Adoptees More Likely to be Troubled

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Memo to Angelina Jolie and Brad Pitt: the next decade may prove to be a difficult one. As the world's most famous adoptive parents, the actors may be alarmed to hear that a new study shows being adopted approximately doubles the odds of an adolescent being diagnosed with a behavior or emotional problem. Furthermore, the findings open up the question of what's behind that increased risk — adoptive parents or genetics?

Americans adopt about 120,000 children each year, and the vast majority grows up happy and healthy. Yet researchers at the University of Minnesota have found that a small minority of those kids — about 14 percent — are diagnosed with a behavioral disorder or have contact with a mental health professional as adolescents, or about twice the odds that non-adopted teens face. "Despite the popularity of adoption, there is persistent concern that adopted children may be at a heightened risk for mental health or adjustment problems," the study's authors write in a report released Monday.

That's in line with what previous adoption research has said for many years. What this new study challenges are the reasons behind this phenomenon. In the past, most researchers have dismissed the adoptees' disproportionate number of behavioral or mental health problems as a result of adoptive parents' demographic trends. That is, since people who adopt tend to be wealthier and more educated, they are likelier to access psychiatric care if their kids exhibit symptoms of, say, attention-deficit/hyperactivity disorder (ADHD). Also, through the adoption process, these parents are generally more familiar with mental health services than non-adoptive parents. Yet after studying more than a thousand children, both adopted and not, Margaret Keyes warns that assumption may be flawed. The Minnesota psychologist and her colleagues found that disparity could be due as often to innate factors such as perinatal care or his birth parents' genes. "The deleterious effects may quite possibly have come before the adoption ever took place," Keyes, the study's lead researcher, says.

Keyes's team was able to make this distinction largely due to its methodology. Whereas most adoption research relies on questionnaires filled in by parents, this study spoke directly to the adoptees themselves. Working with three large adoption agencies in Minnesota, researchers interviewed nearly 700 adopted children and 540 non-adopted children, all ages 11 to 21, as well as parents, mental health professionals and teachers. Participants also had to have a non-adopted sibling within the same age range to help compare behaviors. "We brought them all right into our laboratories and asked the same questions to both the child and the parents," Keyes says. "That way we were able to use our clinical training to diagnose symptoms ourselves."

Another surprising conclusion that the Minnesota study produced was the fact that children adopted from within the U.S. are more prone to behavioral disorders than those adopted from overseas. Some 40,000 children worldwide annually emigrate from more than 100 countries through adoption, a trend increasing rapidly in the U.S. since the 1970s. But these foreign adoptees are far more likely to internalize their problems, suffering more commonly from depression or separation anxiety disorders. Domestic adoptees, on the other hand, tend to act out. While consistent with adolescents studied in both North America and Western Europe, Keyes says, this finding "goes against preconceived notions that kids from foreign cultures would have a harder time adapting to new families."

Despite her study's findings, Keyes is quick to stress that there is nothing in them that should discourage parents from adopting. "Males are likelier to have behavior issues," she says. "But no one is overly concerned about having boys." Still, Keyes advises adoptive parents to be on the lookout for problem behaviors and to rely on the network of mental health providers they built up when applying to adopt their children in the first place. "All adolescents struggle with finding their identity," she says, before adding, "It makes sense adopted children would struggle more than most."