In doing some research for booking the next quarter of Creating a Family shows, I decided to check in with one of my favorite adoption researchers, Dr. Matt McGue with the Department of Psychology at the University of Minnesota. Lo and behold I found a study he published on the mental health of adopted adolescents–“The Mental Health of US Adolescents Adopted in Infancy“. Research has been fairly clear that adopted children with a history of prenatal substance exposure or pre-placement deprivation and those who were older when adopted are at heightened risk for all sorts of social, intellectual, and emotional problems. McGue and his fellow researchers set out to determine if those adoptees with no evidence of early deprivation and placed for adoption before two years of age were at an increased risk for mental health problems. They also compared international adoptees to domestic adoptees.
Dr. McGue’s Study
The study focused on 540 non adopted adolescents randomly selected from Minnesota birth records, and 514 international adoptees and 178 domestic adoptees from three large Minnesota adoption agencies. The international adoptees were mostly female (60.3%) and mostly adopted from South Korea (89.7). The domestic adoptees were 41.0% female and 78.7% white. Consistent with Minnesota demographics, 95.6% of the non-adopted adolescents are white and 54.1% are female.
Researchers found that most adolescence adopted as infants are well-adjusted and psychologically healthy. Nevertheless, a subset of adoptees may be at increased risk for externalizing problems and disorders, such as oppositional defiant (ODD) and attention deficit/hyperactivity (ADHD). The odds of being diagnosed as having ADHD and ODD were approximately twice as high in adoptees compared with non-adoptees. There appeared to be no difference between adopted and non-adopted adolescence for internalizing problems (anxiety, withdrawal, depression, and separation anxiety). Domestic adoptees consistently fared worse than international adoptees, and all adopted adolescents were more likely to have had contact with a mental health professional compared with non-adopted adolescents.
The finding that adopted adolescence and children are over represented in those seeking mental health services has been shown in other studies as well. In addition to reflecting the increase tendency toward externalized problems found in this study, it may also in part, be that adoptive parents are more willing to seek help from a mental health professional for their troubled child because they are better educated, or have greater economic resources than many non-adoptive parents, or because they have previously interacted with social service providers in the process of adoption. I also wonder if adoptive parents are on some level more likely to seek help since they fear less the stigma of bad parenting since they can “blame” the child’s problems on adoption, but this is just my speculation. It is also possible that adoptive parents have a lower threshold than the parent of a non-adopted child for what they consider “enough of a problem” to warrant mental health intervention.
Some have speculated that international adoptees would be at increased risk for mental health problems because they are more likely to have been placed in the adoptive home at a late age, experienced pre-placement adversity, and been exposed to post-placement discrimination. However, this was not found in this study. Researchers have hypothesized that two factors might account for the better adjustment of international than domestic adoptees. First, adoptive parents of international adoptees may be better prepared through pre-adoption education to rear an adopted child than the adoptive parents of domestic adoptees. Also domestic adoptees may experience greater prenatal exposure to teratogenic substances or carry a greater genetic risk for mental health problems than international adoptees. This study was not designed to tease out the cause of this discrepancy, however. Also, it is important to note, that the population on international adoptees studies in this research, no longer represents the majority of international adoptees. South Korea has long been known for providing excellent pre-adoption care.
Image credit: GnondPomme
We are adopting Internationally. Our agency has wrap around services and counseling is encouraged for post placement services. For any adoptee, foreign or domestic, there is always some degree of trauma regardless of age, gender or nationality. Something about being abandoned by birth families wounds your heart….even if there was a legitimate reason for it. Most adoptive parents come to adoption wanting to grow their families. It is through the waiting and the adoptive education that we learn about the trauma these children bring with them. If the prospective adoptive parents have been well prepared, they will have looked at their own past scars and dealt with their own trauma. We need to be stable in order to parent these children that come from hard places. Most of the kids in foster care and/or those that are able to be adopted are fearful that they might be abandoned again—the behaviors they might exhibit are cries for help and they use tactics to guard their hearts from being rejected again. Each kid handles it differently. Some will try to be so good around adoptive family, for fear that they might be returned back to foster care. Some kids try to be so rebellious because they want to hurt you before you have a chance to hurt them. Depending on the reason they were placed up for adoption and at what age that occurred will determine the mental health of the child. Adoptive families here and abroad need to be educated on how to best help their child heal from these wounds. All of these children will grow up to be adults some day. We have the opportunity and the responsibility to equip them with the tools not be defined by their past, but to empower them to rewrite the scripts for their future by helping them want to make choices that will enable them to be successful adults. International adoptions take a significantly longer time to process than domestic adoptions. The circumstances and issues vary drastically (language, culture, limited contact with birth family, etc. for international adoptions). We do a disservice to all adoptees by not being prepared to parent kids from hard places and by thinking that raising adoptees will be the same as raising bio kids. In any adoption story there is loss: for the birth family they lose the chance to parent their child, for the adoptive parents there is usually loss in the form of infertility or change in definition of what family really is, but the adoptees lose the most because they are caught in the middle of the choices that adults have made on their behalf. The people that are supposed to give them security and provide for their basic needs, have failed them. To protect themselves from being hurt again, they will try to get their own needs met because they have learned that adults and authority figures are not to be trusted. Adoptive parents have the responsibility to restore their kids’ trust and show them that the past doesn’t define them, it is just a part of their story, and enable them to rewrite their story by showing them a different example of what it means to be a family. Not all adoptive parents do this well. But the goal of every social worker should look out for the best interests of the child. Their mental health and adjustment to growing up into healthy young adults depends on it.
Thanks for sharing your thoughts. Every kid deserves a parent who will meet his or her unique needs — whether adopted or bio, whether mental or emotional or physical needs, etc. We’re glad to read you are going into this adoption with the mindset of parent education and preparedness before bringing home your child. We have some great resources for folks pursuing international adoption that you might appreciate:
—7 Core Issues in Adoption and Foster Care is a FREE online course through our partnership with Jockey Being Family. Use the coupon code JBFSTRONG when you check out. There are a few other free courses there that might pertain to your process as well.
—Evaluating Risk Factors in International Adoption is a good overview of what to expect and what needs are commonly seen in the international adoption community.
–And Typical Behaviors of Children Adopted Internationally is another preview of what to expect, how to address it, and how to prepare your home for kids from abroad.
Finally, our online support group is a great community in which to connect with other waiting parents and learn from peers, adoptees, and birth parents alike.
Best wishes on your path to your child!
All valid points Michelle! I agree with international adoptions also have alcohol exposure- Russia is one and South Korea is another. I was adopted in the 1970’s and my parents had no pre adoptive counseling whatsoever and no home study was done. Obviously things have changed for the better in terms of education for prospective adoptive parents and this is for the good of all involved in adoptions.
I found it fascinating especially the note about domestic adoptees not faring as well as international. I think the reasons you mentioned are a big part of it. Typically with international adoption it is also transracial and thus the adoption is more “out” and it is that conspicuous family and there is so much education required for international adoptions/agencies. I know for our most recent adoption from South Korea in 2010/2011 my husband and I ended up with almost 60 hours of education! This was from many sources including books, online training, webinars, in person seminars and so forth. It does give the adoptive parent an openness to education and seeking help I think. I am an adult adoptee (domestic at nearly 4 years old), adoptive mother of 3 Korean born children and work in the adoption field so I know I have and will continue to use mental health services when I feel it i needed. I think some people in general have a more openness to utilizing services and accessing them. It makes me wonder if that is a quality seen more in international adoptive families- many of the families I work with at least one parent is a teacher, nurse, or social service provider. Like I said I found the article very interesting and see potentials for more specific research questions.
Very interesting!
First ” Also domestic adoptees may experience greater prenatal exposure to teratogenic substances or carry a greater genetic risk for mental health problems than international adoptees”, I find misleading. Have you read anything about Russian adoptees? It really is a country by country thing for a variety of reasons. And Americans are not the only ones with mental illness. Second, they do not indicate if the domestic adoptees are newborn adoptions or foster care adoptions or both. A HUGE thing to consider. And the majority of domestic adoptions are foster care (state ward adoptions). 1) becuase the age of the child at the time of adoption. Disruption/dissolution is just one stat that age matters a lot. Foster care adoptions rarely happens with newborns and are usually older children. They may have also had multiple placements. Also the system will theroretically pay for the assistance in therapy etc.. so it may be sought out more. 2) all children who come through foster care have been removed for neglect, abuse, or abandonment. ( ie.. trauma). Now it ranges trendmedously from child to child and their ability to be resiliant.And their parents ability to parent a child with a history. Nevertheless, without more info this analogy is incomplete. And are we talking about international adoptees adopted under one or any age? Any country? Any era? Likewise for domestic adoptions. With no researh I bet the results of adoptees from 1970s would have different stats than adoptees of 2010s. The good news is regardless of how you adopt the majority of adoptees are just fine. & Kimberly Peck, your agency did a fabulous job in quantity of adoption education. I have seen few adoptive parents- domestic or international-that get that much education. Kudos to them!
I was wondering if people would find it interesting or troublesome.
Michelle M. Hughes Atty said:
First ” Also domestic adoptees may experience greater prenatal exposure to teratogenic substances or carry a greater genetic risk for mental health problems than international adoptees”, I find misleading. Have you read anything about Russian adoptees? It really is a country by country thing for a variety of reasons. And Americans are not the only ones with mental illness. Second, they do not indicate if the domestic adoptees are newborn adoptions or foster care adoptions or both. A HUGE thing to consider. And the majority of domestic adoptions are foster care (state ward adoptions). 1) becuase the age of the child at the time of adoption. Disruption/dissolution is just one stat that age matters a lot. Foster care adoptions rarely happens with newborns and are usually older children. They may have also had multiple placements. Also the system will theroretically pay for the assistance in therapy etc.. so it may be sought out more. 2) all children who come through foster care have been removed for neglect, abuse, or abandonment. ( ie.. trauma). Now it ranges trendmedously from child to child and their ability to be resiliant.And their parents ability to parent a child with a history. Nevertheless, without more info this analogy is incomplete. And are we talking about international adoptees adopted under one or any age? Any country? Any era? Likewise for domestic adoptions. With no researh I bet the results of adoptees from 1970s would have different stats than adoptees of 2010s. The good news is regardless of how you adopt the majority of adoptees are just fine. & Kimberly Peck, your agency did a fabulous job in quantity of adoption education. I have seen few adoptive parents- domestic or international-that get that much education. Kudos to them!
[[Creating a Family blog] at 6:57 pm on May 31, 2012]