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