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Home / Schedule / Symposium: Psychological and Medical Issues for Internationally Adopted Adolescents: Update 2018
WED July 11, 2018 WED July 11, 2018
1:30 pm 1:30 pm
International II International II

Laura Ferrari

Postdoctoral fellow, Family Studies and Research University Centre, Catholic University of Milan

Jesús Palacios

Jesús Palacios

Professor, Department of Developmental Psychology, University of Sevilla

Maite Román

Associate Professor, Department of Developmental and Educational Psychology, University of Seville

Carmen Moreno

Professor, Department of Developmental and Educational Psychology, University of Seville

Isabel Cáceres

Graduate student in psychology, University of Seville

Marie-Odile Perouse de Montclos

Chief of Psychiatry, Centre Hospitalier Sainte-Anne

Laurie C. Miller

Professor of Pediatrics, Nutirtion and Child Development, Tufts University

Laurie C. Miller

Professor of Pediatrics, Nutirtion and Child Development, Tufts University

Symposium: Psychological and Medical Issues for Internationally Adopted Adolescents: Update 2018

Parent-child relationship and adoptees’ psychosocial adjustment: Mothers’, fathers’, and children’s perceptions

Many studies have emphasized that family processes are relevant factors in promoting adolescents’ psychosocial development, and highlighted the specific role played by mothers and fathers. In the adoption literature there is still a paucity of studies focused on the quality of parents-child relationships, and even less research has assumed a family perspective, comparing the perceptions of different members within the family. According to the multi-informant approach, this study intended to assess the quality of parent-child relationship (i.e. satisfaction, communication), and to compare mothers’, fathers’, and children’s perceptions. Moreover, the links among these relational dimensions and adoptees’ adjustment and risk behaviors will be investigated. One hundred internationally adopted adolescents (13-17 years of age), and their adoptive parents took part to the study. Participants were asked to fill in on-line a self-report questionnaire. Data analyses are still in progress. Findings will be discussed also with attention to practical implication for interventions supporting and promoting adoptive families’ relationships.

Psychological development and life styles in teenagers from the Russian Federation adopted in Spain

Adoptees during the baby boom of intercountry adoption are now in their teenage years, making possible and demanding research into this very relevant developmental stage. Together with China, the Russian Federation was another top destination for adopters from Spain during the years when intercountry adoptions outnumbered domestic adoptions, before the sharp decline in numbers starting in year 2005. Arrived to their new families at an average age of 3.5 years, those children are now in the adolescence. Within the frame of an international research effort involving several European countries, the main goal of the study is to analyze different domains of psychological development and adjustment, as well as several indicators of life style in a sample of internationally adopted adolescents. The sample consisted of approximately 50 teenagers from the Russian Federation adopted by families in Spain. Contents studied include personal development, psychosocial adjustment, interpersonal relationships and health related life styles, including substance abuse. The data of the adopted adolescents will be compared with those of a non-adopted group of community children from the same social context. The results will offer information about some contents little explored so far in adoption research (life style and health related behavior), as well as information about development and adjustment during the critical years of adolescence in adopted youngsters. The comparison with the findings from the other countries in the project will illuminate similarities and differences between adoptees growing up in cultural settings that are both similar and different in their demography, their culture, their life style and the dynamics of family and social life.

Psychopathology of the internationally adopted adolescent: experience in a specialized psychiatric consultation service in Paris

Background:
Research suggests that adopted children have an increase in mental health problems. However, little is known about the type and severity of these diagnoses. The mental and psychological health of internationally adopted adolescents is of particular interest, as this is a period of life where many questions arise related to identity and individuality. Therefore, we reviewed a database of children and adolescents seen in consultation in a psychiatric service directed towards internationally adopted children and their families to determine the patterns of diagnoses and associated demographic factors.

Methods:
A database of all 465 children seen between 2010-15 in the international adoption consultation service (CAI) at Hospitalier St. Anne, Paris was reviewed. Only the 226 children seen for initial visits between the ages of 9 and 20 years were included for this analysis. Of these, only 163 had the diagnosis code for the visit correctly entered. These 163 children (135M:91F) were the subject of this analysis; 71% were seen by the same child psychiatrist. Diagnoses were grouped into 6 clusters, using the standard « Classification internationale des maladies, 10e révision (CIM-10) », as follows : Neurotic disorders, Disorders of psychologic development, Behavioral and conduct disorders, Emotional disorders of childhood, Attachment disorders, and Other.

Results:
Average age at first visit was 13.40+3.02 years. Children had been adopted from 29 different countries (Eastern Europe [EE] 53%, Central/South America [AM] 21%, Asia [AS] 15%, Africa [AF] 8%, and Other 3%). Age at arrival ranged from 4 months to 6 years. Age at first visit did not relate to continent of origin. Attachment disorders were the most common diagnosis (39%), followed by Behavioral and conduct disorders (17%), Disorders of psychologic development (15%), Neurotic disorders (11%), Emotional disorders of childhood (10%), and other (8%). Diagnosis did not relate to age at visit, family composition (single parents vs. couples), or adoption as part of a sibling group. However, continent of origin related significantly to diagnosis (overall 2 37.1, p=.02), with 51% of EE children diagnosed with attachment disorders (vs. 21-30% for the other continents, p=.0042). An additional trend included: 39% of AM children were diagnosed with Neurotic Disorders (vs 11-22% from the other continents, p=.07).

Conclusions:
In a child psychiatry specialty consultation service in France, dedicated to internationally adopted children, a wide range of diagnoses were seen among adolescents. Attachment disorders were the most common conditions identified, and these were particularly prevalent among children adopted from EE. Multiple other diagnoses were also established, highlighting the complexity of mental health problems in this population of adolescents.

Epigenetic factors and growth recovery in internationally adopted teenagers and young adults: theoretical considerations related to later health outcomes

Background: Epigenetics refers to environmentally induced changes in the physical properties of the genome which determine how genes are expressed. Existing literature highlights the epigenetic changes which may influence the development of health problems (obesity, hypertension, diabetes, stroke, osteoporosis, hyperlipidemia) as well as mental health/behavioral disorders (depression, externalizing behaviors, antisocial behavior, attention deficit disorder). Periods of rapid growth in childhood may predispose to later insulin resistance, hypertension, and obesity. These findings are potentially important for internationally adopted children, who often were exposed to stressful prenatal and early life conditions, and then experience unusual growth patterns after adoptive placement. Epigenetic influences during these critical periods could theoretically influence growth and health outcomes for international adoptees.

Methods: Literature review of impact of epigenetic changes on growth and health outcomes, along with secondary analysis of two existing datasets containing growth information (WAZ and HAZ) at arrival and at followup: [dataset I] 70 internationally adopted teenagers and young adults (60% adopted from Eastern Europe), with followup (mean+SD) 12.6+3.4 years later, and [dataset II] 74 young international adoptees (65% adopted from Eastern Europe), mean age 8.4+2.3 years, with followup 5.91+2.84 years later.

Results: Analysis of growth patterns in the two databases revealed improved growth, with larger increases in weight compared to height (respectively [I]:+.71+1.36 vs. +.56+1.36; [II]: +.55+.89 vs. +25+1.12, p=.01). No child had HAZ or WAZ >2 at arrival; however, at followup HAZ>2 was found in 2% of children [I and II], and WAZ>2 was found in 3% [I] and 2% [II]. With shorter followup [II], 6% of children increased their HAZ or WAZ by >2 SD; with longer followup [I], 15% of children increased their HAZ by >2 SD, and 12% increased their WAZ by >2 SD.

Discussion: Complicated factors in early life, including the prenatal period, likely influence growth outcomes of internationally adopted children. Even after the relatively short followup period <6 years, 2% of children had developed overweight. Some children exhibit rapid and marked growth acceleration after adoption; it is unknown how these and other growth patterns after arrival may be linked to the development of chronic medical conditions in adulthood. The scientific basis of these theoretical implications will be discussed.

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