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Final Term Paper: Adoption and its Psychological Consequences

Jennifer Stone (6416 9863)


Psychology 270, Sec. 022
April 10, 2006

When my parents were told by school administration that my brother had ADHD and
should be put on Ritalin, they were quite upset. True, Jeffrey did exhibit many of the symptoms
of this disorder, from frequent inappropriate running to difficulty in paying attention. However,
my parents were convinced that the diagnosis was made without trying to understand what they
saw as the deeper roots of his attention and activity problems: his adoption at a little less than a
year old. After my parents sought therapy for him, he gradually improved, though without a
single dose of the drugs suggested by his teachers or counselors. As Jeffreys case illustrates,
being adopted can leave psychological marks on children. Though often too young to fully
comprehend such a major event, childrens feelings and needs still reflect their life circumstances
and can often help feed into various disorders or issues as they grow older. Jeffrey, for example,
exhibited great fears of separation, what he and my parents termed as big bye-byes. Many
adopted children and adults who were adopted exhibit not only separation anxiety, however, but
a variety of other classifiable psychological disorders and problems as well. These problems
differ according to many factors, but clear links exist between them and the traumatic event of
finding a new family. Despite increased risks of the child developing psychological difficulties,
most adoptions reflect a very positive and important process, especially if adoptive parents are
aware of the psychological difficulties that are potentially involved.
Before examining specific problems related to adoption, it is important to understand the
reasons both sets of parents choose this route. Birth mothers may choose to give up their natural-

born children for a variety of reasons, such as the lack of monetary means to support them and
the stigma associated with having a child out of wedlock (Brodzinsky and Schechter, 1990).
Although this stigma has decreased throughout the latest decades, many biological parents still
choose to put their children up for adoption. A teenager who accidentally becomes pregnant, for
example, might choose this option in order to both be able to continue her studies, and to give
her child better opportunities to succeed. Likewise, parents choose to adopt others children for
many reasons as well. A leading motive is infertility and parents fantasies of raising a child
themselves (Brodzinsky and Schechter, 1990). Parents might also just wish to avoid the birthing
process or to help less fortunate children. Whatever their intentions, however, adoptive parents
often are able to provide children with the better life for which many of their biological parents
hope.
Adopted children, however, also face psychological struggles once in their new homes
and are overall more likely to develop a psychological disorder than are non-adopted children
(Brodzinsky 1993). However, not until children are around 5 to 7 years of age do significant
differences between [adoptees and non-adoptees] begin to emerge. At this age most children
begin to understand the meaning and implications of being adopted (Brodzinsky, 1993). Of
course, only a minority of adoptees are diagnosed with mental disorders, let alone committed to a
mental institution. However, the higher proportions cannot be ignored. One possible explanation
of the differences between rates of mental disorders is simply that adoptive parents are used to
dealing with social services and take note of potential problem behaviors more readily (Adamec
and Pierce, 1991). Another possibility is, of course, that adoptees themselves are more prone to
psychological illnesses. The truth may lie somewhere in the middle.

Adoptees must deal with specific psychological challenges and stressors related directly
to the adoption process, issues that may contribute to the onset of various full-blown disorders.
One problem that can develop particularly in adoptees is attachment disorder, which is a serious
disorder that is common among older adopted children who survived bonding breaks, abuse, or
neglect during the first one and a half to two years of life (also known as the attachment years).
[It] is characterized by an inability to trust and severe behavioral problems that tend to worsen
with age (Groza and Rosenburg, 1998). Having such attachment difficulties may cause
additional troubles, as research has shown that non-attached children display limited abilities in
controlling aggressive impulses and feelings of frustration (Howe, 1998). Another issue with
which many adoptees grapple is feelings of powerlessness: in most cases, children had no or very
little choice in being removed from their original families and in being adopted by a new one.
Dependency conflicts and separation anxiety are also relatively frequent (Brodzinsky, 1993).
Both are likely to be responses to the severe loss suffered by the adoptee so early in life: if one
family (the biological family or foster family) can disappear so readily, why wouldnt another
(the adoptive family)?
Many of these insecurities and conflicts feed into specific DSM-IV disorders. As far as
Axis I disorders (short term problems), adoptees generally show a higher risk of conduct
disorder, attention deficit hyperactivity disorder, depression & dysthymia, and substance abuse.
Children with antisocial tendencies such as conduct disorder exhibit many externalizing problem
behaviors, especially during adolescence (Howe, 1998). Symptoms are referred to as
externalizing because inner problems are being directed outward at others, often by acting
aggressively (Gorenstein and Comer, 2002). Conduct disorder is a disruptive behavior disorder
in which children repeatedly violate others basic rights (Comer, 2004). ADHD, a disorder in

which children have difficulty attending to tasks or behave in an overactive or impulsive manner,
may be caused in part by high stress levels and family dyfunctioning. These are problems that
adopted children undoubtedly face more often than others (Comer, 2004). The onset of major
depressive disorder and dysthymia, on the other hand, may be related to the pervasive feelings of
powerlessness experienced by many adoptees (Brodzinsky and Schechter, 1990). Psychologist
Martin Seligman developed a theory of depression focusing on learned helplessness, in which
feelings of lack of control and self-blame dominate (Comer, 2004). Substance abuse in adoptees
could be a reaction to the many psychological and emotional hardships they encountered. In
addition to these disorders, adoptees are unfortunately at a higher risk for suicide as well.
Suicide attempts are significantly more common among adolescents who live with married
adoptive mothers than among adolescents who live with married biological mothers. (Slap, G.,
Goodman, E., & Huang, B., 2001).
Adoptees also display certain long-standing DSM-IV Axis II disorders in greater
numbers, notably antisocial personality disorder, borderline personality disorder, schizoid
personality disorder, schizotypal personality disorder, and dependent personality disorder. Since
patients with antisocial personality disorder (a disorder in which people persistently ignore and
violate others rights) usually have histories of conduct disorders as children and as adolescents,
the prevalence of this disorder in adoptees makes sense (Comer, 2004). Those with borderline
personality disorder, however, display great instability, shifting their moods and self-image
frequently (Comer, 2004). Those with dependent personality disorder are clinging and obedient,
fearing separation from their parentor other person with whom they are in a close relationship
(Comer, 2004). This makes sense, because in the case of adoptees separation anxiety and
attachment disorders are relatively common. Those with schizoid and schizotypal personality

disorders, meanwhile, exhibit social withdrawal (and in the case of schizotypal, odd patterns of
thinking and behaving) (Comer, 2004). Because personality disorders develop during childhood,
likely in response to parenting and family situations, the additional challenges adoptees
experience might leave them at a predisposition to develop these problems as adults.
In adopted children, these DSM-IV disorders are not only caused by the generalized
etiological factors, but also by hardships specific to the experience of adoption. One such issue
that brings many adoptees to psychotherapy is the painful search for self-knowledge (Treacher
and Katz, 2000). Unfortunately, foradoptees, the self and its origins are specifically
problematic and complex (Treacher and Katz, 2000). This lack of identity might not only
depress and confuse an adoptee, but also create added stress, sometimes released in inappropriate
means (such as in conduct disorder). Similarly, adoptees must also frequently struggle with split
feelings between their birth parents and their adoptive parents (Treacher and Katz, 2000).
Finally, adoptees undergo what Groza and Rosenburg term cumulative adoption trauma: the
series of traumas that adoptees necessarily go through (Groza and Rosenburg, 1998). There are
two main traumas in this cycle: separation from the biological parents and the later realization
that the adoptee was not born to the those he or she calls mom and dad (Groza and
Rosenburg, 1998). Both of these events are undoubtedly very hard to deal with, especially at
such a young age. Perhaps these adversities feed into the various disorders with which adoptees
struggle in disproportionately large numbers.
Various theoretical models can be utilized to help explain the psychological disorders and
conflicts faced by adoptees, one of the most notable coming from the psychodynamic
perspective. The psychodynamic perspective clearly lends itself to adoption because of its
emphasis on how childhood events influence peoples adult selves. This model also stresses the

role of unconscious conflicts in abnormal functioning (Comer, 2004). As children are highly
unlikely to realize they are faced with cumulative traumas, for example, these events influence
them at an unconscious level. According to Freud, in the occurrence of an extreme trauma, the
mind may defend itself by creating delusions as a type of patch to the bruised ego (Treacher
and Katz, 2000). In the case of adoption, beliefs are utilized instead of delusions (Treacher and
Katz, 2000). These people may develop precious beliefs about their origins, which it becomes
the psychotherapeutic task to identify, explore, and help the patient relinquish in some cases
(Treacher and Katz, 2000). Such beliefs might include fantasies about birth parents (these beliefs
are known as parents in the mind) or what their life was like prior to being adopted (Treacher
and Katz, 2000). Since adoptees who were placed at a very young age cannot remember such
early memories, these might take the form of complete imagination in some cases. In
psychodynamic therapy, these beliefs are explored and dealt with.
In addition to psychodynamic perspectives on adoption, biological factors may also influence
the development of psychological disorders. For one, heredity determines many aspects of
adoptees personas. Research has in fact found that adopted children are more similar to their
biological relatives than to their adoptive relatives on characteristics such as intelligence,
personality, and even interests (Brodzinsky, 1993). These inherited traits could play a role in
how well the person copes with adoption, thus determining in part whether or not significant
psychological problems develop. In addition, prenatal experiences may determine the onset of
disorders. Adopted children, who are statistically more likely to experience adverse prenatal
experiences such as heightened maternal stress, poor maternal nutritioninadequate medical
care, [and] fetal exposure to alcohol, drugs, and other teratogenic agents, [may experience]
increased developmental problems in childhood (Brodzinsky, 1993). Fetal exposure to alcohol,

in particular, can result in mental retardation or other complications upon birth (Comer, 2004).
Postnatal care for adoptees, at least prior to the adoption, can also be insufficient. For example, if
a child is born to a poor mother in a third world country, he might not receive proper nutrition.
Therefore, he would be at risk for developmental problems, even after adopted by an affluent
couple in a first world country. These biological problems, out of adoptive parents control,
shape the child who receives them.
Biological and psychodynamic views are not the whole story, however, in the etiology of
adoption-related disorders. Sociocultural and cognitive explanations also clarify much of
adoptees psychological struggles. Based on research, one of the most important risk factors for
psychological problems appears to be the age at which the child was adopted (Brodzinsky and
Schechter, 1990). Older ages at the time of adoption have been correlated to increased chances of
developing difficulties (Brodzinsky and Schechter, 1990). In fact, the majority of studies find
that children adopted after the age of six months tend to show higher levels of anxiety, insecurity
and antisocial externalizing problem behavior during adolescence (Howe, 1998). In addition,
the presence of a biological child in the family, especially if his or her birth follows the adoption,
can be a detriment to the adoptees adjustment (Brodzinsky, 1993). The way the adoptive family
cognitively addresses the issue of adoption is also crucial in the childs adaptation and coping.
Open family communication regarding the adoption has been proven to be more beneficial than a
closed rejection of difference (Brodzinsky, 1993). Accordingly, if the family copes with the
issue of adoption ineffectively and illogically, complications are more likely to result.
It is worth repeating that the majority of adoptees never develop diagnosable
psychological disorders. How can this be, if they have so much to deal with at such a young age
and are at such an increased risk? Like in the cases of many specific illnesses, a diathesis-stress

model can be applied here: despite adoptees biological, psychological, or sociocultural


predispositions to develop a disorder, disorders dont develop unless subjects are exposed to
episodes of severe stress (in this case, individual tensions experienced with the adoptive family)
(Comer, 2004). Thus, the development of psychological disorders in adoptees is similar to the
widely known interplay of nature and nurture, nature being the risks associated with the process
of adoption, and nurture being the way the adoptive family and child cope and deal with these
challenges. This model manifests itself in a fascinating study on schizophrenia in adoptees versus
non-adoptees: Although the rate of having schizophrenia for children who live with
schizophrenic parent is 10%, this drops to only 3% for children of schizophrenic parents if they
are raised by adoptive parents (Howe, 1998). Thus, despite having an equal predisposition to
develop schizophrenia, the environment (nurture) plays a substantial role in the onset of severe
problems. Likewise, adoptees who were born to parents who had high rates of criminal behavior
(many times exhibited by those with antisocial personality disorder) overall had greater rates of
criminal behavior than their adoptive families, but lower rates than their biological families
(Howe, 1998). The adoptive familys dynamics play a large part in whether these predispositions
will develop into full-fledged disorders. Generally, the less favorablethe parenting
environment, the more susceptible are children to poor mental health (Howe, 1998). Thus,
stable and supportive adoptive families can truly help adoptees overcome the odds against them.
Following this line of reasoning, researchers have developed a theory particular to
adoption: the stress and coping model of adoption adjustment. Integrating many perspectives, its
primary assumption is that childrens adjustment to adoption is determined largely by how they
view or appraise their adoption experience and the type of coping mechanisms they use to deal
with adoption-related stress. It is assumed that, when children view adoption as stigmatizing,

threatening, or involving loss, a pattern of negative emotions associated with stressis likely to
be experienced (Brodzinsky, 1993). Thus, satisfaction with and acceptance of adoptive
parenthood, along with warm and accepting attitudes toward the child, are predictive of more
positive adjustments than when parents are rejecting or are dissatisfied (Brodzinsky, 1993).
Cognitive functioning and personality characteristics on the part of the child also effect how the
adoption is appraised (Brodzinsky, 1993). Overall, adoption is largely what the adoptive family
makes of it; it can be either quite positive or quite negative.
Although adoption carries with it numerous psychological risks to the child, one must
examine the alternatives to appreciate how these risks may still be worth it. Biological parents
who choose to give up a child for adoption in most cases could not provide the child with the
same quality of care as the adoptive parents (Brodzinsky and Schechter, 1990). Especially in the
case of international adoptions, available health care and nutrition are inferior to what the child
would receive after being adopted (Brodzinsky, Smith, and Brodzinsky, 1998). Children in foster
care (often a step in between the biological parents and an adoptive family) can also suffer
deplorable care and even abuse (Brodzinsky, 1993). A woman I know who adopted a child from
Columbia was told, in fact, that by choosing to adopt a girl, she was accepting a 50% chance that
the child had been sexually abused in foster care. Research also shows that those adoptees who
lived in long term foster care were more likely to develop alcohol problems later on (Brodzinsky,
1993). Some children put up for adoption are frequently relocated as well, which is a difficult
and confusing experience for young children (Brodzinsky et al., 1998). Adoption to a caring and
supportive family can rescue children from these lamentable environments.
In conclusion, although being adopted puts children at risk for a variety of psychological
issues and disorders, it also often saves them from what would be even worse conditions in

which to grow up. Moreover, the majority of adoptees are in the normal range of psychological,
behavioral, and academic functioning (Brodzinsky, 1993). Although my brother Jeffrey
experienced challenges in dealing with his adoption, he was able to overcome them through
years of therapy and now leads a normal teenage life. If he had remained in Honduras, he would
likely be living in poverty, with very little chance to go to college or otherwise expand his
horizons. Even thinking of such a thing make me cringe.

References

Adamec, C., & Pierce, W.L. (1991). The Encyclopedia of Adoption. New York: Facts on File.
Brodzinsky, D.M. (1993). Long-term Outcomes in Adoption [Electronic version]. The Future of
Children, 3(1), 153-166.
Brodzinsky, D.M., & Schechter, M.D. (Eds). (1990). The Psychology of Adoption. New York:
Oxford University Press.
Brodzinsky, D.M., Smith, D.W., & Brodzinsky, A.B. (1998). Childrens Adjustment to Adoption:
Developmental and Clinical Issues. Thousand Oaks, CA: Sage Publications, Inc.
Comer, R. J. (2004). Abnormal Psychology (5th ed.). New York: Worth Publishers.
Gorenstein, E.E., & Comer, R.J. (2002). Case Studies in Abnormal Psychology. New York:
Worth Publishers.
Groza, V., & Rosenberg, K.F. (1998). Clinical and Practice Issues in Adoption: Bridging the
Gap
Between Adoptees Placed as Infants and as Older Children. Westport, CT: Praeger
Publishers.
Howe, D. (1998). Patterns of Adoption. Malden, MA: Blackwell Science Ltd.
Treacher, A., & Katz, I. (Eds). (2000). The Dynamics of Adoption: Social and Personal
Perspectives. Philadelphia: Jessica Kingsley Publishers.
Slap, G., Goodman, E., & Huang, B. (2001). Adoption as a Risk Factor for Attempted Suicide
During Adolescence [Electronic version]. Pediatrics, 108(2), 1-8.