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Preadoption Risk Factors

Preadoption Risk Factors

Although adoption dates back centuries, the issue of whether or not adopted children are at risk for psychological maladjustment remains controversial. That this dispute would occur at all is not surprising, since as recently as 1926 laws which liberalized adoptions in England were faced with a widespread objection that adoption would encourage depraved conduct (Tizard, 1991; Lipman et al., 1992).

Adopted children are exposed to many stressors that could increase their risks for psychological maladjustment. The biologic parents of children given up for adoption have a high incidence of impulse control problems such as hyperkinesis, chemical dependency and personality disorder. Adopted children are therefore at genetic risk for these disorders. Also, women who become pregnant out of wedlock and later give up their children for adoption often fail to seek prenatal medical care and are at risk of giving birth to premature and low birth weight infants (Kotsopoulos et al., 1993; Rogeness et al., 1993).

Before a permanent adoption placement, adopted children often endure poor nutritional and health status, poor living conditions, discontinuous care taking, disharmonious family environments, inadequate stimulation and affection, neglect and abuse (Tizard, 1991). A study of foreign adopted children by Verhulst and colleagues (1992) found that 45% of the sample experienced neglect, 13% were abused, 54% experienced at least one change in caretakers, 6% experienced three or more changes in caretaking environments, and 43% were in poor physical health upon placement with the adoptive family.

Challenges of Adoptive Childhood

The challenges that adoptive children and parents face do not cease after the formal adoption process has occurred. Adopted children must confront the difficult questions of whom their biologic parents are and why they are no longer with them. Adopted children sometimes account for the narcissistic injury caused by their perceived abandonment by assuming that they were somehow unacceptable to their biologic parents. This rationalization can lead to low self-esteem and fear of future abandonment (Nickman, 1985).

Adopted children are naturally inquisitive about their own backgrounds and that of their biologic families. Unfortunately, they have a double hindrance in this regard, as they usually find it difficult to find their personal histories, and are likely to have feelings of ambivalence and anxiety about what they might discover (Sants, 1964). Unresolved questions about their backgrounds can lead to obstacles in healthy identity formation. A strong identification with an idealized image of their biologic parents sometimes fills the emotional void resulting from these lingering uncertainties. Identification with the idealized biologic parents can compel the adopted child to reject and devalue his or her adoptive parents, which complicates the process of identity formation (Freud, 1959).

Adoptive parenthood involves difficult challenges as well. Adoptive parents must resolve the grief for the wished-for biologic child and come to terms with infertility issues. Anger directed toward the spouse held accountable for the inability or the choice not to conceive can taint family relationships. Insufficient emotional acceptance of the adoption alternative may result in a romanticized image of the biologic child who might have been. Failure to work through the loss of the biologic child can lead to feelings of rejection, alienation, entitlement and misdirected anger toward the adopted child, particularly if he or she fails to meet the adoptive parent's expectations (Solnit and Stark, 1961; Brinich, 1980).

Negative fantasies about the biologic parents can predispose the adoptive parents to be overly concerned about the adopted child's behaviors. These concerns can lead to a prohibitive attitude toward developmentally normal sexual and aggressive childhood activities. The resulting scrutiny by the adoptive parents can convey to the adoptee that the adoptive parents have a negative and antisocial image of him or her (Johnson and Szurek, 1952).

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