Mental Health of Adopted Adolescents

Dawn Davenport

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Mental Health of Adopted Adolescents

Dr. Matt McGue’s study looks at the mental health of US adolescents adopted in infancy.

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

29/05/2012 | by Dawn Davenport | Categories: Adoption, Adoption Blog, Blog | 6 Comments



6 Responses to Mental Health of Adopted Adolescents

  1. Kimberly Peck Kimberly Peck says:

    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.

  2. Kimberly Peck Kimberly Peck says:

    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.

  3. Kimberly Peck Kimberly Peck says:

    Very interesting!

  4. 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!

  5. I was wondering if people would find it interesting or troublesome.

  6. 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]

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