Psychological Adjustment in Intercountry and Domestic Adopted Adolescents: A Systematic Review

Understanding if adoptees present a higher risk of developing psychological problems, compared to non-adopted peers, is a research topic that has aroused considerable interest. This paper reviews research results focusing on the psychological adjustment in intercountry and domestic adopted adolescents. Two hundred and fifty-eight publications were initially identified in different databases but, due to previously defined inclusion criteria, only twelve studies, published between January 2004 and June 2016, were analyzed. Results indicate that, when compared to non-adopted peers, these adoptees showed more psychological problems, namely in externalized behaviors, and a higher attendance at mental health services. A considerable relationship was found between the age at adoption and the likelihood of the development of behavioral and emotional problems. Nevertheless, the relevance of taking into account adoption related variables in order to understand the variability of adoptees’ psychological adjustment is also underlined. This systematic review draws attention to the need for further studies in this topic resorting to more complex research designs which will allow for the identification of different pathways that may lead to (mal) adaptive functioning, psychological (mal) adjustment and the wellbeing of adolescent adoptees.     

Anxiety Among an Australian Sample of Young Girls Adopted From China

This study aims to contribute to the body of knowledge about post-adoption functioning of international adoptees by examining patterns of anxiety among young children adopted from China by Australian families. The study had two objectives: to examine anxiety in children adopted from China comparing this sample to available normative data and to examine the associations among child anxiety and child (e.g., age at adoption) and parent (e.g., age, education level) factors. Parents of 59 children adopted from China completed online a number of measures of child anxiety, temperament, and parent psychological well-being. Results indicated a high prevalence of anxiety symptoms among the adopted children when compared with available data from normative samples, particularly related to separation contexts. A number of factors, including inhibited temperament and younger age of parents, were associated with child anxiety. Clinical and research implications are discussed.     

Mental health service utilization in children adopted from US foster care,US private agencies and foreign countries: Data from the 2007 National Survey of Adoption Parents (NSAP)

Aims

In this analysis, we (1) described the rate of mental health service utilization for children from domestic foster care adoption, domestic private adoption, and international adoption and (2) analyzed the effect of common risk factors on mental health service utilization.

Data

As part of the 2007 National Survey on Adoptive Parents (NSAP), parents with children 5–17 years old (N = 1722) were asked if their children had received mental health services and how helpful these services were. Parents also provided data on the children's demographics and likelihood of pre-adoption adversity (e.g., abuse).

Results

For boys, mental health services were utilized by 52.4% of domestic foster care adoptees, 41.0% domestic private adoptees, and 40.0% of international adoptees. For girls, the corresponding rates were 36.3%, 24.8%, and 30.9% respectively. Parents reported that the services were very helpful for about half of the children. Logistic regression analyses showed that adoptees from domestic foster care were more likely than international adoptees to have received mental health services, but there was no difference between domestic private adoptees and international adoptees. Older age at placement, older age at assessment, having special health care needs, and being male all increased the odds for having received mental health services.     

Psychiatric Disorders and Treatment in Adoptees: A Meta-Analytic Comparison with Non-Adoptees

ABSTRACT

This meta-analysis integrates the results of 85 studies on psychiatric disorders and treatment in adoptees and non-adoptees. The risk of adoptees experiencing psychiatric disorders, contact with mental health services, or treatment in a psychiatric hospital was approximately twice as high as that of non-adoptees. Elevated risks were observed for attention-deficit/hyperactivity disorders, anxiety disorders, conduct disorders/oppositional defiant disorders, depression, substance use disorders, and psychoses. Larger effect sizes were, in part, found in clinical studies than in community-based studies, in studies with a higher percentage of individuals adopted after the age of three years and international adoptees, and in older studies.     

Long-term treatment of emotionally disturberd adoptees and their families

A review of literature on outpatient treatment of emotionally disturbed adoptees is presented. Key issues in adoption therapy are discussed. A model featuring long-term support for adoptive children and their families is described with a menu of accompanying clinical strategies. Applications in mental health settings and directions for research are reviewed.     

In Their Own Words: Adopted Persons’ Experiences of Adoption Disclosure and Discussion in Their Families

This study explored adoption disclosure in a sample of 18 adult adoptees who were adopted as infants. A qualitative analysis of semistructured interviews with adoptees was used to learn about participants’ experiences of adoption disclosure. The majority always knew they were adopted, were able to talk openly with parents about adoption, and had positive feelings related to learning about their adoption. Those who were dissatisfied with their disclosures reported that their parents were uncomfortable with discussing adoption and withheld information. Based on the findings, suggestions are provided for parents and adoption professionals on ways to improve the management of the disclosure process.     

Preadoption Risks,Family Functioning,and Adoption Secrecy as Predictors of the Adjustment of Filipino Adopted Children

Using a correlational multivariate research design, partial least squares (PLS) was applied to examine the direct and indirect influence of pre-adoption risks, family functioning, and adoption secrecy on the adjustment (which is defined in this study as the internalizing and externalizing behaviors) of Filipino adopted children. Thirty-two sets of Filipino adoptees and their respective adoptive mothers participated in the study. Family functioning was found to predict the adjustment of Filipino adopted children while adoption secrecy predicted family functioning. Adopted children's perception of their family functioning and adoption openness buffer the impact of the early adversity experienced by the adopted children. Implications on the clinical practice and adoption practices in the Philippines are discussed.     

Identity Development in a Transracial Environment: Racial/Ethnic Minority Adoptees in Minnesota

It has been argued that transracially adopted children have increased risk of problems related to self-esteem and ethnic identity development. We evaluated this hypothesis across four groups of transracial adoptees: Asian (n = 427), Latino (n = 28), Black (n = 6), mixed/other (n = 20), and same-race White adoptees (n = 126) from 357 adoptive families. No mean differences were found in adoptees’ ratings of affect about adoption or of curiosity about birth parents. Some differences were found in general identity development and adjustment. There were notable differences in communication about race/ethnicity across groups and between parent and child report.     

International Adoption: Counseling and the Adoption Triad

Despite a 60-plus–year history of international adoption (IA) placements, the body of research exploring counseling and psychological interventions for those affected by IA is still in its infancy. This critical review of the state of the literature addresses research, theory, and practice relevant to the international adoption triad (adoptive parents, birth parents, and adoptees). We highlight the lack of empirical attention to the clinical needs of birth parents, the tendency to overlook the clinical needs of adoptive parents both pre- and post-adoption, early childhood vulnerability in international adoptees, and adolescent identity challenges and the attendant clinical issues.     

Prevalence and Risk Factors Among Minors for Online Sexual Solicitations and Interactions With Adults

The research on online child sexual victimization has mainly focused on the sexual solicitation of minors (i.e., sexual requests by an adult), with scarce information available on sexual interactions (e.g., cybersex or meeting in person) in which a minor is exploited by an adult. In the present study, we analyzed the prevalence and risk factors associated with both sexual solicitations and interactions of minors with adults. The sample included 2,731 minors between 12 and 15 years old (50.6% female). The minors completed several self-report questionnaires about sexual solicitations and interactions with adults, including possible risk factors (e.g., sociodemographic variables, Internet use, and psychological adjustment). Of the participants, 15.6% of girls and 9.3% of boys reported sexual solicitations, and 8.2% of girls and 7.4% of boys reported sexualized interactions with adults. Among the variables studied, several appeared related to both sexual solicitations and interactions: older age, having been involved in sexting, being a victim of cyberbullying, having unknown people in friends list, using chat, time spent online on a weekday, and depression symptoms. Gender (being female), using video chat, and instant messaging by computer were significant variables for sexual solicitation but not for sexual interaction; participation in online games was significant only for sexual interactions. Finally, minors reporting sexual interactions presented a higher risk profile than those reporting only sexual solicitations. These findings highlight the relevance of distinguishing between sexual solicitations and sexual interactions and suggest important avenues for prevention programs.     

Moral Incongruence and Pornography Use: A Critical Review and Integration

Internet pornography use (IPU) remains a controversial topic within sexual behavior research fields. Whereas some people report feeling dysregulated in their use of pornography, mental health and medical communities are divided as to whether IPU can be addictive. The present review sought to examine this issue more closely, with a focus on how variables other than pornography use, such as moral disapproval and moral incongruence (i.e., feeling as if one’s behaviors and one’s values about those behaviors are misaligned), might specifically contribute to self-perceived problems around pornography use. Through an examination of recent literature, the present work reviews evidence that moral incongruence about IPU is a common phenomenon and that it is associated with outcomes relevant to current debates about pornography addiction. Specifically, moral incongruence regarding IPU appears to be associated with greater distress about IPU, greater psychological distress in general, greater reports of problems related to IPU, and greater reports of perceived addiction to IPU. The implications of this body of evidence for both clinical and research communities are discussed, and future directions for research are considered.     

The Ethnic Identification of Same-Race Children in Intercountry Adoption

Intercountry adoption is a worldwide phenomenon that has been drawing an ever-increasing amount of research attention. The vast majority of that research has focused on transracial adoptive relationships and, in particular, the ethnic socialization and adjustment of children adopted into racially different families. Very little is known about the ethnic identity development of internationally adopted children who are racially similar to their adoptive parents. In the current study, 50 children adopted into New Zealand from Eastern Europe were interviewed on their ethnic self-identification and self-concept. The adoptees scored in the midrange on an ethnic identity scale and in the high range on a self-concept scale. However, no correlation was found between the two indices, suggesting that ethnic self-identification and self-concept operate independent of each other. These results, plus additional data collected during the interviews, are discussed in light of the New Zealand context and as they relate to the transracial adoption literature.     

The effects of adoption openness and type on the mental health,delinquency, and family relationships of adopted youth

ABSTRACT

Analyzing the 2007 National Survey of Adoptive Parents, this study examines the impact of open adoption, demographics, and other factors on adopted children’s mental health, delinquent behavior, and family relationships. Specifically, we compare findings for youth in private and public (i.e., foster care) adoptions and identify key similarities and differences between predictors of children’s well-being across these two types of adoption. We find that youth in open foster care adoptions are more likely to receive an attachment disorder diagnosis than those in closed foster care adoptions but are also more likely to have family relationships characterized by trust and adoptive parents’ willingness to recommend adoption to others. Further, we find children in both public and private adoptions who are older at placement are more likely to have posttraumatic stress disorder diagnoses. For children in private adoptions, no statistically significant predictors affected youths’ delinquency outcomes or family relationships, with the exception of parents of private adoptees in households characterized by lower levels of poverty indicating they would be more likely to recommend adoption to others. The implications of the key findings are discussed with regard to service provision for multiple types of adoptive families.     

Age at Adoption: Long-Term Measures of Success in Adulthood

Older child adoptions are increasing, yet little attention has been paid to the effect of age at adoption in adoptees’ later years. This study examines a relationship between age at adoption and later educational levels as well as socioeconomic status and psychological well-being. The results suggest that adoptees are similar in all assessed areas by their mid 30s, with the exception of educational attainment, regardless of the age at which they were adopted. Findings draw attention to the need for educational support for late-placed adoptees.     

Adoptee Dissimilarity from the Adoptive Family: Clinical Practice and Research Implications

A review of theoretical, clinical, and empirical literature was conducted regarding the effect of adoptee dissimilarity from the adoptive family. There is empirical evidence of a relationship between dissimilarity and searching for birth parents, satisfaction with the adoption, and adjustment. A theory of an effect of identity-seeking on searching by adoptees has also been formulated. It is suggested, therefore, that an effort to establish one's identity may mediate a relationship between adoptee dissimilarity and searching. Implications are presented for social work practice and research, and for public policy and education, in instances of same race and transracial adoption.     

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.     

Behavioral and Socioemotional Adjustment in International Adoptees: A Comparison Between Italian and Spanish Adoptive Parents’ Reports

Dominated by intracultural comparisons between adopted and nonadopted children, adoption research has until now paid little attention to cross-cultural differences in the adoptees’ behavioral and socioemotional adjustment. The present study is aimed at comparing children adopted in two different countries—Italy and Spain—and at verifying, through their parents’ perceptions, the extent to which cultural context may contribute to shaping children's emotional and behavioral problems. A sample of 207 international adoptees (127 Italian and 80 Spanish) aged between 6 and 14 years was studied. The children's adjustment was assessed using the Child Behavior Checklist, which was filled out by the adoptive parents. Results indicated the presence of more similarities than differences between Italian and Spanish subjects: children adopted both in Italy and Spain between 3 and 5 years old were more likely to exhibit behavior problems than were children who entered the adoptive family at any other age. Some differences related to the birth country also emerged.     

Contributing Factors of Adult Adoptees’ Identity Work and Self-Esteem: Family Communication Patterns and Adoption-Specific Communication

Drawing from family communication patterns (FCP) theory and the communication-based conceptual model of adoptive identity work (Colaner & Soliz, 2015), we investigated the ways that families’ adoption-focused communication and general communication environment predict identity work and self-esteem in adult adoptees (n = 143). Specifically, we tested the assumption that FCP (i.e., conversation and conformity orientation) serve as a backdrop for adoption communication openness and adoptive identity work. Structural equation modeling revealed that conversation orientation—but not conformity orientation—significantly predicted adoptive parents’ communicated openness about adoption. Adoption communication openness negatively predicted adoptees’ preoccupation with adoption. Indirect paths between conversation orientation, adoption communication openness, and adoptive identity and self-esteem illuminated the importance of the general communication environment on adoption outcomes. Implications are explored for expanding understanding of adoptive family communication and advancing FCP theory by testing its nature as a context-specific and/or global assessment of family communication.     

Stressful Life Events and Physical and Psychological Health: Mediating Effects of Differentiation of Self in a Spanish Sample

The pathways between differentiation of self and health remain only partly elucidated. This cross‐cultural study sought to test Bowen's hypothesis about the associations between differentiation, stressful life events, and physical and psychological health, in a sample of 466 Spanish adults. Results show that people with higher levels of differentiation were less prone to physical ailments (e.g., heart disease, cancer, or blood disorders) and psychological symptoms (e.g., depression or anxiety). Further, differentiation mediated the association between stress (i.e., perceived negativity of stress in the past year and number of stressful events across the lifetime) and physical and psychological health. The current research provides cross‐cultural empirical evidence for the links between differentiation and mind and body health in a Mediterranean culture.