapinleimu
- Turku University Hospital, Department of Pediatrics and Adolescent Mecicine, Finland
- Turku University, Finland
| | - Marko Elovainio
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
- National Institute for Health and Welfare, Finland
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10
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Yulaf Y, Gümüştaş F. Kurum bakımında yaşayan ve evlat edinilen çocuk ve ergenlerin ruhsal bozukluklar açısından karşılaştırılması. Cukurova Medical Journal 2019. [DOI: 10.17826/cumj.504819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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11
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Grotevant HD, Lo AYH, Fiorenzo L, Dunbar ND. Adoptive identity and adjustment from adolescence to emerging adulthood: A person-centered approach. Dev Psychol 2018; 53:2195-2204. [PMID: 29094980 DOI: 10.1037/dev0000352] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Adopted persons face special challenges in the development of identity, as aspects of their histories may be unknown, making it difficult to construct a coherent narrative linking past, present, and future. Extensive literature on adjustment outcomes for adopted persons indicates an elevated risk for adjustment problems. In this study, a low-risk sample of adopted youth is involved to examine, longitudinally, connections between adoptive identity and adjustment. Participants included 145 adopted youth who participated in Waves 2 (W2: adolescence: mean age = 15.7) and 3 (W3: emerging adulthood: mean age = 25.0) of a longitudinal study with a nationwide sample. Children were placed with same-race adoptive families (over 95% White) as infants through domestic private adoption agencies in the U.S. Internalizing and externalizing behaviors were assessed by the Youth Self Report (W2) and the Adult Self Report (W3). Adoptive identity was assessed by ratings of 6 dimensions coded from interviews which, using cluster analysis, revealed 4 adoptive identity subgroups: unexamined, limited, unsettled, and integrated. Factorial ANCOVA examined mean differences in W3 internalizing problems across identity clusters while controlling for W2 internalizing. The main effect for adoptive identity cluster was significant: F(3, 840.72) = 3.724, p = .011. Adopted adolescents in the unsettled group had significantly higher levels of internalizing problems in emerging adulthood than persons in the unexamined and limited categories. A similar ANCOVA for W3 externalizing behavior was not significant. Identity profiles high in negative affect may be at particular risk of increased levels of internalizing problems. (PsycINFO Database Record
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Affiliation(s)
- Harold D Grotevant
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst
| | - Albert Y H Lo
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst
| | - Lisa Fiorenzo
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst
| | - Nora D Dunbar
- Department of Psychological Sciences, Northern Arizona University
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Jia Y, Konold TR, Cornell D, Huang F. The Impact of Validity Screening on Associations Between Self-Reports of Bullying Victimization and Student Outcomes. Educ Psychol Meas 2018; 78:80-102. [PMID: 29795948 PMCID: PMC5965624 DOI: 10.1177/0013164416671767] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Self-report surveys are widely used to measure adolescent risk behavior and academic adjustment, with results having an impact on national policy, assessment of school quality, and evaluation of school interventions. However, data obtained from self-reports can be distorted when adolescents intentionally provide inaccurate or careless responses. The current study illustrates the problem of invalid respondents in a sample (N = 52,012) from 323 high schools that responded to a statewide assessment of school climate. Two approaches for identifying invalid respondents were applied, and contrasts between the valid and invalid responses revealed differences in means, prevalence rates of student adjustment, and associations among reports of bullying victimization and student adjustment outcomes. The results lend additional support for the need to screen for invalid responders in adolescent samples.
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Affiliation(s)
- Yuane Jia
- University of Virginia, Charlottesville, VA, USA
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13
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Liu Y, Hazler RJ. Predictors of attachment security in children adopted from China by US families: implication for professional counsellors. Asia Pacific Journal of Counselling and Psychotherapy 2017. [DOI: 10.1080/21507686.2017.1342675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Yanhong Liu
- School of Intervention and Wellness, The University of Toledo, Toledo, OH, USA
| | - Richard J. Hazler
- Department of Educational Psychology, Counselling, and Special Education, The Pennsylvania State University, University Park, PA, USA
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14
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Nadeem E, Waterman J, Foster J, Paczkowski E, Belin TR, Miranda J. Long-Term Effects of Pre-Placement Risk Factors on Children's Psychological Symptoms and Parenting Stress Among Families Adopting Children From Foster Care. J Emot Behav Disord 2017; 25:67-81. [PMID: 29263641 PMCID: PMC5734114 DOI: 10.1177/1063426615621050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This exploratory longitudinal study examined behavioral outcomes and parenting stress among families with children adopted from foster care, taking into account environmental and biological risk factors. Child internalizing and externalizing problems and parenting stress were assessed in 82 adopted children and their families at 2 months post-placement, 12 months post-placement, and then yearly until 5 years post-placement. A history of abuse/neglect predicted significantly higher externalizing and internalizing problems at a borderline level of statistical significance. In the initial stages after placement, externalizing problems were significantly higher among children who were 4 years or older at placement versus those who were younger than 4, although differences were no longer significant 5 years post-placement. Statistical trends in parenting stress reflected reduced stress in the first 12 months followed by a plateau for parents who adopted older children and greater stress for parents who adopted younger children. Familiar limitations for observational cohort data apply. Nonetheless, the availability of longitudinal follow-up on a sizable sample of children adopted from foster care adds insight to the psychological dynamics for adoptive families and suggests that families of children adopted from the foster care system may have unique needs for ongoing support around behavioral issues.
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Affiliation(s)
- Erum Nadeem
- Yeshiva University, New York, NY, USA
- New York University School of Medicine, New York City, USA
| | | | - Jared Foster
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
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15
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van Alphen NR, Stewart JG, Esposito EC, Pridgen B, Gold J, Auerbach RP. Predictors of Rehospitalization for Depressed Adolescents Admitted to Acute Psychiatric Treatment. J Clin Psychiatry 2017; 78:592-598. [PMID: 27529444 PMCID: PMC5313382 DOI: 10.4088/jcp.15m10326] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 12/18/2015] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Presently, little is known about what factors predict adolescent psychiatric rehospitalization. Thus, the present study tested whether a battery of demographic and clinical characteristics predicted readmission within 6 months of discharge. METHODS Participants were 165 adolescents (112 females) aged 13-19 years (mean = 15.61, SD = 1.48) admitted to an acute residential treatment program between November 25, 2013, and November 18, 2014. Patients met diagnostic criteria (DSM-IV-TR) for current major depressive disorder or dysthymia. At admission, participants completed a battery of clinical interviews and questionnaires assessing demographics, early life stress, comorbid diagnoses, psychiatric symptoms, suicidality, self-injury, and risky behavior engagement. At discharge, psychiatric symptoms were reassessed. Readmission to the same residential service was monitored over a 6-month period following discharge. RESULTS Overall, 12.1% of adolescents were rehospitalized. We conducted a series of Cox regression survival analyses to test demographic and clinical predictors of patients' time to readmission. More frequent self-injurious behaviors in the month prior to hospitalization was significantly associated with a more rapid time to rehospitalization (β = 0.05, SE = .02, Wald₁ = 4.35, P = .037, OR = 1.05, 95% CI = 1.003-1.10). CONCLUSIONS It is critical to more effectively manage self-injury during the treatment of depressed adolescents, as this is the strongest predictor of later rehospitalization.
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Affiliation(s)
- Nienke R van Alphen
- Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands.,Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA
| | - Jeremy G Stewart
- Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Erika C Esposito
- Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Bryan Pridgen
- Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Joseph Gold
- Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Randy P Auerbach
- McLean Hospital, 115 Mill St, Mailstop 331, de Marneffe Bldg, Room 240, Belmont, MA 02478. .,Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA
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Askeland KG, Hysing M, La Greca AM, Aarø LE, Tell GS, Sivertsen B. Mental Health in Internationally Adopted Adolescents: A Meta-Analysis. J Am Acad Child Adolesc Psychiatry 2017; 56:203-213.e1. [PMID: 28219486 DOI: 10.1016/j.jaac.2016.12.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/19/2016] [Accepted: 12/21/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate whether mental health problems differ between internationally adopted adolescents and their non-adopted peers and examine design and sample characteristics that might underlie differences among studies. METHOD Studies published through August 2015 were collected through Embase, Medline, PsychINFO, Web of Science, ERIC, and Svemed+. Combined effect estimates were calculated using random-effects models. RESULTS Eleven studies investigating 17,919 adoptees and 1,090,289 non-adopted peers were included in the meta-analysis. Internationally adopted adolescents reported more mental health problems across domains than their peers, with effect estimates (standardized mean differences [SMDs]) of 0.16 (95% CI 0.03 to 0.28) for questionnaire-based studies and 0.70 (95% CI 0.50 to 0.90) for register-based studies. They also reported significantly more externalizing difficulties (SMD 0.20, 95% CI 0.03 to 0.38), although the effect estimate for internalizing difficulties was not statistically significant (SMD 0.10, 95% CI -0.03 to 0.24). Studies using categorical measurements of mental health problems, indicating more serious problems, yielded larger effect estimates than continuous measurements (SMD 0.31, 95% CI 0.21 to 0.41; SMD 0.13, 95% CI -0.01 to 0.26, respectively). The difference in mental health problems between international adoptees and their peers was somewhat larger when using parent report compared with self-report. More recent studies (conducted in 1995 and later) yielded larger estimates than older studies, although no significant difference was found for this analysis or subgroup analyses investigating sex and age at adoption. CONCLUSION Although most internationally adopted adolescents are well adjusted, adoptees as a group report higher levels of mental health problems compared with non-adopted peers. This difference should be acknowledged and adequate support services should be made available.
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Affiliation(s)
- Kristin Gärtner Askeland
- Norwegian Institute of Public Health, Bergen and the Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health.
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health
| | | | | | | | - Børge Sivertsen
- Norwegian Institute of Public Health, Bergen and the Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health; Helse Fonna, Haugesund, Norway
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Abstract
This article presents an overview of the practice of adoption to counseling psychologists to promote clinical understanding of the adoption experience and to stimulate research on adoption. The article includes definitions of adoption terminology, important historical and legal developments for adoption, a summary of adoption statistics, conceptualizations of adoption experience, themes and trends in adoption outcome research related to adoptees and birthparents, and selected theoretical models of adoption. The importance of considering social context variables in adoption practice and research is emphasized.
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Le Mare L, Audet K, Kurytnik K. A longitudinal study of service use in families of children adopted from Romanian orphanages. International Journal of Behavioral Development 2016. [DOI: 10.1177/0165025407076436] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Post-adoption service use and unmet service needs were examined longitudinally in three matched groups of children: children adopted from Romanian orphanages following a minimum of eight months' institutional experience (RO: n = 36); children from Romania who were destined for orphanages but were adopted early in infancy (EA: n = 25); and Canadian born non-adopted children (CB: n = 42). Data were collected when the adoptees had been in their adoptive homes for 11 months, at age 4.5 years and 10.5 years. Results indicated higher rates of service use and unmet service needs across time in the RO group. Unmet service needs in the RO group may be due in part to the unique challenges faced by post-institutionalized adoptees. Service use in the EA group jumped significantly at Phase 3, suggesting that the impact of their lesser degree of early deprivation was seen later in development under the additional challenge and stress of the demands of school. Findings, particularly from the EA group, supported the suggestion that adoptive parents have a lower threshold for referring their children for clinical services than do non-adoptive parents. Service needs of adoptees changed over time and those with unmet needs experienced greater challenges than those whose service needs were met.
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Abstract
Using recent data from the American Community Survey, the author investigated how the dynamics of immigration influence our understanding of the adoption-schooling relationship. The results suggest that implications of immigrant and adoption statuses could be understood within specific familial contexts. Thus, no statistical differences were found in the outcomes of foreign-born adoptees in U.S. native families and their peers with immigrant parents. Instead, the most favorable patterns of schooling progress were found among U.S.-born adoptees living in immigrant families. Among immigrants, the analysis indicated similar patterns of achievement among Hispanic and White adoptees that are inconsistent with the predictions of segmented assimilation theory. However, there was a Hispanic disadvantage relative to Whites among immigrant children living with biological and stepparents. The article concludes with a discussion of the implications of these findings for kinship selection and assimilation processes and the contention that alternative theoretical frameworks should be used to understand the implications of adoption status.
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Affiliation(s)
- Kevin J Thomas
- Department of Sociology, The Pennsylvania State University, 211 Oswald Tower, University Park, PA 16801 ( )
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Pedrini L, Sisti D, Tiberti A, Preti A, Fabiani M, Ferraresi L, Palazzi S, Parisi R, Ricciutello C, Rocchi MBL, Squarcia A, Trebbi S, Tullini A, De Girolamo G. Reasons and pathways of first-time consultations at child and adolescent mental health services in Italy: an observational study. Child Adolesc Psychiatry Ment Health 2015; 9:29. [PMID: 26300965 PMCID: PMC4545546 DOI: 10.1186/s13034-015-0060-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 06/18/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND An increasing number of young people have made contact with the Child and Adolescent Mental Health Services (CAMHS). However, only a small proportion of the population with emotional problems, actually seek specialized care. Research concerning the help-seeking process and pathways to care of a clinical sample could help to develop effective health policies to facilitate access to specialized care. AIM To analyze the access pattern for CAMHS, reasons of contact and care pathways of a consecutive sample of first-time patients. Our aim was to analyze the association between source of referral, socio-demographic and clinical variables. METHODS Standardized assessment instruments and information concerning access patterns and care pathways were collected from 399 patients at first-time contact with CAMHS in a Northern Italian Region. RESULTS Most patients were referred to CAMHS by school teachers (36 %) or health professionals (32 %), while only 17 % of the parents sought help by themselves. School issues (50 %) and emotional problems (17 %) were the most frequent reasons for contact. The proportion of first-time contacts with no diagnosis of mental disorder at their first consultation did not differ by source of referral. Parents of children who did not receive a clinical diagnosis of mental disorders described them as "psychosocially impaired" and their condition as "clinically severe" likewise parents of patients who received a psychiatric diagnosis. Patients with externalizing problems were more frequently referred by the parents themselves, while youth with internalizing problems were more often referred through health professionals. Families with non-traditional structures (adoptive, foster care, mono-parental) were more likely to consult CAMHS directly, while immigrant youth were more often referred by teachers. CONCLUSION Socio-demographic and clinical characteristics can affect pathways to care. To improve early access to care for children and adolescents with ongoing mental disorders, a plan for proper action addressed to teachers and health professionals may well be important. This would improve their ability to recognize emotional and behavioral problems and use proper referral pathways, while informative intervention addressed to non-Italian families should inform them about the functioning and the mission of CAMHS.
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Affiliation(s)
- Laura Pedrini
- IRCCS San Giovanni di Dio Fatebenefratelli di Brescia, via Pilastroni 4, Brescia, 25125 Italy
| | - Davide Sisti
- Dipartimento di Scienze Biomolecolari, Università degli Studi di Urbino “Carlo Bo”, Piazza Rinascimento 6, Urbino (PU), 61029 Italy
| | - Alessandra Tiberti
- Servizio Neuropsichiatria Infanzia e Adolescenza, Spedali Civili di Brescia, P.le Spedali Civili 1, Brescia, 25123 Italy
| | - Antonio Preti
- Centro di Psichiatria di Consulenza e Psicosomatica dell’ Azienda Ospedaliero Universitaria di Cagliari, via Ospedale, 09124 Cagliari, Italy ,Dipartimento di Pedagogia Psicologia e Filosofia, Università di Cagliari, Via Mirrionis 1, Cagliari, 09123 Italy
| | - Michela Fabiani
- UONPIA, AUSL di Reggio Emilia, Via Amendola 2, Reggio Emilia, 42100 Italy
| | - Linda Ferraresi
- UONPIA, AUSL di Modena, Via Alessandrini 2, Sassuolo, 41049 Italy
| | - Stefano Palazzi
- UONPIA, AUSL di Ferrara, via Messidoro 20, Ferrara, 44124 Italy
| | - Roberto Parisi
- UONPIA, AUSL di Piacenza, Corso Vittorio Emanuele 169, Piacenza, 29100 Italy
| | | | - Marco B. L. Rocchi
- Dipartimento di Scienze Biomolecolari, Università degli Studi di Urbino “Carlo Bo”, Piazza Rinascimento 6, Urbino (PU), 61029 Italy
| | | | - Stefano Trebbi
- NPI, Az. USL di Bologna, Via Crisalidi 2, Vado (Monzuno), BO 40036 Italy
| | - Andrea Tullini
- Servizio N.P.E.E., Az. USL di Rimini, Via Coriano 38, Rimini, 47921 Italy
| | - Giovanni De Girolamo
- IRCCS San Giovanni di Dio Fatebenefratelli di Brescia, via Pilastroni 4, Brescia, 25125 Italy
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Quevedo K, Johnson AE, Loman MM, Lafavor T, Moua B, Gunnar MR. The impact of early neglect on defensive and appetitive physiology during the pubertal transition: a study of startle and postauricular reflexes. Dev Psychobiol 2015; 57:289-304. [PMID: 25773732 DOI: 10.1002/dev.21283] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 12/10/2014] [Indexed: 11/07/2022]
Abstract
This study tested the effect of early neglect on defensive and appetitive physiology during puberty. Emotion-modulated reflexes, eye-blink startle (defensive) and postauricular (appetitive), were measured in 12-to-13-year-old internationally adopted youth (from foster care or from institutional settings) and compared to non-adopted US born controls. Startle Reflex: adopted youth displayed lower overall startle amplitude across all valences and startle potentiation to negative images was negatively related to severity of pre-adoption neglect. Postauricular reflex (PAR): adopted youth showed larger PAR magnitude across all valences. Puberty: adopted youth showed diminished PAR potentiation to positive images and startle potentiation during mid/late puberty versus the opposite pattern in not-adopted. Early neglect was associated with blunted fast defensive reflexes and heightened fast appetitive reflexes. After puberty, early neglected youth showed physiological hyporeactivity to threatening and appetitive stimuli versus heightened reactivity in not adopted youth. Behavioral correlates in this sample and possible neurodevelopmental mechanisms of psychophysiological differences are discussed.
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Affiliation(s)
- Karina Quevedo
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
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Baker M, Biringen Z, Meyer-Parsons B, Schneider A. EMOTIONAL ATTACHMENT AND EMOTIONAL AVAILABILITY TELE-INTERVENTION FOR ADOPTIVE FAMILIES. Infant Ment Health J 2015; 36:179-92. [DOI: 10.1002/imhj.21498] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Langrehr KJ, Yoon E, Hacker J, Caudill K. Implications of Transnational Adoption Status for Adult Korean Adoptees. Journal of Multicultural Counseling and Development 2015. [DOI: 10.1002/j.2161-1912.2015.00061.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Eunju Yoon
- Counseling Psychology Program, Loyola University Chicago
| | | | - Kathy Caudill
- Department of Emergency and Urgent Care, Northwestern Memorial Hospital, Chicago, Illinois
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Merz EC, McCall RB, Wright AJ. Attention and language as mediators of academic outcomes following early psychosocial deprivation. International Journal of Behavioral Development 2013. [DOI: 10.1177/0165025413490867] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Children adopted from institutions at older ages are at increased risk of persistent attention problems, lower cognition, and academic difficulties. This study examined cognitive and behavior problems as mediators of the association between early psychosocial deprivation and academic functioning. Participants were 8–17-year-old children adopted from psychosocially-depriving Russian institutions after 14 months of age ( n = 34) and before 9 months of age ( n = 39). Children completed a cognitive assessment, while their parents completed questionnaires on child behavior problems and use of learning support services in school. Children adopted after 14 months were found to have significantly lower vocabulary, higher levels of attention problems, and higher rates of using learning support services relative to children adopted before 9 months after controlling for age at assessment. The two groups did not differ significantly in nonverbal reasoning, anxiety, or oppositional behavior. Attention and vocabulary significantly mediated the association of early psychosocial deprivation with the use of learning support services. These findings suggest that interventions targeting attention regulatory and language skills may be beneficial in terms of improving school performance in this population.
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Affiliation(s)
- Emily C. Merz
- University of Texas Health Science Center at Houston, USA
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Raaska H, Elovainio M, Sinkkonen J, Matomäki J, Mäkipää S, Lapinleimu H. Internationally adopted children in Finland: parental evaluations of symptoms of reactive attachment disorder and learning difficulties - FINADO study. Child Care Health Dev 2012; 38:697-705. [PMID: 21827526 DOI: 10.1111/j.1365-2214.2011.01289.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study investigated the association between psychological symptoms, such as features of reactive attachment disorder (RAD), and learning difficulties among international adoptees in Finland. METHODS The data for this study came from the FINnish ADOption (FINADO) study covering all internationally adopted children in Finland (n= 1450), with a response rate of 55.7%. The subsample consisted of 395 adopted children aged 9-15 (51.6% girls, 48.4% boys). Learning difficulties were evaluated by a screening questionnaire 'Five To Fifteen' and symptoms of RAD by FINADO RAD scale. RESULTS The parents estimated that one-third (33.4%) of the internationally adopted children had some, and 12.7% had severe learning difficulties, i.e. three and six times more than in normal population, respectively. RAD symptoms at the time of adoption were associated with learning difficulties at school age (OR 4.57, 95% CI 2.57-8.13). CONCLUSIONS Learning difficulties are common among internationally adopted children in Finland and symptoms of RAD are associated with a child's learning difficulties.
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Affiliation(s)
- H Raaska
- Department of Child Psychiatry, Helsinki University Hospital, Finland.
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Laubjerg M, Petersson B. Juvenile delinquency and psychiatric contact among adoptees compared to non-adoptees in Denmark: a nationwide register-based comparative study. Nord J Psychiatry 2011; 65:365-72. [PMID: 21332296 DOI: 10.3109/08039488.2011.558115] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Research stresses that adoptees are at high risk of psychiatric contact, but are they also more likely to be at risk of juvenile delinquency? The aim is to clarify whether the variable "adoptee" is an independent risk factor for criminal conviction and to highlight relationships between convictions and their relapses and psychiatric contacts. METHOD A nationwide comparative register-based study, 1994-2004. The cohort is composed of 282,986 individuals aged 15-27, Danish and foreign born (immigrants); 1.3% are adoptees, included adopted stepchildren. RESULTS The variable "adoptee" is not a risk factor for transnational adoptees and Danish ≤12 months at adoption, but Danish adoptees >12 months at adoption and adopted stepchildren have a 3-4 times higher risk than non-adoptees. However, "country of origin" has a negative impact on foreign-born adoptees and foreign-born non-adoptees. "Age at adoption", "psychiatric contact" and "not living with parents" (at time of inclusion) are risks of conviction and conviction relapse. Boys are at higher risk than girls, but girls' psychiatric contact is highest. Stepchildren are an overlooked risk group. CONCLUSION "Adoptee", as such, is not a risk factor for convictions, but it seems that it is the way adoption-related matters are handled. Gender-specific care for children and adolescents with new thinking in relation to child relinquishment, institutionalization and mental health care is important to ensure both boys and girls a youth free of crime.
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Affiliation(s)
- Merete Laubjerg
- Unit of Women and Gender Research in Medicine, Section of General Practice, Institute of Public Health, University of Copenhagen, Denmark
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Aratani Y, Cooper JL. Racial and Ethnic Disparities in the Continuation of Community-Based Children’s Mental Health Services. J Behav Health Serv Res 2012; 39:116-29. [DOI: 10.1007/s11414-011-9261-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Nilsson R, Rhee SH, Corley RP, Rhea SA, Wadsworth SJ, Defries JC. Conduct Problems in Adopted and Non-adopted Adolescents and Adoption Satisfaction as a Protective Factor. Adopt Q 2011; 14:181-198. [PMID: 22259226 PMCID: PMC3259118 DOI: 10.1080/10926755.2011.608030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The present study compared the level of conduct problems at age 17 in a large, non-clinical sample of adopted participants placed in infancy and children in non-adoptive families matched to the adoptive families on demographic characteristics. Higher levels of adolescent and parent adoption satisfaction were associated with lower levels of conduct problems. Gender by adoption status interactions were not significant. However, female adopted participants had higher levels of conduct problems than female non-adopted participants, whereas male adopted and non-adopted participants had similar levels of conduct problems. In the overall sample, differences between adopted and matched control participants on all conduct problem measures were nonsignificant.
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Wiik KL, Loman MM, Van Ryzin MJ, Armstrong JM, Essex MJ, Pollak SD, Gunnar MR. Behavioral and emotional symptoms of post-institutionalized children in middle childhood. J Child Psychol Psychiatry 2011; 52:56-63. [PMID: 20649913 PMCID: PMC2978793 DOI: 10.1111/j.1469-7610.2010.02294.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Experience in institutional/orphanage care has been linked to increased mental health problems. Research suggests that children adopted from institutions experience specific difficulties related to inattention/overactivity. Evidence of internalizing and conduct problems relative to non-adopted peers has been found in early childhood and early adolescence, but problems may not differ from other adopted children. This study clarifies the understanding of behavioral and emotional symptoms of post-institutionalized (PI) children during middle childhood. METHODS Eight- to eleven-year-old PI children (n=68) and two comparison groups, children internationally adopted from foster care (n=74) and non-adopted children (n=76), and their parents completed the MacArthur Health and Behavior Questionnaire related to attention-deficit/hyperactivity disorder (ADHD), externalizing, and internalizing symptoms. Group means for symptom level and number of children with symptoms above clinical cutoffs were compared. RESULTS PI children displayed an increased level of ADHD symptoms per parent report. PI child and parent report indicated a higher number of PI children above clinical ADHD cutoff. Both groups of internationally adopted (IA) children had higher levels of externalizing symptoms relative to non-adopted children, with parent report indicating higher numbers of IA children above the externalizing clinical threshold. Informants differed in their report of internalizing symptoms. Parents indicated that both IA groups displayed increased internalizing symptom levels and greater numbers above clinical threshold; however, children reported this to be true only for the PI group. CONCLUSIONS PI children differ from non-adopted peers across symptom domains in middle childhood. Whether these concerns were more broadly associated with international adoption rather than institutional care depended on symptom domain and informant. An understanding of this variability may be beneficial for treatment and intervention.
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Affiliation(s)
- Kristen L. Wiik
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Michelle M. Loman
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | | | | | - Marilyn J. Essex
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Seth D. Pollak
- Department of Psychology and Waisman Center, University of Wisconsin, Madison, WI, USA
| | - Megan R. Gunnar
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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Ierago L, Malsol C, Singeo T, Kishigawa Y, Blailes F, Ord L, Florsheim P, Phillips L, Kuartei S, Tiobech J, Watson B, Ngiralmau H. Adoption, family relations and psychotic symptoms among Palauan adolescents who are genetically at risk for developing schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2010; 45:1105-14. [PMID: 19885633 DOI: 10.1007/s00127-009-0154-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Accepted: 10/01/2009] [Indexed: 11/28/2022]
Abstract
PURPOSE This paper focuses on the role of adoption and family relations as moderators of genetic risk for psychotic disorders. METHODS Participants included 184 adolescents in the Republic of Palau identified to be at genetic risk for schizophrenia and other psychotic disorders. Palau is an island nation in Micronesia with a lifetime prevalence of 1.99% for schizophrenia and 2.67% for psychotic disorders more broadly defined. In Palauan culture, kinship adoption is a common cultural practice; 47 of the 184 participants had been adopted at an early age. The current study was designed to test the hypothesis that adoption would function as a protective factor among Palauan youth at genetic risk for the development of psychotic symptoms. Participants were evaluated for psychotic and other psychiatric symptoms using KSADS-PL. Concurrently, the Youth Self Report was used to assess the perceived quality of family relationships. RESULTS Results indicated that adopted adolescents were more likely to develop psychotic symptoms than non-adopted adolescents. However, perceived family relations moderated the association between adoption status and psychotic symptoms, such that adopted adolescents with poorer family relations reported disproportionately higher rates of psychotic symptoms. Family relations also moderated the association between level of genetic risk and psychotic symptoms, independently of adoption status. CONCLUSION Consistent with previous research, adolescents at high genetic risk who reported more positive family relations also reported fewer psychotic symptoms.
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Affiliation(s)
- Laura Ierago
- Palau Youth Project, Ministry of Health, P. O. Box 6027, Koror 96940, Palau
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Ji J, Brooks D, Barth RP, Kim H. Beyond preadoptive risk: The impact of adoptive family environment on adopted youth's psychosocial adjustment. Am J Orthopsychiatry 2010; 80:432-442. [PMID: 20636948 DOI: 10.1111/j.1939-0025.2010.01046.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Adopted children often are exposed to preadoptive stressors--such as prenatal substance exposure, child maltreatment, and out-of-home placements--that increase their risks for psychosocial maladjustment. Psychosocial adjustment of adopted children emerges as the product of pre- and postadoptive factors. This study builds on previous research, which fails to simultaneously assess the influences of pre- and postadoptive factors, by examining the impact of adoptive family sense of coherence on adoptee's psychosocial adjustment beyond the effects of preadoptive risks. Using a sample of adoptive families (n = 385) taking part in the California Long Range Adoption Study, structural equation modeling analyses were performed. Results indicate a significant impact of family sense of coherence on adoptees' psychosocial adjustment and a considerably less significant role of preadoptive risks. The findings suggest the importance of assessing adoptive family's ability to respond to stress and of helping families to build and maintain their capacity to cope with stress despite the sometimes fractious pressures of adoption.
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Affiliation(s)
- Juye Ji
- School of Social Work, College of Human Ecology, Syracuse University, Syracuse, NY 13244, USA.
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Habersaat S, Tessier R, Larose S, Nadeau L, Tarabulsy G, Moss E, Pierrehumbert B. Adoption, adolescence et difficultés de comportement : quels facteurs de risque ? Annales Médico-psychologiques, revue psychiatrique 2010. [DOI: 10.1016/j.amp.2009.03.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
The current article provides a review of adoption research since its inception as a field of study. Three historical trends in adoption research are identified: the first focusing on risk in adoption and identifying adoptee—nonadoptee differences in adjustment; the second examining the capacity of adopted children to recover from early adversity; and the third focusing on biological, psychosocial, and contextual factors and processes underlying variability in adopted children’s adjustment. Suggestions for future areas of empirical investigation are offered, with an emphasis on the need to integrate research, policy, and practice.
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Affiliation(s)
| | - David Brodzinsky
- Evan B. Donaldson Adoption Institute and Rutgers University, USA
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Abstract
OBJECTIVE Children adopted internationally from institutions are a growing population presenting to professional care providers. Although postinstitutionalized (PI) children are adopted from multiple world regions, current knowledge is predominantly based on those adopted from Romania and Eastern European countries. This study examines and compares developmental outcomes of PI children adopted from multiple world regions. METHOD Five to 11 years after adoption, 8- through 11-year-old PI children (N = 91), children internationally adopted early from foster care (N = 109), and nonadopted children (N = 69) completed screening measures assessing vision, hearing, growth, and cognitive and language abilities. Parents completed questionnaires on service utilization, school performance, preadoptive history, and postadoption environment. RESULTS Forty-four percent of PI children's growth was stunted (height <10th percentile) at adoption. At assessment, although physically smaller, nearly all PI children had average growth parameters. Relative to nonadopted children and children adopted early from foster care, PI children performed more poorly on cognitive and language screens with increased time in institution related to lower performance. Notably, group means on these measures were within the average range. PI children were more likely to be falling behind academically and to use intervention services. Family environment did not differ between PI and nonadopted children. There were few differences for PI children by world region of adoption once accounting for duration of institutionalization. CONCLUSIONS Despite currently living in similar environments, PI children have specific needs that differ from early-adopted and nonadopted children. Consideration of multiple factors, including length of institutionalization, is essential when providing care for these children.
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Laubjerg M, Christensen AM, Petersson B. Psychiatric status among stepchildren and domestic and international adoptees in Denmark. A comparative nationwide register-based study. Scand J Public Health 2009; 37:604-12. [DOI: 10.1177/1403494809105799] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims: To investigate adoptees’ psychiatric contact compared with non-adoptees and to clarify the related diagnoses. Method: Observational, nationwide, register-based study, where correlations between psychiatric, demographic and socioeconomic variables were analyzed for adoptees compared with non-adoptees. The study period is 1992—2008. The setting is Denmark, encompassing seven different types of adoptees registered from 1988 to 2005 (n = 13,524). The non-adoptees (n = 839,989) are matched on sex, age and residence. Various comparison models are designed: one with delayed entries (17 years) shows a 5.0% psychiatric contact prevalence for non-adoptees and 9.2% for adoptees (adjusted odds ratio: 2.91). Another design without delayed entries (2 years) shows a 2% prevalence for non-adoptees and 3.9% for adoptees (adjusted odds ratio 2.65). p-values <0.0005. Results: Only one type of adoptee: ‘‘registered partner’s adoption of the other partner’s child’’ has a lower risk than non-adoptees (odds ratio: 0.26). Comparison within the same birth region shows a significant increased risk for most adoption types. More adoptees than non-adoptees have more than one contact. Age at adoption is an additional risk factor for4one year only. The most frequent diagnosis is ‘‘Inherent or acquired brain suffering’’ (ICD-10: F50 — F99). Conclusions: The results stress that ‘‘adoptee’’ is an independent risk factor for psychiatric contact for international as well as for Danish adoptees. Danish stepchildren have a higher risk than non-adopted Danish children, while ‘‘registered partner’s child adopted by the other partner’’ have a lower risk than non-adopted Danish children.
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Affiliation(s)
- Merete Laubjerg
- University of Copenhagen, Institute of Public Health, Section of General Practice, Unit of Women and Gender Research in Medicine, Copenhagen, Denmark,
| | - Anne Maj Christensen
- University of Copenhagen, Institute of Public Health, Section of General Practice, Unit of Women and Gender Research in Medicine, Copenhagen, Denmark
| | - Birgit Petersson
- University of Copenhagen, Institute of Public Health, Section of General Practice, Unit of Women and Gender Research in Medicine, Copenhagen, Denmark
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Siira V, Wahlberg KE, Miettunen J, Läksy K, Tienari P. MMPI measures as signs of predisposition to mental disorder among adoptees at high risk for schizophrenia. Psychiatry Res 2008; 158:278-86. [PMID: 18272233 DOI: 10.1016/j.psychres.2006.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2005] [Revised: 02/24/2006] [Accepted: 12/07/2006] [Indexed: 11/27/2022]
Abstract
The DSM-III-R diagnoses of a group of adoptees were predicted by the MMPI (Minnesota Multiphasic Personality Inventory) schizophrenia-related scales in the Finnish Adoptive Family Study. The sample consisted of 60 high-risk (HR) adopted-away offspring of biologic mothers with a diagnosis of broad schizophrenia spectrum and 76 low-risk (LR) control adoptees. They were assessed with the MMPI before the onset of any psychiatric disorder at a mean age of 24 years. High scores on the Psychopathic Deviate scale predicted psychiatric disorder at 11-year follow-up. Furthermore, LR adoptees', but not HR adoptees', mental disorders could be predicted with the MMPI scales Psychopathic Deviate and Golden-Meehl Indicators. These scales measure schizophrenia-related personality traits, including a social behavior, anhedonia, ambivalence, interpersonal aversiveness, and formal thought disturbances.
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Abstract
INTRODUCTION International adoption involves more than 40 000 children a year. The objective of this review is to estimate the effects of international adoption on externalizing behaviour problems during adolescence. In this paper we examine the prevalence of externalizing problem behaviours in samples of adolescents who were adopted from a foreign country as infants or young children, compare to non-adopted adolescents. SETTING We searched Medline, Inist and psycInfo from 1960 to 2005 using the terms adopt* combined with behaviour problem, behaviour disorder, maladjustment or mental health. METHODS The search was limited to English and French-language publications. Studies that were selected involved adoptees in the general population and compared international adoptees with non-adopted controls. Adoptees from 12 to 22 years old were included. We included studies using the Child Behaviour Check List or related measures to measure externalizing problem behaviour. We reviewed 10 studies from 1990 to 2002 and 2 meta-analyses (2003, 2005). RESULTS Results indicate that 6 studies conclude that internationally adopted adolescents exhibit more externalizing behaviour problems than do non-adopted adolescents, and 4 studies conclude that there is no difference between the two groups. The two meta-analyses concluded that the prevalence of externalizing behaviour problems is increased. The difference, however, is small. International adoptees with preadoption adversity showed more externalizing problems than international adoptees whithout evidence of extreme deprivation. CONCLUSION Finally, it should be stressed that adoption itself is not a risk factor in the adjustment of adolescents. Differences between groups of adopted and non-adopted adolescents may reflect the presence of a small number of severely disturbed adolescents, possibly with extremely adverse pre-placement histories.
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Affiliation(s)
- A Harf
- Service de Psychopathologie de l'Enfant et de l'Adolescent et de Psychiatrie Générale (Professeur Marie-Rose Moro), Hôpital Avicenne (APHP), Université Paris XIII
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Elmund A, Melin L, von Knorring AL, Proos L, Tuvemo T. Relation problems in internationally adopted juvenile delinquents. Ups J Med Sci 2007; 112:105-21. [PMID: 17578813 DOI: 10.3109/2000-1967-100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Internationally adopted delinquents are overrepresented in juvenile Swedish institutions. With the purpose of investigating possible reasons for this overrepresentation, this study compared adopted delinquent adolescents and internationally adopted controls in the structure and functioning of their current relations, especially with their parents. METHODS Internationally adopted adolescents admitted to institutional care (N=20) and non-delinquent internationally adopted controls (N=21) were compared through: a questionnaire; "family relations", a subscale in I think I am; "Family climate" (from Karolinska Scale of Personality); Individual Schedule of Social Interaction; and an Attachment Test. RESULTS Bad relations with adoptive parents were more prevalent in internationally adopted delinquents compared to internationally adopted controls. Furthermore, the adopted delinquents and their parents blamed each other for the problems and the adopted delinquents reported physical and emotional abuse. CONCLUSIONS Internationally adopted delinquents reported more problems in their relationships to their parents than adopted controls did.
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Affiliation(s)
- Anna Elmund
- Department of Women's and Children's Health, Uppsala University, University Hospital, Uppsala, Sweden.
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van Ijzendoorn MH, Juffer F. The Emanuel Miller Memorial Lecture 2006: adoption as intervention. Meta-analytic evidence for massive catch-up and plasticity in physical, socio-emotional, and cognitive development. J Child Psychol Psychiatry 2006; 47:1228-45. [PMID: 17176378 DOI: 10.1111/j.1469-7610.2006.01675.x] [Citation(s) in RCA: 174] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Adopted children have been said to be difficult children, scarred by their past experiences in maltreating families or neglecting orphanages, or by genetic or pre- and perinatal problems. Is (domestic or international) adoption an effective intervention in the developmental domains of physical growth, attachment security, cognitive development and school achievement, self-esteem, and behaviour problems? METHOD Through a series of meta-analyses on more than 270 studies that include more than 230,000 adopted and non-adopted children and their parents an adoption catch-up model was tested. RESULTS Although catch-up with current peers was incomplete in some developmental domains (in particular, physical growth and attachment), adopted children largely outperformed their peers left behind. Adoptions before 12 months of age were associated with more complete catch-up than later adoptions for height, attachment, and school achievement. International adoptions did not lead to lower rates of catch-up than domestic adoptions in most developmental domains. CONCLUSIONS It is concluded that adoption is an effective intervention leading to massive catch-up. Domestic and international adoptions can be justified on ethical grounds if no other solutions are available. Humans are adapted to adopt, and adoption demonstrates the plasticity of child development.
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Nickman SL, Rosenfeld AA, Fine P, Macintyre JC, Pilowsky DJ, Howe RA, Derdeyn A, Gonzales MB, Forsythe L, Sveda SA. Children in adoptive families: overview and update. J Am Acad Child Adolesc Psychiatry 2005; 44:987-95. [PMID: 16175103 DOI: 10.1097/01.chi.0000174463.60987.69] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To summarize the past 10 years of published research concerning the 2% of American children younger than 18 years old who are adoptees. METHOD Review recent literature on developmental influences, placement outcome, psychopathology, and treatment. RESULTS Adoption carries developmental opportunities and risks. Many adoptees have remarkably good outcomes, but some subgroups have difficulties. Traditional infant, international, and transracial adoptions may complicate adoptees' identity formation. Those placed after infancy may have developmental delays, attachment disturbances, and posttraumatic stress disorder. Useful interventions include preventive counseling to foster attachment, postadoption supports, focused groups for parents and adoptees, and psychotherapy. CONCLUSIONS Variables specific to adoption affect an adopted child's developmental trajectory. Externalizing, internalizing, attachment, and posttraumatic stress disorder symptoms may arise. Child and adolescent psychiatrists can assist both adoptive parents and children.
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Abstract
This study addresses the controversy of whether adopted adolescents are at risk for more mental health problems than the nonadopted and specifically evaluates differences in suicide ideation and depression. Same gender comparisons were made between 346 adopted adolescents and nearly 14,000 others living with biological parents, with nationally representative data from the National Longitudinal Study of Adolescent Health. Results showed few divergences in suicide ideation, attempts, and depression between adopted and nonadopted adolescents and young adults. Future studies employing this same dataset will need to pay closer attention to the high percentages of respondents adopted by blood relatives, which only became known with the collection of the Wave III Add Health data.
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Affiliation(s)
- William Feigelman
- Department of Sociology, Nassau Community College, Garden City, NY 11530, USA.
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Juffer F, Stams GJJM, van Jzendoorn MHI. Adopted children's problem behavior is significantly related to their ego resiliency, ego control, and sociometric status. J Child Psychol Psychiatry 2004; 45:697-706. [PMID: 15056302 DOI: 10.1111/j.1469-7610.2004.00264.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Many studies have documented that adopted children are at higher risk for behavior problems, but less is known about the correlates of their problem behavior. METHOD The correlates of parent-reported and teacher-reported problem behavior in 7-year-old internationally adopted children (N = 176) were investigated by examining these children's ego resiliency, ego control, and sociometric status, and exploring possible risks factors in the home and racial influences. RESULTS Using the 25th percentiles lowest and highest scores on ego resiliency and ego control as cut-off criteria, we found that: (1) resilient children were almost free of behavior problems; (2) overcontrolling children showed predominantly internalizing behavior problems (33% at school, and 28% at home); (3) undercontrolling children showed high rates of externalizing behavior problems (50% at school, and 34% at home), and an elevated rate of comorbidity (21% at school, and 21% at home). Adopted children identified by peer report as controversial or rejected had significantly higher externalizing problem scores than popular, average or neglected adopted children. The adopted children did not experience much (racial) discrimination. Nevertheless, children who wished to be white (46%) presented more mother-reported behavior problems. CONCLUSIONS Our findings replicate R.W. Robins et al.'s (1996) work on three types of personality functioning: resilients, overcontrollers and undercontrollers (identified by J. Block, 1971), extending the model from adolescent boys to school-aged boys and girls, adopted from Asia and South America. The wish to identify with white parents and white peers may constitute a potential risk factor for internationally adopted children in middle childhood.
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Affiliation(s)
- Femmie Juffer
- Leiden University, Center for Child and Family Studies, The Netherlands.
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Abstract
BACKGROUND Many intercountry adoptees are reaching adolescence in western Europe and the USA, and the mental health and social adjustment of these individuals as adolescents and young adults has now become an important issue. We aimed to assess mental health disorders and social maladjustment in adolescence and young adulthood in intercountry adoptees in Sweden. METHOD Our data was obtained from the Swedish national registers for the cohort born in 1970-79. We used multivariate Cox's regression models of person-years to compare indicators of suicide death (1986-95), court sentences (1986-93), and discharges for psychiatric illness, suicide attempts, and substance abuse (1987-94) in 11,320 intercountry adoptees with 2343 Swedish-born siblings, 4006 immigrant children, and a general population of 853 419 Swedish-born residents. FINDINGS After adjustment for major sociodemographic confounders, intercountry adoptees were more likely than other Swedish-born children to die from suicide (odds ratio 3.6, 95% CI 2.1-5.9); attempt suicide (3.6, 3.1-4.2); be admitted for a psychiatric disorder (3.2, 2.9-3.6), drug abuse (5.2, 2.9-9.3) or alcohol abuse (2.6, 2.0-3.3); or to commit a crime (1.6, 1.5-1.7). Siblings in adoptive homes had lower odds ratios for most outcomes than did adoptees, whereas adoptees and immigrant children had much the same odds ratios. INTERPRETATION Adoptees in Sweden have a high risk for severe mental health problems and social maladjustment in adolescence and young adulthood. We advise professionals to give appropriate consideration to the high risk of suicide in patients who are intercountry adoptees.
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Affiliation(s)
- Anders Hjern
- Centre for Epidemiology, National Board of Health and Welfare, Stockholm, Sweden.
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Abstract
Adoption, whether formal or informal, has always been a superior method of assuring survival for children whose parents are unwilling or unable to care for them. However, adoption can also affect child development in profound ways. Data collected over the past three decades support adoption as a superior means of promoting normal development in children permanently separated from birth parents. Out of calamity and loss, children recover and progress to become functionally and emotionally competent adults. For children suffering severe neglect or abuse in early life, an adoptive family is a remarkable environment for healing emotional and physical trauma and reversing developmental deficits.
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Affiliation(s)
- Dana E Johnson
- Mayo Mail Code 211, 420 Delaware Street SE, Minneapolis, MN 55455, USA.
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