About Adoptee Rage

Statistics Identify large populations of Adoptees in prisons, mental hospitals and committed suicide.
Fifty years of scientific studies on child adoption resulting in psychological harm to the child and
poor outcomes for a child's future.
Medical and psychological attempts to heal the broken bonds of adoption, promote reunions of biological parents and adult children. The other half of attempting to repair a severed Identity is counselling therapy to rebuild the self.

Sunday, November 30, 2014

The Adopted Child's Burden Guilt and Denial of Truth, What Happens to Unwanted Babys

ADOPTEE RAGE!

The Adopted Childs Burden,Guilt, and Denial of Truth

What Happens to the Unwanted Baby 
__________________________________________

To an adopted child, the sad truth in being an unwanted baby, is to the adopted child a 
The horrible truth....But"Truth" that others deny us.

#1."you were not wanted by your biological mother"
#2."She did not want to mother you" and
#3. "She chose Not to Mother You by abandonment"

At the birth of an unwanted baby, the biological mother trusted strangers to take her child off her hands., Our life was handed over to unknown or first name basis, administrative personnel, that had no intention of child caring, only to take us somewhere else.
The administrative personnel took the unwanted newborn baby to the institution of foster care where we became the property, Ward of the State, and the states social service institution's newest financial burden. There we are cataloged, photographed and marketed to anyone that is in the market for a human child. The social service organizations create marketing campaigns to drum up business and recruit potential adoptive parents. Laws are created to streamline the adoption process, erase our identities and sever any potential ties such as biological fathers, grandparents and biological families or any potential relatives that may step forward if they had known about our birth and object to our adoptions. The paper trail of our existence is stamped confidential and all files by court actions are closed and concealed from ourselves and all potential biological family or or future welfare check access. 

We are shifted from foster family to care facilities to avoid the potential child attachment to caregivers. When finally we are adopted and the duration of each adoption placement is considered a successful adoption outcome. When the adoptive parents grow distressed and send us back, the records are sealed and we are simply put back into the system to be re-adopted and re-fostered. There is no paper trail of our entire journey, just to the point of the last placement and re-enter the foster care system. If our biological family wanted to find us it is impossible, as all of our records are closed. We float between the hopes and disappointments of the adults who temporarily employ us in their care until we reach the age of majority 18 years old. We are now adults and expected to become contributing members of society,
without the psychological or developmental tools to live productive lives.   














Study Long-Term Effects of Adoption

ADOPTEE RAGE

 Study Long-Term Effects of Adoption
__________________________________________


Original Article




Citation
M Lieberman, J Morris. Long-Term Effects Of Adoption: An Empirical Study Of Adult Adoptees. The Internet Journal of Academic Physician Assistants. 2003 Volume 4 Number 1.
Abstract
The present study seeks to identify psychological differences between extrafamilial adult adoptees and a non-adopted comparison group through projective tests and life history interviews. Two demographically matched groups (18 adoptees and 16 non-adoptees) were administered the Thematic Apperception Test and Loevinger's Sentence Completion Test (a measure of Ego Stage). The TAT was scored thematically for "Alienation" and McClelland's "Need For Affiliation". Interview data were examined for corroboration or refutation of themes present in the projective tests. Results indicated no between group differences in Ego Stage however adoptees were significantly higher on some "Alienation" scores and non-adoptees were significantly higher on some "Affiliation" scores (p < .05). In addition, adoption status was predictable (p < .05) from a discriminant analysis using variables that had significantly zero-order correlations with it .

Introduction

The purpose of this study was to compare extrafamilial adult adoptees and a group of non-adoptees on the Thematic Apperception Test and Loevinger's Sentence Completion Test. The TAT was scored using McClelland's “Need for Affiliation” and a system specifically developed for this study, called “Alienation.” The Sentence Completion Test yields a measure of Ego Stage. In addition various demographic variables were collected for descriptive purposes. Life history interviews were administered to the adopted group for the purpose of examining themes emergent in the projective tests.
Adoptee research has been plagued by a dearth of comparative studies and statistical analyses, largely relying instead upon clinical case studies, interviews, and intuitive essays. Studies that do compare adoptees and nonadoptees have been inconclusive with respect to their findings. Most rely on standardized instruments to evaluate between group differences, rather than instruments, interviews, and questionnaires, designed to elicit material salient for adoptees.
Cubito (1999) compared adoptees to normative data utilizing the Brief Symptom inventory as a measure of overall distress, the Zung Self-Rating Depression Scale, and the Anger Content Scale of the MMPI-2. Adoptees were compared to two normative scales; one for everyday people in our society, and one for a sample of outpatient mental health clinic patients. The overall finding was the adoptees scored about halfway between the outpatient and normative data on all of the test instruments. The same author found another sample of adoptees to score significantly higher (p<.01) on the same measures of overall distress and depression but not on the anger scale when compared with normative data for these tests (Cubito, 1996). Cubito and Brandon (2000) reported higher levels of psychological maladjustment among adult adoptees when compared to normative data; however, their scores did not approach those levels of a typical outpatient population. Their study also found that females scored higher on a scale measuring anger. Fletcher (1997) compared adopted and nonadopted adults with a survey instrument designed to identify correlates of psychosocial adjustment. Overall, the nonadopted group manifested better adjustment than the adopted group. Like the Cubito studies however, both groups were within the normal range of adjustment. Over four thousand adopted adolescents were compared to the same number of nonadopted adolescents on nine (9) factors of emotional and behavioral adjustment and three factors of family functioning. The study found that adoptees showed lower levels of adjustment on nine of the twelve scales (Sharma, McGue, & Benson, 1996). Earlier studies (Maughan, Collishaw, & Pickles, 1998) found that adopted women showed very positive adult adjustment in all areas; however, adopted men have difficulty in the employment and social support domains. Wasserman (1998) compared the psychosocial adjustment of a group of young adults who had been adopted as children with that of a group of young adults who had not. He was able to discriminate searching from nonsearching adoptees using a Life Events Question instrument but otherwise was unable to show significant differences between the two groups using the Miller Behavioral Style Scale, or the Repression-Sensitization Scale of the MMPI. Finally, Delmonaco (1997), found that adoptees who rated themselves as more similar to their adopted parents scored significantly higher on the Tennessee Self-Concept Scale than those who rated themselves as more dissimilar to their adoptive families. Feigelman (1097) compared the adult behavior patterns of adoptees with those of others raised by both biological parents. The study found that adoptees showed a greater incidence of problem behaviors than children raised by biological parents during adolescence. However, in areas such as recent use of drugs, educational attainments, job holding, and marital stability, they appeared similar to those raised in intact biological families.
Conditt (1998) used the Rosenberg self-esteem scale to measure the effects of eight weeks of group therapy on the self-esteem of five (5) adult adoptees. The study found no significant changes in self-esteem.
Data from the National Child Development Study (NCDS) were used to examine the psychosocial functioning of an unselected sample of adopted and non-adopted children from similar birth circumstances. The study found that adopted adult women showed positive adjustment in all examined domains. However, findings suggest some difficulty for adopted adult men in the employment and social support domains. A number of adoption studies have found an increased risk for behavior problems among adoptees (Collishaw, Maughan, & Pickles, 1998).
Sobczak (1988) compared adult adoptees and nonadoptees on levels of depression and quality of relationships with parents. The Beck Depression Inventory, the Parent Bonding Instrument, the Social Readjustment Rating Scale, and a Personal Data form was completed by one hundred and fifty-one (151) adoptee and non-adoptees. The findings suggest that adoptees can enjoy mental health and normal interpersonal relationships. However, they are somewhat vulnerable to depression and are highly sensitive.
Adoptees' portrayal of the development of family structure was explored in a study of college students (Sobol, 1994). A group of college undergraduate adoptees was compared to a group of college undergraduates who were nonadopted regarding recollection of family relationships at different points of development. Adoptees remembered being close to their fathers during the preschool period. Both groups expressed a similar pattern of distance during adolescence.
Brodzinsky's (1993) research supports the notion that adoptees are more vulnerable to emotional, behavioral, and academic problems than the nonadopted living with their biological parents.
Data from the National Health Interview Survey were used to determine if adopted children are more likely to have emotional or behavioral problems than non-adopted children (Brand & Brinich, 1999). They found that adopted and foster children are more likely to have mental health contacts than non-adopted children. When comparing adopted and foster children with non-adopted children to see which group had more behavioral problems, the findings are mixed; however, there were no significant differences between these two groups when a small group of influential cases were eliminated. The study also found that the differences between the groups were not representative of adoptees and foster children as a whole. Patterns of behavior problems among the majority of adopted and non-adopted children were found to be comparable.
Eldred (1976) related psychopathology in adoptees to age at placement, agency versus independent placement, and the best age to tell a child they are adopted.
Cohen and Westhues (1995) compared self-esteem, school achievement, and friends between inter-country adoptees and their siblings. One hundred twenty-three (123) Canadian families were studied to see how social factors influence the development of self-esteem. One hundred fifty-five (155) international children had been adopted by these families during the 1970s. The study found that the self-esteem among adoptees is at least as strong as the self-esteem among the general population. In the general population, both females and males demonstrate the same pattern of self-esteem development. Females take longer to develop inner security. The findings concur with the thesis of M. Rosenberg (1989) that parental interest, school achievement, positive peer relationships, and special talents or skills enhance self-esteem. The sense of belonging to one's family, school, and peers, appears to be linked to self-esteem.
Fletcher (1997) studied one hundred adopted and one hundred non-adopted adults over eighteen years of age to identify correlates of psychosocial adjustment. A survey instrument was completed, which included maternal overprotection, maternal caring, biological and adoptive mother contacts, knowledge of background information surrounding the adoption, similarity between respondents and adoptive parents, age at which they learned adoption status, and gender. Self-esteem, attachment, subjective well-being, anxiety, and depression were included in the outcome measures. The study found that the non-adopted sample showed better adjustment than those who were adopted. However, the majority of both groups fell within normal ranges on the adjustment measures.
The psychosocial adjustment of a group of young adults who had been adopted as children, was compared with that of a group of young adults who had been raised with their biological families (aged 20-35 years). Personality factors, interpersonal behavior styles, and social support networks were used to measure psychosocial adjustment (Haan-Alvarez & Johanna, 1990). The Sixteen Personality Factors Questionnaire, the Firo-B, and the Interpersonal Network Questionnaire were the instruments used. The findings suggest that nonadoptees were more intelligent than adoptees; however, the validity of this finding is questionable. The study concluded that young adult adoptees showed no difference in psychological adjustment when compared with nonadopted young adults. Adoptees seeking information about their backgrounds was viewed as normal rather than neurotic.
Ingersoll (1997) supports the view that genetic and environmental factors contribute to the manifestation of externalizing disorders that adopted children are prone to. Results indicate that adopted children are disproportionately represented in child psychiatric populations due to genetic as well as the pre-, peri-, and post-natal adverse environmental factors associated with adoption. The author suggests that professionals and parents not limit the psychiatric problems of adoptees to a single factor. Early intervention for children at risk is urged
Kelly, Towner-Thyrum, Rigby, and Martin (1998) compared adopted and nonadopted college students. The purpose of the study was to identify family characteristics that predict successful adjustment and identity formation for young adult adoptees. The sample was made up of forty-nine (49) adopted and a randomly selected control group of forty-nine (49) nonadopted college students. The study found that adoptees have been as successful as nonadoptees in achieving developmental tasks appropriate to their age.
Langbehn, Cadoret, Yates, Troughton, and Stewart (1998) focused on the predictive aspect of adult antisocial behavior. A descriptive multivariate statistical method was used to examine the relationship between individual symptoms of juvenile conduct and oppositional defiant symptoms to adult antisocial behavior. Genetic and environmental influences of having antisocial parents were separated. The data were drawn from a study by R. J. Cadoret. Findings support oppositional defiant disorder in adolescents as a biologically influenced phenomenon and predictive of adult antisocial behavior.
The psychosocial ramifications of infant adoptions vary between men and women. One study examines the psychosocial functioning of an unselected sample, from the National Child Development Study, of adopted, and nonadopted children born in Britain during the week of March 3-9, 1958. Interviews and questionnaires were used measure adult outcome. The study found that adopted women showed very positive adult adjustment in all areas; however, the study suggests that adopted men have difficulty in the employment and social support domains (Maughan, Collishaw, & Pickles, 1998).
A number of studies have explored the problems faced by adopted adults. In April 1954, fifty-eight (58) adopted adults were studed to see how adopted people experienced adoption, and the problems they encountered (McWhinnie, 1997).
Other studies have explored the relationship between adoptees and conduct disorders. A sample of children who attended outpatient psychiatric services over a fourteen year period were used to study the relationship between adoptive status and presenting psychopathology to demographic and psychosocial variables. One study found that adoptees were at increased risk of conduct disorders and Attention Deficit Hyperactivity Disorder (A.D.H.D.) (Moore, & Fombonne, 1999).
Various case studies have explored older child adoption functioning domains. A research program involving older child adoptions attempted to evaluate the post-placement readjustment process. Five domains of functioning (cognitions, resources, stressors, coping, relationship formation) were featured in the formulation of a theoretical model from a short-term longitudinal study currently underway. Preliminary findings were presented as a case study (Pinderhughes, 1996).
Other studies have focused on the reaction of older adoptees to nontraditional family constellations. Conceptions of family and adoption in older adoptees and nonadopted peers were compared. One study found that older adoptees were more likely to accept nontraditional family constellations. Those adoptees who had more foster-care experience were more realistic regarding placement permanence (Sherrill, & Pinderhughes, 1999).
Certain life stressors affect personalities. Adoption is an early life stressor which affects the personality and subsequent life experiences of an individual. Smyer, Gatz, Simi, and Pedersen (1998) studied the long term impact of adoption on a sample of sixty (60) pairs of twins were taken from the Swedish Adoption/Twin Study of Aging. The twins were separated at an early age and reared apart. One member was raised by biological parents and the other by adoptive parents. Univariate and multivariate analyses were employed to assess factors associated with being raised in adoptive and non-adoptive homes. The results of the study show that there are few significant effects of adoption on adults. Childhood socioeconomic status appeared to mediate the stress of adoption. However, adoptees reported higher psychological stress.
Measurement instruments were sometimes developed to examine the emotional, cognitive, social, and academic development of children placed late for adoption. The selection of outcome measures used by the Maudsley Family Research team to assess outcomes in a broad range of developmental areas of permanent placement for children and adolescents is described. These instruments were developed for use with a longitudinal sample of children placed late for adoption (Rushton, 1998).
Other areas of research explore models for professionals seeking to provide an effective, affordable method of post-adoption search and reunion support services. In one such study, twenty-six people (26) participated in eight group counseling sessions facilitated by a social worker. The group was composed of people who were eighteen years and older, self-referred adoptive parents, adopted persons, or biological parents of an adopted person. Loss, loyalty, clarification of search and reunion concerns, helpfulness of the group, and negative feelings toward social workers were the five major themes that emerged in analyzing data from pre- and post intervention questionnaires and social worker process notes. However, the helpfulness of the group experience over time was questionable (Valley, Bass, & Speirs, 1999).
Overall, there are few studies comparing adoptees with nonadoptees that do not utilize comparison groups that are either normative, clinical, or involve comparisons of adoptees with other adoptees. The present study constitutes an exploration of differences between adopted and nonadopted adults utilizing life history interviews and projective tests with the goal of exploring salient concerns for the adult adoptee.

Methods

Participants

The sample consisted of 34 adults (26 females, 8 males), aged 21-44 from the Boston metropolitan area. Adoptees represented 53% and non-adoptees represented 47% of the sample. The adoptees were composed of those searching for their birth parents (n=13) and those not searching for their birth parents (n=5). The comparison group of non-adoptees were recruited via posted notices left a two universities and local area stores and were selected on the basis of matching demographic characteristics with the adopted group, including age, sex, marital status and educational level.

Instruments

The TAT was analyzed for “Need for affiliation,” as described by McClelland . He defined the “Need for Affiliation” as the desire to establish, restore or maintain a close relationship; concern over possible separation; or the desire to participate in convivial activities. The TAT was also analyzed for “Alienation,” which refers to a distancing, either physically or emotionally, of one person from another through conscious effort or as the result of an external or emotional block to intimacy. “Alienation” was scored via an empirically derived scoring system, constructed by taking a random sample of five adoptee protocols and performing a thematic analysis. This analysis resulted in 13 frequently appearing themes included in the final system.
Loevinger's sentence Completion Test was used for measuring “Ego Stage.” The concept of ego development, as conceptualized within this model, supposes a progression from an egocentric thought process toward a more holistic view of human beings.
The TAT and Ego Stage measures were chosen because they allowed quantitative comparisons to be made between the two groups using psychological measures that address the issues found in the literature review. In addition, the projective nature of the tests allows maximum flexibility for participants to reveal their own concerns or issues without the constraints of a questionnaire or checklist which “suggests” the nature of the issues being sought.
In addition, the interview given to the adoptees after the administration of the tests allowed for more specific questioning and self-description of issues related to adoption. It also allowed for comparison of the issues stated during the interview with the material found in the projective tests for both groups.

Procedures

In the adopted group, letters were sent to potential subjects from a member's list provided by the Orphan Voyage President. For those who did not respond immediately, phone calls were made two weeks later. A total of 18 eventually participated. Comparison group members who were volunteers were selected on the basis of matching demographic features including age, sex, marital status, and educational level with the adopted group.
Each subject met once with the investigator for approximately two hours during which general information and consent forms were completed followed by administration of either the TAT or Sentence Completion. These were alternated in order to control for order effects. For the adoptees, the testing phase was followed by administration of the life history interview in order to avoid contamination of the test material with issues aroused during the interview.
Each subject was asked to read carefully the instruction sheet attached to the front of the TAT. For the Sentence Completion Test, instructions were read verbatim from the Loevinger Manual as suggested in Appendix A of Volume 1 (Loevinger, 1970). During these periods, verbal interaction was kept to a minimum to avoid instrumentation bias introduced through variation in the test instructions.

Data Analysis/Scoring

This study utilized a combination of descriptive and inferential statistical analyses to compare the responses of adoptees and non-adoptees on two projective tests – the TAT and Loevinger's Sentence Completion Test. Life history interviews were also administered to the adoptees.
The TAT utilized six pictures depicting children either alone or with an adult in ambiguous contexts. It is hypothesized that these pictures will call forth salient concerns for the adoptees, particularly with respect to early childhood experiences and relationships to adults, offering a contrast to the more neutral material anticipated from the comparison group. The TAT was scored using McClelland's (1972) Affiliation scoring system in which a story that passes one of his three “prime tests for the Affiliation Motive” is then scored “1” each time an additional theme is present in the story. An individual's score is the sum of all 1's (themes) that have been checked. A theme can only be checked once.
Alienation will be scored and summed similarly with the exception that there is no “prime test” for Alienation. Each theme is simply checked if it appears in a story. In addition, word counts were performed for key words found to correlate with overall Alienation scores.
The Ego Stage measure was scored by a trained rater. Inter-rater reliability for this measure has generally been in the .8-.9 range (Loevinger, 1978).
Two raters scored the TAT's due to the somewhat greater subjectivity of these scales. Inter-rater reliability for the TAT has ranged from .30-.96 (Tomkins, 1967). The great variability seems to derive from the diverse case material present in the stories, raters of varying ability, and differences in the conceptual and inferential frame-works utilized by the raters. Tomkins reports a variety of inter-rater reliability checks on the TAT with the majority falling into the .50-.70 range. He states that reliability frequently improves when raters are permitted to hash out their differences after scoring.
Inter-rater reliability for the present study for both alienation and affiliation fell within the acceptable range for this instrument. In some cases, total affiliation themes and total separation fears, inter-rater reliability exceeded .80. Even when reliability was somewhat lower for the same components of the scoring system, two-thirds of the reliability coefficients were higher than 0.50.
Figure 1
Table 1

Results and Conclusion

TAT Affiliation (p = 9) and Alienation (p = 13) scores, the Ego Stage Measure total score, and the four demographic variables (age, gender, marital status, education) were correlated with adoption status (adopted or not). Ego Stage, age, gender and marital status were not significantly related to adoption status. However, several Affiliation scores (existence of an Affiliation theme, convivial activities, existence of Affiliation Imagery, anticipate success, positive feeling, and affiliation central plot) were significantly correlated with adoption status, with adoptees being lower on these scales. On the other hand, the Alienation scores (existence of Negativity, someone doesn't know, and someone is lonely) that were significantly correlated with adoption status were such that adoptees were higher on the scales than non-adoptees. (See Table 2.)
Figure 2
Table 2
In addition, a predictive discriminant analysis was conducted predicting adoption status from those above discussed variables that were significantly related to it (Table 3). The total predictive accuracy (84.9%, z = 3.96), as well as accuracies for the adoptees (88.9%, z = 2.93) and non-adoptees (80.0%, z = 2.69) were all significant (p < .05).
Figure 3
Table 3
Results supported the major hypothesis that adoptees would score higher than non-adoptees on Alienation variables and that non-adoptees would score higher than adoptees on Affiliation variables. As well, it was determined through a predictive discriminant analysis that classification into adoption status categories could be accomplished quite accurately from the set of variables that were significantly related to it. Qualitative analyses of interview questions produced frequently appearing themes that amplify and extend the quantitative results.
Perhaps the most important contribution made by this study is an analysis couched in sound statistical techniques and based upon group comparisons of adoptees who are nonclinical with nonadopted matched controls. The use of regression and discriminant analysis as well as between group comparisons and descriptive statistics, provides an opportunity to examine adoption as a contributing factor in behavioral pathology after other factors have already been accounted for. One criticism frequently leveled at previous conclusions from adoptee research is that the psychological issues could result from any number of factors including those peculiar to any individual of that particular age, social class, or time period.
The thematic analyses of projective tests and life history interviews can illuminate areas for future research and stimulate further hypothesis generation; the eventual goal of all such research being the provision of a remodeled adoptive structure capable of supporting and protecting the rights, personal dignity, and humanity of all concerned with the adoption process. The present analysis represents another step into a hopefully continuing line of research into these issues.

References

r-0. Brand, A.E., & Brinich, P.M. (1999). Behavior problems and mental health contacts in adopted, foster, and nonadopted children. The Journal of Child Psychology and Psychiatry and Allied Disciplines, 40, 1221-9.
r-1. Brodzinsky, D.M. (1993). Long-term outcomes in adoption. The Future of
Children, 3, 153-166.
r-2. Cohen, J. & Westhues, A. (1995). A comparison of self-esteem, school achievement, and friends between inter-country adoptees and their siblings. Early Childhood Development & Care, 106, 205-224.
r-3. Collishaw, S., Maughan, B., & Pickles, A. (1998). Infant adoption: Psychosocial outcomes in adulthood. Social Psychiatry and Psychiatric Epidemiology, 33, 57-65.
r-4. Conditt, P.M. (1998). Psychoeducational group therapy with adult adoptees: The treatment of self-esteem. Doctoral dissertation, Theological Seminary, School of Psychology, (1998).
r-5. Cubito, D. (1996). The psychological adjustment of a non-clinical sample of adult extra-familial adoptees. Dissertation Abstracts International: Section B: The
Sciences & Engineering, 57(2-B), 1487.
r-6. Cubito, D.S., & Brandon, K.O. (2000). Psychological adjustment in adult adoptees: Assessment of distress, depression, and anger. American Journal of Orthopsychiatry, 70(3), 408-413.
r-7. Delmonaco, J. P. (1997). Adult adoptees perceptions of sameness to/difference from adoptive family: The relationship to self-concept and loss. Dissertation Abstracts International: Section B: The Sciences & Engineering Jun 1997, Vol 57 (12-B), 7765.
r-8. Eldred, C.A. (1976). Some aspects of adoption in selected samples of adult adoptees. American Journal of Orthopsychiatry, 46, 279-90.
r-9. Feigelman, W. (1997). Adopted adults: Comparisons with persons raised in conventional families. Marriage and Family Review, 25, 199-223.
r-10. Fletcher, J. F. (1997). Correlates of psychosocial adjustment among adult adopted children. Dissertation Abstracts International Section A: Humanities & Social Sciences Jul 1997, Vol 58 (1-A), p 0290.
r-11. Fletcher, J.F. (1997). Adult adoptees' perceptions of sameness to/difference from adoptive family: The relationship to self-concept and loss. Dissertation Abstracts
International: Section B: The Sciences & Engineering, 57, 7765.
r-12. Haan-Alvarez, & Johanna G. (1990). Psychosocial adjustment of adopted and nonadopted young adults: A comparative study. Dissertation Abstracts International, 51,
(10B), 5050.
r-13. Ingersoll, B.D. (1997). Psychiatric disorders among adopted children: A review and commentary. Adoption Quarterly, 1, 57-73.
r-14. Kelly, M.M., Towner-Thyrum, E., Rigby, A., & Martin, B. (1998). Adjustment and identity formation in adopted and nonadopted young adults: Contributions of family environment.American Journal of Orthopsychiatry, 68, 497-500.
r-15. Langbehn, D.R., Cadoret, R.J., Yates, W.R., Troughton, E.P., & Stewart, M.A. (1998). Distinct contributions of conduct and oppositional defiant symptoms to adult antisocial behavior: Evidence from an adoption study. Archives of General Psychiatry, 55, 821-829.
r-16. Maughan, B., Collishaw, S., & Pickles, A., (1998). Infant adoption: Psychosocial outcomes in adulthood. Social Psychiatry & Psychiatric Epidemiology, 33 (2), 57-65.
r-17. Maughan, B., Collishaw, S., & Pickles, A., (1998). School achievement and adult qualifications among adoptees: A longitudinal study. Journal of Child Psychology and Psychiatry and Allied Disciplines, 39, 669-685.
r-18. McWhinnie, A.M. (1967). Adopted children: How they grow up. New York: Humanities Press, 3.
r-19. Moore, J., & Fombonne, E. (1999). Psychopathology in adopted and nonadopted children: A clinical sample. American Journal of Orthopsychiatry, 69, 403-409.
r-20. Pinderhughes, E. (1996). Toward understanding family readjustment following older child adoptions: The interplay between theory generation and empirical research. Children and Youth Services Review, 18, 115-138.
r-21. Rushton, A. (1998). Measuring outcomes for children late placed for adoption. Children & Society, 12 (3), 190-191.
r-22. Sharma, A.R., McGue, M.K., & Benson, P.L. (1996). The emotional and behavioral adjustment of United States adopted adolescents: Part I. an overview. Children and Youth Services Review, 18, 1-2, 83-100.
r-23. Sharma, A.R., McGue, M.K., & Benson, P.L. (1996). The emotional and behavioral adjustment of United States adopted adolescents: Part II. Age at adoption. Children and Youth Services Review, 18, 101-114
r-24. Sharma, A.R., McGue, M.K., & Benson, P.L. (1998). The psychological adjustment of United States adopted adolescents and their non-adopted siblings. Child
Development, 69, 791-802.
r-25. Sherrill, C., & Pinderhughes, E. (1999). Conceptions of family and adoption among older adoptees. Adoption Quarterly, 2 (4), 21-47.
r-26. Smyer, M.A., Gatz, M., Simi, N.L., & Pedersen, N.L., (1998). Childhood
adoption: Long term effects in adulthood. Psychiatry, 61, 191-205.
r-27. Sobczak, J.M., (1988). A comparison of adult adoptees and nonadoptees on level of depression and quality of relationships with parents. Dissertation Abstracts
International, 48(8-B), 2469-2470.
r-28. Sobol, M.P., Delaney, S., & Earn, B.M., (1994). Adoptees' portrayal of the development of family structure. Journal of Youth and Adolescence, 23(3), 385-401.
r-29. Valley, S., Bass, B., & Speirs, C., (1999). A professionally led adoption triad group: An evolving approach to search and reunion. Child Welfare, 78(3), 363-379.
r-30. Wasserman, K.L., (1998). Approach-avoidance strategies among searching and nonsearching adoptees. Dissertation Abstracts International: Section B: The Sciences & Engineering Sep 1998, Vol 59 (3-B), p 1381.
  • {full_citation}

Observations In Adopted Children

ADOPTEE RAGE!

Marshall D. Schechtner 
            "Observations in Adopted Children"
__________________________________________


Marshall D. Schechter, “Observations on Adopted Children,” 1960

Marshall Schechter, a psychiatrist in private practice in Beverly Hills, California, reported in 1960 that adoptees were 100 times more likely than non-adoptees to present a range of serious emotional problems. Like a number of other contributions to the psychopathology literature, Schechter’s report was based on a tiny number of cases. He presented information about 120 children seen in his practice between 1948 and 1953, of whom exactly sixteen (or 13.3 percent) were adopted. Since adoptees numbered less than one-tenth of one percent in the general population, adopted children were greatly over-represented in his practice. Schechter’s friend, Povl Toussieng, a child psychiatrist at the famous Menninger Clinic, had also told him that up to one-third of all children seen as outpatients at the clinic were adopted. Schechter’s own observations, confirmed by a trusted colleague, were the basis for his conclusion. Adoption had an emotionally damaging impact on child development.
What exactly was it about adoption that caused problems? According to Schechter, the answer could be found in the psychoanalytic theory that “object relations” (the first and closest ties formed between infants and the adults who care for them) were crucial determinants of personhood. Children could not cope with the knowledge that they had been rejected by birth parents and no amount of reassurance that their adoptive parents loved and wanted them could make up for the “severe narcissistic injury” that adoption inflicted. Each and every one of his sixteen cases illustrated “how the idea of adoption had woven itself into the framework of the child’s personality configuration.”Telling children they were adopted was mandatory, Schechter agreed, but it also precipitated psychological difficulties. Carefully timing and managing the details of telling could help mitigate the resulting problems. (Later studies challenged this view. See, for example, the excerpt from Benson Jaffee and David Fanshel, How They Fared in Adoption.)
Schechter was not the first person to suggest that adoption posed intrinsic psychological risks. As early as 1937, psychiatrist David Levy presented case histories showing that adoptees suffered from “primary affect hunger,” a term he used to describe what is now called attachment disorder. A number of other clinicians in the U.S. and Britain published reports in the 1940s and 1950s about the deleterious consequences of growing up “without genealogy.” It was the boldness of Schechter’s claim that adopted children were much more likely to become neurotic and psychotic that galvanized helping professionals and therapeutic approaches to adoption. It also generated a great deal of controversy. H. David Kirk, author of Shared Fate, called Schechter’s study “spurious.” Many other researchers were equally skeptical that adoption was the sort of risk factor Schechter maintained it was.
Schechter’s methodology drew the most fire. Small numbers of detailed case histories had long been standard features of medical research and psychiatrists renowned for their contributions to developmental theory, including Sigmund Freud and Anna Freud, relied on them extensively. But psychologists and social workers with training in scientific research methods insisted that Schechter’s sample was far too small to be representative and disparaged his crude and inaccurate statistical calculations. His research design was so flawed as to be hopelessly unreliable.
Schechter responded by sending a questionnaire to members of the Southern California Psychiatric Society and various regional institutions. A follow-up report presented empirical data showing that adoptees showed up in clinical populations everywhere at much higher than average rates.
Schechter’s account of the damage that adoption did to children was vigorously contested during the 1960s. Today, it is widely accepted by parents and professionals who agree that attachment and loss are at the heart of what makes adoption a distinctive and difficult experience. This consensus was efficiently summarized in a book that Schechter co-edited with developmental psychologist David Brodzinsky: The Psychology of Adoption (1990).

Adoption Jeopardizes Adoptee's Mental Health

ADOPTEE RAGE!

Adoption Jeopardize Adoptee's Mental Health 
__________________________________________

Does adoption jeopardize the mental and emotional health of children, making adoptees especially vulnerable to developmental, behavioral, and academic problems? Most people connected to adoption today think it does. Most Americans agree that adoption is a “risk factor,” according to public opinion polls.
The belief that adoption has a psychology of its own is recent, indebted to a tradition of controversial clinical studies linking adoption to psychopathology. Beginning around World War II, some mental health professionals, often influenced by psychoanalysis, proposed that the losses associated with adoption made normal development tricky for adopted children and stability difficult to achieve for adoptive families. The new worries about adoption generated by psychopathology studies added to already well established concerns that available children were feeble-minded and adoption unusually risky.
Psychopathology studies equated difference with damage. They helped to transform adoption into a full-fledged object of casework and counseling, and this was essential for the emergence of therapeutic adoption. The rapid spread of post-adoption services, non-existent in 1950, indicates that many parents and professionals now accept the need for long-term, perhaps permanent, help in order to avoid or manage adoption-related problems.
Awareness that the parties to adoption face unique psychological challenges may well be one of the things that makes twentieth-century adoption practices historically distinctive—as distinctive as the psychology of adoption itself.

The Psychosocial Development of Adopted Children

ADOPTEE RAGE!


_The Psychosocial Development of Adopted Children  De___________________________________________________




PSYCHOSOCIAL DEVELOPMENT OF ADOPTED CHILDREN
by Geoffrey A. Rickarby FRANZCP



ABSTRACT

 This paper develops the earlier work of the author and his colleagues, with the hindsight of a further twenty years of caring for disturbed adopted children. 
It examines the themes of attachment/detachment, trust/distrust, gratitude, obligation and belonging, major difficulty in identity formation, response to obfuscated adoption motivation and high levels of conditioning and control that are the lot of those adopted children who are fortunate to be brought up in a family where they can remain until at least middle adolescence.
  
An Eriksonian model is used, and the work of Stierlin is drawn upon in understanding psychosocial separation issues of late adolescence.  The thesis is put forward that adoptive children have more difficult and less culturally supported developmental tasks to achieve than those in a moderately functioning biologically related family.  It puts a plea for more education of adoptive parents in these special difficulties, as they also suffer severely as a result of ignorance of these mostly inevitable processes.

Erikson’s model of human development is epigenetic.  This is to say that each stage of psychosocial development is built upon the previous stage or stages of development and their outcome.  For example a child who has a significant sense of basic trust, will seek autonomy and test it behaviourally without readily falling into shame and doubt.  Or obversely a child with  poor resolution of shame and doubt issues will have more trouble developing initiative unclouded by excessive guilt.
These earlier developmental stages form a developmental pattern at the same time as the child’s primary school education is beginning the serious years of acquiring literacy and adapting to the whole theme of continuing education.

In an adoptive family the child has nearly always been told he or she is adopted, often long before the conceptual notion of the word is within his range.  In an adoptive family with a successful marriage with mutual motivation to adopt -  as well as the capacity to grieve their infertility, and assuming the absence of mental illness including alcoholism, the child has adapted to their new parents’ idiosyncrasies sufficiently to have arrived at this stage of development with their own pattern of function.  Note, that for the purposes of this paper, we are talking about those adoptive families still functioning as a family.

To Erikson, Primary School is the time of development where the maturing nervous system and psyche is being shaped by education, nurture and activities.  He sees the time as one where the development is one of industry and the psychosocial alternative is a feeling of inferiority.

In common speech the issue of these years is, “Am I an okay kid?” 
Not only must he or she be ‘okay’ in parent’s eyes, but now the teachers and peer group are becoming more and more important. 

Working at education and development is always to the standards of the family where they are brought up, and the school chosen.  This is one place where the fit between adoptive parents and child does matter.  Biological parents readily recognise their own behaviours and temperament in their children, which might lead to compassion or even over-reaction at elements of themselves they accept.  Adoptive parents are, with good reason, often bewildered.  The child has different abilities and interests than they had, they seem to relate to other children in a manner that is unfamiliar; their spontaneous reactions to shock or frustration seem strange. At this stage the child is being tested hard by his social field.   When he goes home and relates this, he or she needs every bit of validation by mirroring in hearing, “You’re okay.”, that is available.

It is from being an okay child with a sense of self that the adolescent finds his or her identity.  Identity in our culture is an underrated issue for the reason that those who have an identity arising from a greater family background and strong sense of self take it for granted.  They don’t know what it is like to struggle for an identity.  Those who don’t have one, are depressed, lack direction, are distracted by substance abuse, settle for destructive relationships and stop trying.

In the greater family there is nearly always significant contact with other children, most commonly cousins.  Cousins are a common source of information, some of it wrong or distorted.  The material has its origins in the aunts and uncles’ discussions about the circumstances of the adoption, and snippets of gossip or speculation about the original mother and father of the boy or girl.  A child who is not informed derives information readily from other children; cousins are a frequent source; many crises may occur from wrong information, sometimes far-fetched, and even information that is roughly correct.

For an adoptive child one alternative to this is no information whatsoever, a total wall of silence about his or her origins. Some adoptive parents provide information that is fed to them by agencies to be used at the appropriate age.  Often this is edited, distorted or simply not factual, even the result of communication mistakes.

Anglo-Saxon and European culture has a background of centuries of successful breeding techniques long before it received help from science or the discipline of genetic research.  Every family has its myths of who took after whom, and what the family was noted for in abilities, character and appearance.  It is hard for an adoptive child to “…know what I am really like.”  Other difficult notions are there for the child, such as “had to give you up for adoption.”, and “we chose you.”   The culture doesn’t help the adoptive family either, because common culture says, “It will be just as if you had your own children.”  The family are let down by not being supported by the culture in which they are supposed to exist as if adoption had had not occurred..  Confusion and insecurity readily occurs, particularly if one of Erikson’s first three stages has left some mistrust, shame, doubt or guilt as a problem for the child.

There is insecurity on both sides of the adoption.  The child is insecure in not knowing how strong is this bond from adoptive parents – how committed are they to staying with it. And insecure children, despite their relative health, test out the adults of their family.  Sometimes they do it aggressively, other times by adopting the behaviours of a younger care-eliciting child.  When this goes on and on, and the child’s temperament appears strange and unfamiliar, some adoptive parents are tested too much in the same way as a fostering placement is tested and is unable to go on.  Crisis phenomena occur and the more committed families seek help instead of giving up or blaming the child.

Adoptive parents who are insecure about adoption are outwardly distinct from the secure ones. 

The secure ones know quite a lot about children generally and are interested in what the particular child is like and how they will develop.  If this development requires straight answers or testing their origins, they make that possible without giving prejudicial information.  They are able to let the adoptee differentiate into an adult with adult interests and finally develop a good adult/adult relationship with them.  If they are anxious about reunion, it is that the adoptee won’t suffer a major let down or be rejected.  They are usually interested in the biological family and what they do without deprecation. It is rare to see a mother and an adoptive mother become good friends, and it can’t come about any other way than with real trust, but I have seen it be ultimately good for the adoptee and his family.

The more insecure the adoptive family, however, the more they are worried that the child will leave them, judge them, and not want to know them, the more they will make up myths or stories to make the child think they are better off with them than they would have been otherwise, and the more there are stories that their mother couldn’t keep them or didn’t want them.  The messages to the adopted child about biological parents may be blatant: such as: “You’d have been starving in a humpy outside some little town.”, or subtle and projective,  “Your ‘birth mother’ seems rather brittle don’t you think?” Insecurity is not all or nothing: there are degrees of insecurity, and varieties - reflective of the adoptive family attitudes and preconceptions.   Unfortunately there is no known way of screening out which adoptive families will be insecure, but there is the opportunity to educate them in the hazards and help them with common insecurities.   It is to be remembered that most of the ones we are discussing are in the middle or top group of adoptive families, and not ones who are drunk, drugged, divided or displaced.  They are essentially people who are trying their best and are deserving of our compassion for their own insecurity and distress.

The adoptee’s insecurity is: Am I a good enough kid and grateful enough for you to see me through my development without wanting to get rid of me? - their attachment is essentially anxious.

The adoptive parent’s insecurity is about, “Did I really do well enough to have justified my having somebody else’s child to rare?  How do I keep the deep down guilt feelings quiet?”  An adoptive parent who has open communication with his or her spouse might be asking, “Did we do well enough…?”, and even that sense of them doing it together is of immense value to the adopted child.
Some adoptive parents want school results and trophies on shelf, and, if they just happen without anxiety and pressure, that is fine.  But the adopted child is left with a burden of feelings of how to come to terms with obligation and expectations of gratitude.  The secure adoptive parent can talk openly about this aspect of adoption and express what they themselves are thankful and joyful about.  The insecure adoptive parents want their due.

One aspect of ‘wanting their due’, is control and maintaining the relationship on their own terms through later life. Stierlin has studied the ‘mission’ that families give to children and that begins to be acted on in a deeper manner when they are in later adolescence.  In many adoptive families it is to be outstanding in some manner, and generally to give the message of what a great family they were brought up in.  If the pressure behind this is not too great and the means to this is flexible, it is restricting, but not too damaging.  If the pressure is great and the means inflexible, then the child is often under unbearable stress.
To prevent age appropriate separation from the family at the age where their peers are becoming adults is another insecurity issue.  The mechanisms seem to be universal in Western Culture.   To do everything for them so they are dependent for living skills is a simple one, more serious is to undermine their sense of their own capacity to cope with adult life and relationships and live by their own decisions (this is a shame and self-doubt theme) and the third is about the triggering of guilt – guilt themes and guilt games are painful, the response often set up in very early life; and, at a deeper level, linked in the adoptee to his or her fear of abandonment that is easily displaced later onto their mother and how they will feel when they meet her.

As I have pointed out in my earlier writings about the selection of adoptive parents, adoption motivation is very strong. I have already discussed such motivation factors as mutuality and a genuine interest in children as good outcome factors, and indicated that we are not discussing the family broken up by alcohol, or where a difficult marriage was to be temporarily propped up by the advent of a child.  However it is important to remember that strong motivation themes, which may be very different between the couple and indeed their relatives, is a background to the development of an adopted child.  The grandparent who rejects her adopted grandchild in favour of cousins for example, or the child with one parent who was not ‘the adopter’ in the first place, where the issue might be indifference: what difficulties does this make for a child’s understanding of their place in the world?  I mention these issues here, but they are available in more detail from my earlier writings.

In Erikson’s terms, the stages of industry and identity in psychosocial development are a hard time for the adopted child, and, because they are the foundations for the later stages of intimacy and generativity that lead on to the child accepting themselves and their life, they are pivotal in the making of the person and the family of the future.   While there are even echoes of adoption in society all parties to adoption require our compassion and support.











___

Friday, November 28, 2014

Adoptee's Suicide Study

ADOPTEE RAGE!

Adoptee's Suicide Risk 4 Times Higher 
                                      than Biological Offspring
__________________________________________

As an adopted child I learned early that death was just about the only real way out of my miserable adopted existence. The self seeking comfort I feel in isolation, privacy and hiding out away from where my adoptive mother can not find me. The only way to end this circular- recurring cycle of psycho narcissist adoptive mother's control, domination, sickly abusive relationship in that everything in the world revolves around her, was suicide. I learned about killing one's self from the frequent 2:am drunken brawls at home where the parents are wasted, exhausted and have become too warn down from fighting each-other, to go on. That is the point where the 38 handgun is retrieved from the dresser, with a quick inspection of the six bullets, and it is snapped back in place for the dad's Grand Finale, threatening to kill himself infront of my crying self and siblings. We beg dad not to do it, although this is part of the ritual where mom already told him to fuck off and went to bed. The first time I was in serious trouble about 12 years old, caught for sneaking out with a girlfriend to meet some boys, my brother tracked me down and dragged me back to the house. My first thought, I went and got the 38 and said to my friend "we have to kill ourselves" (as I am going to be punished)   My friend called her mother to come get her, I didn't understand why she wanted to leave. In my mind the punishment that my parents were going to give me was far worse than my own self inflicted gunshot through my mouth-back out of the back of my head. I was more devastated in loosing a friend than planning my own suicide. The next couple of attempts were bottles of pills of which I woke up from. I slit my wrists wrong and made a big mess but no one ever knew. I would daydream as I got older of using the car's exhaust and a hose to the window. The plastic bag and propane, helium, Carbon dioxide. My daydreams of killing myself were not stress related, and with each new and better idea, other more cleaner ways came about in my mind.  
After I had my own daughters, I never wanted them to suffer from the mess I left behind or think that my suicide had anything to do with them. 
Myself included six failed attempts, but I would never make a threats of suicide fearing being put into a straight jacket or mental hospital and ultimately loosing my freedom when the time cam and I was more serious. I have never threatened to off myself, it is a personal secret like with the many other plans 
But the prolonged haunting keeps me from doing it.
Suicide is not some sickness or mental illness, it is the ultimate end to the drain people like me suck from society. We are society's dependents and never contributors, as when our temporary "adoption role" was played out we lacked the ability to coexist, to create or live. We are the watchers on the sidelines of life with no capacity to redevelop that what we have missed out. Only knowing one insignificant role to please one significant person, who at this point I am sure wishes me dead......In time mother.

Risk of Suicide Attempt in Adopted and Nonadopted Offspring

OBJECTIVE: We asked whether adoption status represented a risk of suicide attempt for adopted and nonadopted offspring living in the United States. We also examined whether factors known to be associated with suicidal behavior would mediate the relationship between adoption status and suicide attempt.
METHODS: Participants were drawn from the Sibling Interaction and Behavior Study, which included 692 adopted and 540 nonadopted offspring and was conducted at the University of Minnesota from 1998 to 2008. Adoptees were systematically ascertained from records of 3 large Minnesota adoption agencies; nonadoptees were ascertained from Minnesota birth records. Outcome measures were attempted suicide, reported by parent or offspring, and factors known to be associated with suicidal behavior including psychiatric disorder symptoms, personality traits, family environment, and academic disengagement.
RESULTS: The odds of a reported suicide attempt were ∼4 times greater in adoptees compared with nonadoptees (odds ratio: 4.23). After adjustment for factors associated with suicidal behavior, the odds of reporting a suicide attempt were reduced but remained significantly elevated (odds ratio: 3.70).
CONCLUSIONS: The odds for reported suicide attempt are elevated in individuals who are adopted relative to those who are not adopted. The relationship between adoption status and suicide attempt is partially mediated by factors known to be associated with suicidal behavior. Continued study of the risk of suicide attempt in adopted offspring may inform the larger investigation of suicidality in all adolescents and young adults.


Adopted offspring were nearly 4 times more likely to attempt suicide than nonadopted offspring, according to a study (See Above) September 9 in the Pediatrics.
The study included 692 adopted children and 540 nonadopted children, all residing in Minnesota. Fifty-six offspring in the study attempted suicide; 47 of those were adoptees.
The study's lead author cautioned, however, that the increased risk did not characterize adopted children as a whole. "The majority of adoptees are psychologically healthy," Margaret A. Keyes, PhD, told Medscape Medical News. Dr. Keyes is a research associate at the Department of Psychology, University of Minnesota, Minneapolis. "With elevated risk, we are talking about a very small number of people."
Dr. Keyes and colleagues conducted an initial interview of children and parents and then completed a second assessment roughly 3 years later (mean interval, 3.36 years; standard deviation [SD], 0.45 years) between 1998 and 2008. The appraisal included a comprehensive mental health assessment, a personality assessment, an assessment for the presence of childhood disruptive disorders such as oppositional defiant disorder, attention-deficit/hyperactivity disorder, major depressive disorder, and substance abuse disorders. Parents and children were asked separately whether the child had attempted suicide.
Among the 47 adoptees who attempted suicide between the first and second assessment, 16 were boys and 31 were girls; of the 9 nonadoptees who attempted suicide, 4 were boys and 5 were girls.
The odds ratio (OR) for reported suicides among adoptees compared with nonadoptees was 4.23, after adjusting for age and sex. When the odds were adjusted for factors associated with suicidal behavior, such as substance abuse, depression, disruptive behavior disorders, and disruption in family and school life, the OR remained significantly elevated, at 3.70.
Dr. Keyes said this research is in line with findings in earlier studies, including research in Sweden showing increased numbers of suicide attempts among adoptees. A 2002Lancet study also found that intercountry adoptees were more likely than other Swedish-born children both to die from suicide (OR, 3.6) and to attempt suicide (OR, 3.6).
"They have documented this [increased risk] in very large national cohort studies," Dr. Keyes said. A US study published in Pediatrics in 2001 also found an increased suicide risk among adoptees. In that study, the researchers assessed 6577 adolescents, including 214 adoptees. Of those, 7.6% of adoptees attempted suicide compared with 3.1% of children living with their biological families.
The current study should stand as a warning to clinicians to take the concerns of adoptive parents seriously, Dr. Keyes said. "Adoptive parents are sometimes viewed as overreporters and quick to refer to helping agencies, social service agencies, or their family doctor. I think their concerns should be taken seriously and not necessarily viewed as overreporting or overanxiousness. They may be looking at a real phenomenon in their family."
The authors did not find that specific adoption factors, including age of adoption placement, ethnic minority status, intercountry adoption, and domestic placement, predicted suicide attempts. However, a variety of behavioral issues were more common among suicide attempters than nonattempters (aggregate risk, 1.9 SD), and those same behaviors were more common among adoptees than nonadoptees (aggregate risk, 0.31 SD).
Among the risks associated more consistently with adoptees were childhood disruptive disorders (mean difference [d], 0.40; 95% confidence interval [CI], 0.27 - 0.53; P < .001), reports of family discord (d, 0.40 [95% CI, 0.22 - 0.58; P < .001] when reported by parents and d, 0.26 [95% CI, 0.12 - 0.39; P < .001] when reported by children), academic disengagement (d, 0.21; 95% CI, 0.08 - 0.27; P < .001). Adoptees also had greater levels of teacher-reported externalizing behavior (d, 0.28; 95% CI, 0.12 - 0.43; P < .001) and teacher-reported negative mood (d, 0.34; 95% CI, 0.20 - 0.48;P < .001).
The researchers note, however, that these differences were more pronounced when they compared those who attempted suicide and those who did not, regardless of adoptive/nonadoptive status. The authors reported a d of 1.05 (95% CI, 0.76 - 1.33) for childhood disruptive disorders between attempters and nonattempters and 1.05 (95% CI, 0.76 -1.34) for major depressive disorder (P < .001 for both), a d of 0.64 (95% CI, 0.36 - 0.91) for substance disorders (P < .001), a mean difference of 0.71 (95% CI, 0.43 - 0.99) for low control (P < .001), a d of 0.69 (95% CI, 0.41 - 0.97) for alienation (P < .001), and a d of 0.52 (95% CI, 0.23 - 0.81; P < .001) for low well being.
Parent-reported family discord was also greater for attempters than nonattempters (d, 1.01; 95% CI, 0.67 - 1.34; P < .001), as was child-reported family discord (d, 0.92; 95% CI, 0.61- 1.23; P < .001). Teacher ratings for externalizing behavior and negative mood were also higher for those who attempted suicide (d, 0.92 [95% CI, 0.57 - 1.27] for externalizing behavior; d, 0.71 [95% CI, 0.37 - 1.05] for negative mood; P< .001 for both).
The mean age for adopted children in the Minnesota study was 14.95 years (SD, 1.9 years); nonadoptees had a mean age of 14.89 years (SD, 1.9 years). All the adopted children had been placed in permanent homes before the age of 2 years (mean, 4.7 months; SD, 3.4 months), and 96% were placed before 1 year. Seventy-four percent of the adoptees were born outside the United States; 90% of the international adoptees were born in South Korea, and 60% of the international adoptees were girls.
Chuck Johnson, president of the National Council for Adoption, an Alexandria, Virginia–based advocacy organization, emphasized the good news from the study, saying that most adoptees are not at risk for suicide.
"It doesn't surprise me that children who've been adopted in great numbers have struggles, which, I guess, if you took to its natural consequences, would increase the suicide rate," he told Medscape Medical News. "But the thing that really comes out at me is it appears a vast majority of children are doing really well."