Adoptees at Higher Risk for ADHD

Terry Matlen, ACSW Health Guide
  • A new research study, published this month in the Archives of Pediatric and Adolescent Medicine, found that adolescents adopted as infants are twice as likely to have behavioral disorders as those who are not adopted. These behavioral disorders include ADHD and oppositional defiant disorder.


    The study followed 514 internationally adopted adolescents, 178 domestically adopted adolescents and 540 non-adopted adolescents, aged 11 to 21. The adoptions had occurred by the time the adoptees were aged 2.


    Lead researcher, Margaret A. Keyes, Ph.D., of the University of Minnesota, Minneapolis and her colleagues assessed the adolescents using child and parent reports of attention-deficit/hyperactivity, oppositional defiant, conduct, major depressive and separation anxiety disorders, teacher reports of psychological health, in-depth psychological interviews and contact with mental health professionals. Testing was done when the adolescents were on average, 15 years of age.

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    "We found that most of the adolescents - adopted and non-adopted - were
    overwhelmingly psychologically healthy," Keyes says. But Keyes also found what
    she calls "an adoption effect." Approximately seven out of
    every 100 non-adopted teens had a diagnosis of ADHD, a number that rose to 14 or
    15 for adopted youngsters.  Similarly, the risk of ODD was nearly doubled. Says Dr. Keyes, "These are kids who argue with their parents, who refuse to follow through on chores, maybe argue with their teachers, blame other people for their own mistakes." But Keyes and her colleagues found the adopted youths had no increased risk for depression, anxiety or aggressive tendencies or vandalism.


    Rutgers University professor emeritus, Dr. David Brodzinsky, who is considered a leader in the field of adoption research, expressed little surprise that adopted children showed some psychological problems.

    "Many of the serious problems associated with adoption have less to do with
    adoption, per se, than with what happens before adoption," says Brodzinsky.


    Dr. Brodzinsky adds that there are various factors to consider, such as the health of the biological parents, genetic factors, possible exposure to alcohol or drugs in utero- all which can affect the mental health of children.


    In addition, his own research reveals that adoptive parents tend to be better educated, more financially stable and more motivated to seek help than parents who do not adopt. Therefore, when adoptees exhibit psychological problems, they are more likely to seek out professional help.


    The study revealed a surprising and interesting finding: adopted children born in another country - most in this study were from South Korea - were slightly less likely to have ADHD than adopted children born in the United States, though it was thought it may be due to health conditions before birth impacted by alcohol or drugs.


    In addition, they found that international adoptees internalized their problems, with teachers reporting significantly more anxiety in this group than non-adopted adolescents, while the parents reported more depressive disorders and separation anxiety disorders. As international adoptees were more apt to internalize their problems, domestic adoptees were more likely to externalize, thus the ADHD and ODD disorders. It is not known why this is so.

  • "We brought them all right into our laboratories and asked the same questions to both the child and the parents," Keyes says. "That way we were able to use our clinical training to diagnose symptoms ourselves."

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    Though there are other studies on ADHD and adoption, this one was unusual in that participants also had to have a non-adopted sibling within the same age range to help compare behaviors.

    Adoption experts said that the study supports what they have known intuitively for a long time.

Published On: May 13, 2008