Internalizing Problems in Adopted Eastern European Adolescents: The Role of the Informant, Early Adversity and Post-Adoption Processes.

BACKGROUND: Internationally adopted children who suffered early institutionalization are at risk of a late onset of internalizing problems in adolescence. Both pre-adoption, adversity-related, and post-adoption factors predict variability in internalizing problems in this population. Previous studies have suggested different patterns of parent-adolescent informant discrepancies in adoptive dyads Method:: We analyzed internalizing problems among 66 adolescents internationally adopted from Russia to Spanish families using both the parent- and self-report version of the Strengths and Difficulties Questionnaire and comparing them with a low-risk, community group ( = 30). We assessed pre-adoption and post-adoption factors and evaluated cross-informant discrepancies. RESULTS: Internationally adopted adolescents exhibited more internalizing problems by parent-report than community adolescents, but there were no differences by self-report. Adopted youth showed no discrepancies between parent and self-report, whereas community adolescents reported more internalizing symptoms than their parents. Pre-adoption adversity-related factors predicted parent-reported internalizing problems, while post-adoption factors predicted self-reported internalizing problems. CONCLUSIONS: Parent-adolescent informant discrepancies in adopted adolescents from Eastern Europe for internalizing symptoms were lower than in community adolescents. Both adversity-related factors and the lived experience of adoption may influence the development of internalizing symptoms in internationally adopted adolescents.

Birth mothers' experiences of support before, during, and after adoptive placement.

Birth mothers, or women who have relinquished parental rights of their child, are an understudied and stigmatized population. Prior literature has suggested that protective factors, such as supports (e.g., practical, emotional, peer, informational), are beneficial for birth mothers. This study qualitatively explored perceptions and experiences of support before, during, and after placement among 51 birth mothers whose children were adopted as infants via private adoption in the United States 8 months to 50 years (M = 15.39 years) from the time of data collection. Thematic analysis revealed six overarching themes: (a) impact of lived circumstances, (b) importance of early adequate support, (c) an emotionally complex process, (d) access to timely information, (e) feeling ready to utilize resources, and (f) coping with ongoing adjustment needs. Prevalence of Themes pre-, during, and postplacement were shared among participants. Time since placement and adoption openness (e.g., contact with adoptive families) were also important factors related to these themes. We discuss implications of these results for policy and practice related to birth mothers' well-being and adjustment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

[The search for the origins of the person entrusted to the adoption]. / La quête des origines chez la personne confiée à l'adoption.

This text offers the testimony of a reality sometimes very complex to conceive, that of a person entrusted to adoption who goes in search of his origins. The process seems simple, but it covers many intertwined aspects, which make the quest perilous. The adopted person, his adoptive parents as well as the original ones, will all find themselves embarked on a new page of their history, full of emotions. They will have to tame the result and continue their journey with this new personal baggage.

Single parent adoption in India: Mental health and legal perspectives and the way forward.

Single parent adoption (SPA) is a relatively new construct worldwide and in India. The Ministry of Women and Child Development, Government of India, has laid down criteria for adoption in general and SPA in particular, in conjunction with the Juvenile Justice Act (Care and Protection of Children), 2015. There is scant literature on this topic of SPA, more so in India, that looks into the various psychological nuances of SPA from a mental health professional's (MHP) perspective. This review paper aims to assess SPA from the perspective of a MHP that will focus on its various legal nuances as well as the psychological connotations attached to it. For this, a search strategy was employed that included a thorough literature search from two databases (PubMed and Google Scholar) with relevant keywords related to the topic. The various legal issues pertaining to SPA in the current scenario, the psychological issues and challenges faced by single parents, the behavioral outcomes of adoptees who are adopted by single parents, and ways to deal with the various obstacles of SPA are discussed.

The adult outcome of childhood quasi-autism arising following extreme institutional deprivation.

BACKGROUND: Rutter and colleagues' seminal observation that extended early life exposure to extreme institutional deprivation can result in what he termed quasi-autism (QA), informed both our understanding of the effects of adversity on development and the nature of autism. Here we provide the first detailed analysis of the adult outcomes of the group of institutionally deprived-then-adopted children identified as displaying QA. METHODS: Twenty-six adult adoptees identified with QA in childhood (Childhood QA+) were compared to 75 adoptees who experienced extended institutional deprivation (>6 months) but no QA (Childhood QA-), and 116 adoptees exposed to Low/No institutional deprivation. The outcomes were child-to-adult developmental trajectories of neuro-developmental symptoms (autism, attention-deficit/hyperactivity disorder (ADHD), disinhibited social engagement (DSE) and cognitive impairment), adult functioning, life satisfaction and mental health. RESULTS: Childhood QA+ was associated with elevated and persistent trajectories of broad-based autism-related difficulties, ADHD and DSE symptoms and low IQ, as well as adult mental health difficulties and functional impairment, including high rates of low educational attainment and unemployment. Life satisfaction and self-esteem were unaffected. Autism-related communication problems, in particular, predicted negative adult outcomes. Childhood QA+ was still associated with poor outcomes even when ADHD, DSE and IQ were controlled. CONCLUSIONS: Early and time-limited institutional deprivation has a critical impact on adult functioning, in part via its association with an early established and persistent variant of autism, especially related to communication difficulties. Apparent similarities and differences to non-deprivation related autism are discussed.

Navigating puberty, identity, and race among transnationally, transracially adopted Korean American adolescents.

This exploratory study examined the relation between pubertal timing and dimensions of ethnic-racial identity among adopted Korean Americans raised transracially in White families. The study also examined whether internalized racism moderated the association between pubertal timing and ethnic-racial identity. Adopted Korean American adolescents (N = 202; 108 females; ages 13-19 years) completed measures of pubertal development, ethnic-racial identity, and internalized racism in 2007. There was no significant main effect of pubertal timing for either male or female adolescents. Internalized racism moderated the relation between pubertal timing and ethnic-racial identity clarity (B = -.16, p = .015) among male adolescents. Specifically, earlier pubertal timing was significantly associated with lower ethnic-racial identity clarity for male adolescents with higher levels of internalized racism.

Care of Diverse Families: Foster Care and Adoption.

Foster care is a service for children who cannot live with their families. There are many reasons for foster care, the most common of which is parental neglect and/or substance abuse. At any one time, more than 400,000 US children are in foster care. Although 59% are eventually reunited with their parents, some end up in other situations, including adoption. Children should undergo a physician evaluation within 72 hours of entering foster care, a comprehensive evaluation within 30 days, and a follow-up visit within 60 to 90 days, followed by routine care. Adoption occurs for 1 of every 50 children; approximately 1% of adoptees are from other countries. There are many forms of adoption, including open (birth parents have contact with the adopted child), closed (contact is not permitted), and kinship (adopting parents are relatives of the child). Approximately one-quarter of adoptions are transracial/transethnic. Adoptions by LGBTQIA+ (lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual/agender, and other identities) people also are common. Parents planning adoption should talk to the physician who will care for the child to review the child's health records, and continue with routine care after adoption. For international adoptions, numerous infectious disease tests are required before and after the child's arrival in the United States. Adoptees also should undergo developmental evaluation and screening for adverse childhood experiences and mental health issues.

Concept analysis of adoption: A hybrid model.

BACKGROUND: Adoption is a multidimensional concept affected by cultural and social factors. On the other hand, the number of adoptees has recently increased indicating the need to pay more attention to this issue. However, no clear definition of this concept has been provided so far. OBJECTIVE: The objective of this study was to analyze the concept of adoption. METHODS: The present study was an analysis using a hybrid model in three phases. During the theoretical phase, using the keyword "adoption," pertinent articles published between 2010 and 2022 were searched. In the field work phase, eight adoptive parents as the participants were interviewed and the data were analyzed using conventional content analysis method. In the final analysis phase, a general analysis of the two previous phases was performed and a final definition was presented. RESULTS: Adoption is one of the ways of having children that helps infertile couples to experience parental pleasure. If adoption is done wisely based on the abilities of parents, it can provide the best care setting for the child's growth leading to the consolidation of the family and a purposeful life. In adoption, all of the rights and responsibilities of the child are transferred from the biological parents to the adoptive parents, which is affected by religious and cultural beliefs. CONCLUSION: The analysis of the concept of adoption provided a good basis for identifying the various dimensions of adoption and its challenges. The parents need to pay attention to all dimensions of adoption before selecting this path. It also provided a good platform for future research in the field of adoption.

Do adoption age and country of origin matter for non-kin adoptees' risk of psychiatric contact and post-adoption out-of-home care placement?

AIM: The aim of this study was to investigate within-group differences among Danish non-kin adoptees with regard to probability of mental health problems and post-adoption out-of-home care (OHC) placement, with a particular focus on whether adoption age and country of origin mattered. METHODS: I used Danish registry data on non-kin adoptees born between 1989 and 1994 (N=2922) at the age of 17 and applied bivariate analyses and seemingly unrelated regression to describe associations between non-kin adoptees' adoption characteristics and two outcomes: (a) psychiatric contact and (b) post-adoption OHC. RESULTS: Psychiatric contact and post-adoption OHC co-occurred among non-kin adoptees, and these two life events should be considered jointly. Adoption age mattered equally for the risk of psychiatric contact and OHC, but country of origin mattered more for psychiatric contact than for OHC. Adoption at one year of age and older was associated with an elevated risk of psychiatric contact and OHC. Romanian adoptees had a higher likelihood of psychiatric contact when compared to all the other adoptees, regardless of country of origin. In contrast, adoptees from India had a lower probability of psychiatric contact and of entering OHC compared to all the other adoptees. CONCLUSIONS: The heterogeneity in non-kin adoptees' psychiatric contact and OHC in terms of adoption age and country of origin is important to consider in future research, as well as for social workers and clinicians in their role of promoting health and preventing mental health problems.

Deficits in adolescent social functioning, dysfunctional family processes and genetic risk for schizophrenia spectrum disorders as risk factors for later psychiatric morbidity of adoptees.

Social functioning deficits during adolescence are associated with later psychiatric morbidity, particularly in offspring at high genetic risk for schizophrenia spectrum disorders. However, a shortcoming of earlier study findings is the lack of control of the impact of the family rearing environment. The study was aimed to examine the association of adoptees' social functioning during adolescence, adoptive family functioning, and adoptees' high (HR) or low (LR) genetic risk for schizophrenia spectrum disorders with adoptees' later psychiatric morbidity. The present subsample from the nationwide Finnish Adoptive Family Study of Schizophrenia included 57 HR and 60 LR adoptees. Adolescent social functioning was assessed using UCLA Social Attainment Survey (UCLA SAS). Adoptive family functioning was based on Global Family Ratings (GFRs) and psychiatric disorders on DSM-III-R criteria. The results indicated that, after controlling for adoptive family functioning and genetic risk for schizophrenia spectrum disorders, deficits in peer relationships during adolescence were associated with an increased likelihood of psychiatric morbidity of adoptees. Our findings highlight social functioning deficits during adolescence, specifically in peer relationships, as plausible independent risk factors for later psychiatric disorders. These results can be utilized in identifying possible at-risk groups and targets for prevention and in developing preventive strategies.

Caring for nontraditional families: Kinship, foster, and adoptive.

PURPOSE: Information about nontraditional (kinship, foster, and adoptive) families is typically scattered or overlooked both in nursing education and nursing practice settings. Using a nursing-centric, population-focused lens, the current state of nontraditional families in the United States is briefly described. An overview of the challenges and psychological dynamics involved when a nonbiological parent assumes the role of caregiver is provided. CONCLUSION: Based on the 2010 Census findings and other indicators, we now understand that nontraditional families and their children make up a considerable portion of the population. Nurses, regardless of level of practice, have the potential to positively impact health outcomes of nontraditional parents and their children. Knowledge of the formation and needs of nontraditional families can inform, and improve, culturally safe, trauma-informed nursing care. PRACTICE IMPLICATIONS: This discussion is a first step in appreciating the formation of nontraditional families and the importance of trauma-informed, unbiased, nonstereotypic discourse in nursing care. By describing the heterogeneity of how families are built through kinship care, foster placements, and adoptive homes, nurses' assessments and interventions will be informed and through a lens of the high potential for past traumas. With this foundational knowledge, nurses interfacing with nontraditional families are better prepared to provide much needed support and relevant care for this unique population.

The effect of cognitive behavior therapy on attitude of infertile individuals toward child adoption.

Background: Infertility is one of the most important life-threatening crises that will cause serious psychological problems and serious stressful experiences for couples. Granting the parenting of neglected children can benefit both infertile couples and those children. Purpose: The study aimed to investigate the effect of Cognitive-Behavioral Counseling (CBT) on the attitude of infertile individuals towards child adoption. Methods: It is a clinical trial study. Forty samples were determined in each case and control group. Five 90-minute cognitive-behavioral counseling sessions were held for the intervention group. Control group participants were on the waiting list. Data were reported based on frequency distribution, central distribution, dispersion, Wilcoxon, and paired T-test. The level of significance was set at p < 0.05. Findings: Participants in this study had a mean age of 32.5 years old, the mean years without children was 6.29 years, most of them had higher education. The majority of individuals in the control and intervention groups referred more than once to treat infertility. Based on the current study results, the attitude score of the intervention group before the consultation was 100.74, and it was 112.46 after counseling (p = 0.046). Moreover, the score of attitudes toward adoption after counseling in the control group was 97.10 and 112.46 in the intervention group (p < 0.001). Conclusions: CBT has been influential on the attitude of infertile people towards adoption.

Prática psicológica mediada por tecnologia: relato de experiência de grupos reflexivos com pretendentes à adoção de crianças e adolescentes / Psychological practice mediated by technology: experience report of reflective groups with applicants for adoption of children and adolescents / Práctica psicológica mediada por tecnología: informe de experiencia de grupos reflexivos con solicitantes de la adopción de niños y adolescentes

Os grupos reflexivos voltados à temática da adoção surgem como forma de proporcionar espaços grupais comprometidos com a elaboração das moti-vações e angústias que permeiam o processo adotivo. Com a chegada da pandemia da COVID-19, muitas atividades foram adaptadas para o contexto on-line e fizeram uso de tecnologias da informação, incluindo os grupos no âmbito da adoção. Assim, o presente relato de experiência se propõe a refletir sobre a potência e especificidades das intervenções grupais, considerando os desafios e possibilidades da atuação on-line, bem como delinear estratégias de condução e modos de coordenação de grupos on-line no contexto da parentali-dade adotiva. Observou-se que a vivência de grupos online com pretendentes à adoção pode ser uma forma de intervenção profícua e possibilita reflexões grupais com participantes de diferentes etapas da pré-adoção, bem como integrantes de diferentes localidades. Além disso, observou-se que a moda-lidade on-line facilitou a participação, otimizando o tempo. Como desafios, foi relatada a dificuldade na conexão de internet e a falta de contato físico e conversa frente a frente. A partir de algumas temáticas, buscou-se propor-cionar a reflexão sobre todo o projeto adotivo, desde as motivações para a adoção ao momento pós-adoção.

Reflective groups, focused on the theme of adoption, appear as a way to provide group spaces committed to developing the motivations and anxieties that permeate the adoption process. With the arrival of the COVID-19 pandemic, many activities were adapted to the online context and made use of infor-mation technologies, including groups within the scope of adoption. Thus, this experience report aims to reflect on the power and specificities of group interventions, considering the challenges and possibilities of online action, as well as outlining strategies for conducting and mediating online groups in the context of adoptive parenting. It was observed that the experience of online groups with applicants for adoption can be a fruitful form of intervention and enables group reflections with participants from different stages of pre--adoption, as well as members from different locations. Furthermore, it was observed that the online modality facilitated participation, optimizing time. As challenges, difficulties with internet connection and lack of physical contact and face-to-face conversation were reported. From some themes, we sought to provide reflection on the entire adoptive project, from the motivations for adoption to the post-adoption moment.

Los grupos reflexivos enfocados en el tema de la adopción surgen como una forma de proveer espacios grupales comprometidos con la elaboración de motivaciones y ansiedades que pertenecen al proceso de adopción. Con la llegada de la pandemia COVID-19, muchas actividades fueron adaptadas al contexto on-line e hicieron uso de tecnologías de la información, incluyendo grupos acerca de la adopción. Así, el presente informe de experiencia se propone reflexionar sobre la potencia y especificidades de intervenciones grupales, considerando los desafíos y posibilidades de actuar en línea, así como delinear estrategias para conducir y coordinar grupos on-line en el contexto de la parentalidad adoptiva. Se observó que la experiencia de grupos on-line con solicitantes de adopción puede ser una forma de intervención fructífera y permite reflexiones grupales con participantes de diferentes etapas de adopción previa, así como miembros de diferentes localidades. Además, se observó que la modalidad on-line facilitó la participación, optimizando el tiempo. Como desafíos se reportaron dificultades en la conexión a internet y falta de contacto físico y conversación cara a cara. A partir de algunos temas, se buscó propor-cionar una reflexión sobre todo el proyecto adoptivo, desde las motivaciones para la adopción hasta el momento posterior a la adopción.

Adoption, Infertility, and Love Affirmed.

A nurse describes the emotional journey of getting pregnant and giving birth after the experiences of adoption and infertility.

Exploring the relationship between adoption and psychological trauma for children who are adopted from care: A longitudinal case study perspective.

Children who have been adopted from care are very likely to have experienced early adversity that may result in psychological trauma. A current debate in the field is whether adoption provides a pathway to healing for traumatised children, helping them to recover from past psychological harm, or creates trauma for children through the very nature of being an adopted child. OBJECTIVE: This study aimed to use longitudinal data pertaining to children who had been adopted from care to examine the relationship between being adopted from care and psychological trauma. PARTICIPANTS AND SETTING: Seventeen adopted children had been interviewed in their adoptive homes during the third wave of the Care Pathways and Outcomes study (McSherry et al., 2013), when they were aged between nine and 14 years old. Ten of these children were selected for specific consideration in this article. Checklists for early adversities and psychological trauma were used to support the creation of case studies that highlighted the extent of psychological trauma in the children's lives. RESULTS: The adopted children either experienced possible pre-care psychological trauma, with the impact of this reducing over time, in utero developmental harm due to their mother's alcohol misuse during pregnancy, inherited an intellectual disability, with the resultant difficulties superseding any concern regarding possible pre-care psychological trauma, or possible psychological trauma when moving from an established foster placement to adoption. Recommendations for policy and practice are provided.

When the Good Object is also a Thief: A Memoir of Adoption.

This contemporary Kleinian memoir explores the possible existence of an intrapsychic, adoption-specific preoedipal triad including child, birth mother, and adoptive mother that can shape the emerging mind. As an intrapsychic construct, the adoption triad comes to exist in the infantile mind, requiring that adoptees contend with four additional part-object maternal representations: a villain (bad birth mother), a victim (good birth mother), a rescuer (good adoptive other), and a thief (bad adoptive mother). The psychic complexities of this possible adoption triad are explored, with an eye to how it might illuminate the psychosocial challenges experienced by some adoptees, including dysregulated behavior, rage, dissociation, and shame. To this end, Bion's ideas regarding presymbolic, nondefensive communication and Winnicott's understanding of use of the object are invoked. Expanding the preoedipal paradigm of adoption to include the possibility of an intrapsychic, adoption-specific maternal triad can enhance our understanding of the psychology of adoption, as well as highlight the need to consider the ways in which internal objects can exist simultaneously in both dyadic and triadic paradigms.

A trauma-informed substance use disorder prevention program for transracially adopted children and adolescents.

The prevalence of substance use among transracial and international adoptees is higher than that of non-adopted persons, and yet no specialized treatment modalities exist for this underserved population. Our purpose is to propose a substance use disorder (SUD) prevention program for transracial adoptive families that addresses the specific issues that face this community. There are several pre- and post-adoption factors which position transracial and international adoptees (TRIAs) to be at higher risk to develop SUDs. Some of these factors include adoption identity, trauma, loss, genetics, and racial discrimination. The biopsychosocial (BPS) model (Engel, 1977) is used to conceptualize SUDs in adoptees, and theories that focus on adoption-related development issues such as the Adoptee Stress and Coping Model (Brodzinsky, 1990) are also presented. Our proposed program, Strengthening Transracial Adoptive Families (STAF), utilizes the Guiding Good Choices (GGC) prevention program as its foundation to integrate a culturally responsive adoption-focused curriculum to best serve transracial adoptive families.

Advocating the need for neuro-informed working with intercountry adoptees.

BACKGROUND: Intercountry adoption is declining and many adoptees at any point of their life are in search of therapeutic services. Specialized care is scare and regular services seem to be missing the point. Regular therapeutic services do not cater to the specific needs of adoptees because they often forget to take the early adversity into account. Adoption specific therapeutic services are called for worldwide, this needs not be very difficult. Affective neurobiology, trauma and attachment research next to adoption studies have given practitioners many tools to design a sustainable therapeutical practice for both adoption aware assessment as well as adoption aware treatment. OBJECTIVE: Advocating a neuro-informed approach to treatment when intercountry adoptees present developmental or other mental health problems. This approach is based on a combination of professional reflection as well as on theory and the idea is that it can be used broadly by clinicians, even when not specifically trained or focused on intercountry adoptions. PARTICIPANTS AND SETTING: Theoretical insights are combined with clinical experience in De Adoptiepraktijk, a private, specialized mental health practice, making the argument for embracing a neuro informed approach in working with intercountry adoptees in the Netherlands. METHODS: Theoretical evaluation, argumentation and personal reflection illustrated by a small case study. Results Overview of problems, models and methods to be used in clinical work with intercountry adoptees. CONCLUSIONS: Proposition to use theoretical and practical insights from the neurosequential network, dyadic developmental psychotherapy, sensorimotor psychotherapy1 and the polyvagal theory to help clinicians assess the problems adopted clients encounter and plan interventions accordingly.

Adopted individuals' interest in elective genomic testing.

PURPOSE: Adoptees are a population that could benefit from genetic testing to fill gaps in family health history (FHH). Elective genomic testing (EGT) provides adoptees with clinical genetic testing options to learn about genetic health risks in the absence of FHH. We assessed adoptees' interests in, motivations for and perceived utility of EGT. METHODS: Adult adoptees and non-adoptees completed an anonymous, online survey regarding their interest and motivations for EGT, perceived utility of potential results and willingness to pay for EGT. A validated measure of social identity was included to measure the effects of social identity on testing interest. RESULTS: There were 112 adoptees and 229 non-adoptees included in the study. Adoptees reported greater interest in EGT (OR 5.0, 95% CI 2.2 to 11.3) than non-adoptees. They were motivated by curiosity and a desire to learn information about risks to children and grandchildren more than non-adoptees. Adoptees with higher education and non-adoptees with higher incomes were significantly more likely to spend more on EGT. Adoptees with higher incomes and non-adoptees with higher education were not significantly more likely to spend more. Social identity was a significant mediator between adoption and testing motivation. CONCLUSION: Understanding adoptees' unique motivations and interests in EGT will allow healthcare providers to better address the informational needs and desires of this population. Social identity provides a foundation for recognising adoptees' universal experiences that influence motivations for genetic testing.