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Behavior problems in postinstitutionalized internationally adopted children

Published online by Cambridge University Press:  22 January 2007

MEGAN R. GUNNAR
Affiliation:
University of Minnesota
MANFRED H. M. VAN DULMEN
Affiliation:
Kent State University

Abstract

Using the Child Behavior Checklist (CBCL), the rate and type of behavior problems associated with being reared in an institution prior to adoption were examined in 1,948, 4- through 18-year-old internationally adopted children, 899 of whom had experienced prolonged institutional care prior to adoption. The children's adoptions were decreed between 1990 and 1998 in Minnesota. Binomial logistic regression analyses revealed that early institutional rearing was associated with increased rates of attention and social problems, but not problems in either the internalizing or externalizing domains. Independent of institutional history, children who were adopted ≥24 months had higher rates of behavior problems across many CBCL scales, including internalizing and externalizing problems. In general, time in the adoptive home, which also reflected age at testing, was positively associated with rates of problem behavior. Thus, there was little evidence that the likelihood of behavior problems wane with time postadoption. Finally, children adopted from Russia/Eastern Europe appeared at greater risk of developing behavior problems in several domains compared to children adopted from other areas of the world.Members of the International Adoption Project (IAP) Team, all of whom are from the University of Minnesota, are H. Grotevant (Family Social Science); R. Lee (Psychology); W. Hellerstedt (Epidemiology); N. Madsen and M. Bale (Institute of Child Development); and D. Johnson, K. Dole, and S. Iverson (Pediatrics). This research was supported by an NIMH grant (MH59848) and K05 award (MH66208) to M. R. Gunnar. The authors thank the IAP parent board, the Minnesota Adoption Unit and its director, Robert DeNardo, and the adoption agencies that encouraged this work: Children's Home Society, Lutheran Social Services, Crossroads, Hope International, Bethany International, Child Link International, European Children Adoption Services, International Adoption Services, Great Wall China Adoption, and New Horizons. Special thanks are due to the many parents who completed the IAP survey.

Type
Research Article
Copyright
© 2007 Cambridge University Press

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References

REFERENCES

Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4–18 and 1991 profile. Burlington, VT: University of Vermont, Department of Psychiatry.
Ames, E. (1997). The development of Romanian orphanage children adopted to Canada (Final Report to the National Welfare Grants Program: Human Resources Development Canada). Burnaby, Canada: Simon Fraser University.
Ames, E. W. (1990). Spitz revised: A trip to Romanian “orphanages.” Canadian Psychological Association Developmental Psychology Section Newsletter, 9, 811.Google Scholar
Berry, M., & Barth, R. P. (1989). Behavior problems of children adopted when older. Children and Youth Services Review, 11, 221238.CrossRefGoogle Scholar
Bohlin, G., & Janols, L. O. (2004). Behavioural problems and psychiatric symptoms in 5–13 year-old Swedish children—A comparison of parent ratings on the FTF (Five to Fifteen) with the ratings on CBCL (Child Behavior Checklist). European Child and Adolescent Psychiatry, 13(Suppl. 3), 422.Google Scholar
Bohman, M., & Sigvardsson, S. (1980). A prospective, longitudinal study of children registered for adoption. Acta Psychiatrica Scandinavica, 61, 339355.CrossRefGoogle Scholar
Brand, A. E., & Brinich, P. M. (1999). Behavior problems and mental health contacts in adopted, foster, and nonadopted children. Journal of Child Psychology and Psychiatry, 40, 12211229.CrossRefGoogle Scholar
Croft, C., O'Connor, T. G., Keaveney, L., Groothues, C., & Rutter, M. (2001). Longitudinal changes in parenting associated with developmental delay and catch-up. Journal of Child Psychology and Psychiatry, 42, 649659.CrossRefGoogle Scholar
DeRosier, M., & Thomas, J. M. (2003). Strengthening sociometric predictions: Scientific advancement of children's peer relations. Child Development, 74, 13791392.CrossRefGoogle Scholar
Durston, S., Tottenham, N. T., Thomas, K. M., Davidson, M. C., Eigsti, I., Yang, Y., et al. (2003). Differential patterns of striatal activation in children with and without ADHD. Biological Psychiatry, 53, 871878.CrossRefGoogle Scholar
Fisher, L., Ames, E. W., Chisholm, K., & Savoie, L. (1997). Problems reported by parents of Romanian orphans adopted to British Columbia. International Journal of Behavioral Development, 20, 6782.CrossRefGoogle Scholar
Gunnar, M. R. (2000). Early adversity and the development of stress reactivity and regulation. In C. A. Nelson (Ed.), The effects of adversity on neurobehavioral development. The Minnesota Symposia on Child Psychology (Vol. 31, pp. 163200). Mahwah, NJ: Erlbaum.
Gunnar, M. R. (2001). Effects of early deprivation: Findings from orphanage-reared infants and children. In C. A. Nelson & M. Luciana (Eds.), Handbook of developmental cognitive neuroscience (pp. 617629). Cambridge, MA: MIT Press.
Groza, V., & Ileana, D. (1996). A follow-up study of adopted children from Romania. Child and Adolescent Social Work Journal, 13, 541565.CrossRefGoogle Scholar
Groza, V., & Ryan, S. D. (2002). Pre-adoption stress and its association with child behavior in domestic special needs, and international adoptions. Psychoneuroendocrinology, 27, 181198.CrossRefGoogle Scholar
Hodges, J., & Tizard, B. (1989). Social and family relationships of ex-institutional adolescents. Journal of Child Psychology and Psychiatry and Allied Disciplines, 30, 7797.CrossRefGoogle Scholar
Ingersoll, B. D. (1997). Psychiatric disorders among adopted children: A review and commentary. Adoption Quarterly, 1, 5773.CrossRefGoogle Scholar
Johnson, D. (2000). Adopting a post-institutionalized child: What are the risks? In T. Tepper, L. Hannon, & D. Sandstrom (Eds.), International adoption: Challenges and opportunities (2nd ed., pp. 58). Meadowlands, PA: Parent Network for Post Institutionalized Children.
Johnson, D. E. (2001). The impact of orphanage rearing on growth and development. In C. A. Nelson (Ed.), The effects of adversity on neurobehavioral development: Minnesota Symposia on Child Psychology (Vol. 31). New York: Erlbaum.
Juffer, F., & van Ijzendoorn, M. H. (2005). Behavior problems and mental health referrals of international adoptees: A meta-analysis. Journal of the American Medical Association, 293, 25012515.CrossRefGoogle Scholar
Kish, L. (1965). Survey sampling. New York: Wiley.
Lindblad, F., Hjern, A., & Vinnerljung, B. (2003). Intercountry adopted children as young adults: A Swedish cohort study. American Journal of Orthopsychiatry, 73, 190202.CrossRefGoogle Scholar
Maclean, K. (2003). The impact of institutionalization on child development. Development and Psychopathology, 15, 853884.CrossRefGoogle Scholar
Marcovitch, S., Goldberg, S., Gold, A., Washington, J., Wasson, C., Krekewich, K., et al. (1997). Determinants of behavioural problems in Romanian children adopted in Ontario. International Journal of Behavioral Development, 20, 316.Google Scholar
Miller, B. C., Fan, X., Christensen, M., Coyl, D., Grotevant, H. D., & van Dulmen, M. (2000). Adopted adolescents' over-representation in mental health counseling: Adoptees' problems or parents' lower threshold for referral. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 18.Google Scholar
O'Connor, T. G., & Rutter, M. (2000). Attachment disorder behavior following early severe deprivation: Extension and longitudinal follow-up. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 703712.CrossRefGoogle Scholar
Peters, B. R., Atkins, M. S., & McKay, M. M. (1999). Adopted children's behavior problems: A review of five explanatory models. Clinical Psychology Review, 19, 297328.CrossRefGoogle Scholar
Posner, M. I., & Petersen, S. E. (1990). The attention system of the human brain. Annual Review of Neuroscience, 13, 2542.CrossRefGoogle Scholar
Reijneveld, S. A., Brugman, E., Verhulst, F. C., & Verloove-Vanhorick, S. P. (2005). Area deprivation and child psychosocial problems: A national cross-sectional study among school-aged children. Social Psychiatry and Psychiatric Epidemiology, 40, 1823.CrossRefGoogle Scholar
Roy, P., Rutter, M., & Pickles, A. (2000). Institutional care: Risk from family background or pattern of rearing? Journal of Child Psychology and Psychiatry, 41, 139141.Google Scholar
Roy, P., Rutter, M., & Pickles, A. (2004). Institutional care: Associations between overactivity and lack of selectivity in social relationships. Journal of Child Psychology and Psychiatry, 45, 866873.CrossRefGoogle Scholar
Rutter, M. (1981). Maternal deprivation reassessed. New York: Penguin Books.
Rutter, M. (1998). Developmental catch-up, and deficit, following adoption after severe global early deprivation. English and Romanian Adoptees (ERA) Study Team. Journal of Child Psychology and Psychiatry and Allied Disciplines, 39, 465476.Google Scholar
Rutter, M., Anderson-Wood, L., Beckett, C., Bredenkamp, D., Castle, J., Groothues, C., et al. (1999). Quasi-autistic patterns following severe early global privation. English and Romanian Adoptees (ERA) Study Team. Journal of Child Psychology and Psychiatry and Allied Disciplines, 40, 537549.CrossRefGoogle Scholar
Rutter, M., Kreppner, J. M., & O'Connor, T. G. (2001). Specificity and heterogeneity in children's responses to profound institutional privation. English and Romania Adoptees (ERA) Study Team. British Journal of Psychiatry, 179, 97103.Google Scholar
Rutter, M., & O'Conner, T. G. (2004). Are there biological programming effects for psychological development? Findings from a study of Romanian adoptees. English and Romania (ERA) Study Team. Developmental Psychology, 40, 8194.Google Scholar
Sharma, A. R., McGue, M. K., & Benson, P. L. (1998). The psychological adjustment of United States adopted adolescents and their nonadopted siblings. Child Development, 69, 791802.CrossRefGoogle Scholar
Simmel, C., Brooks, D., Barth, R. P., & Hinshaw, S. P. (2001). Externalizing symptomatology among adoptive youth: Prevalence and pre-adoption risk factors. Journal of Abnormal Child Psychology, 29, 5769.CrossRefGoogle Scholar
Smyke, A. T., Dumitrescu, A., & Zeanah, C. H. (2002). Attachment disturbances in young children. I: The continuum of caretaking casualty. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 972982.Google Scholar
StataCorp. (1997). Stata statistical software: Release 5.0. College Station, TX: Author.
Tarullo, A., & Bruce, J. & Gunnar, M. R. (in press). False belief and emotion understanding in post-institutionalized children. Social Development.
Tessler, R., Adams, G., Houlihan, L., & Groza, V. (2004). Mother–daughter relationships among Chinese and Romanian adoptees. International Journal of Child and Family Welfare, 1, 2643.Google Scholar
Tieman, W, van der Ende, J., & Verhulst, F. (2005). Psychiatric disorders in young adult intercountry adoptees: An epidemiological study. Journal of Psychiatry, 162, 592598.CrossRefGoogle Scholar
Tizard, B., & Hodges, J. (1978). The effect of early institutional rearing on the development of eight-year-old children. Journal of Child Psychology and Psychiatry and Allied Disciplines, 19, 99118.CrossRefGoogle Scholar
Verhulst, F. C., Althaus, M., & Versluis-Den Bieman, H. J. (1990a). Problem behavior in international adoptees: I. An epidemiological study. Journal of the American Academy of Child & Adolescent Psychiatry, 29, 94103.Google Scholar
Verhulst, F. C., Althaus, M., & Versluis-Den Bieman, H. J. (1990b). Problem behavior in international adoptees: II. Age at placement. Journal of the American Academy of Child & Adolescent Psychiatry, 29, 104111.Google Scholar
Verhulst, F. C., Althaus, M., & Versluis-den Bieman, H. J. (1992). Damaging backgrounds: Later adjustment of international adoptees. Journal of the American Academy of Child & Adolescent Psychiatry, 31, 518524.CrossRefGoogle Scholar
von Knorring, A. L., Bohman, M., & Sigvardsson, S. (1982). Early life experiences and psychiatric disorders: An adoptee study. Acta Paediatrica Scandinavica, 65, 283291.CrossRefGoogle Scholar
Westhues, A., & Cohen, J. S. (1997). A comparison of the adjustment of adolescent and young adult inter-country adoptees and their siblings. International Journal of Behavioral Development, 20, 3346.Google Scholar
Warren, S. B. (1992). Lower threshold for referral for psychiatric treatment for adopted adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 31, 512527.CrossRefGoogle Scholar