RESUMEN

Background: After decades of research output, it is well established that transnational adoptees-i.e., individuals who are placed for adoption outside their country of birth-exhibit an increased risk of various negative mental health outcomes. Even so, there is a lack of suggestions for preventive measures or treatment interventions targeting the transnational adoptee population in the literature. Objective: To explore experiences, opinions, and needs among adult transnational adoptees in Sweden concerning healthcare in general and mental healthcare in particular. Methods: Sixty-six adult transnational adoptees residing in Sweden, born in 15 different non-European countries, were recruited for individual in-depth interviews about their experiences and opinions regarding psychosocial support and healthcare. The interview data were analyzed employing a codebook thematic analysis approach. Results: Three overarching themes were identified: (a) barriers to adequate treatment, (b) helpful resources in dealing with health-related issues, and (c) health-related needs and suggestions for the development of adequate support. Identified barriers include a lack of insight into and interest in adoptee health, colorblindness and unwillingness to address racism, expectations of gratitude, steep financial costs, lack of support from adoptive parents, and mistrust of support structures that involve adoptive parents or adoption organizations. Participants also describe helpful resources, such as the community of fellow transnational adoptees. Health-related needs and suggestions include more well-defined and easily accessible structures of support, improved knowledge and competence, a broader psychotherapeutic repertoire that better addresses adoption-related themes, improved support in situations that can be particularly stressful for adoptees (such as during pregnancy and as new parents), routine follow-up during childhood and adolescence, and education targeting adoptive parents. The need for greater attention to the well-being of children of transnational adoptees is also highlighted. Implications: Based on these findings, a number of recommendations can be made. For example, knowledge about adoptee health should be strengthened, and psychotherapeutic competence in addressing issues related to racism should become a priority. After over 20 years of discussion, one or more national research and knowledge hubs on transnational adoption should be created. Moreover, economic resources should be made available to support transnational adoptees in accessing adequate treatment.

Asunto(s)

RESUMEN

Previous work has examined the impact of prenatal illicit drug use (PDU) on children's problem behaviors. However, many PDU-related risk factors, including genetic and rearing environmental risks, can also influence offspring's problem behaviors, thus confounding PDU, genetic, and rearing environmental influences. This study aimed to (a) identify effects of PDU on school-aged children's problem behaviors, including both externalizing and internalizing behaviors at Age 7, after controlling genetic and specific rearing environmental (e.g., maternal and paternal hostility at Ages 4.5 and 6) influences and (b) examine interaction effects between PDU and maternal and paternal hostility in predicting children's problem behaviors at Age 7. We used a parent-offspring adoption design to partition genetic and prenatal effects from postnatal rearing environmental influences. Participants were 561 children adopted at birth (42% female; 56% White, 19% multiracial, 13% Black/African American, 11% Latine, and 1% other), their adoptive parents, and their birth parents. Results indicate that PDU did not show a direct impact on Age 7 problem behaviors before or after controlling genetic risks and adoptive mother's and father's hostility. However, we found significant interactions between adoptive father's hostility and PDU when predicting children's problem behaviors, such that higher paternal hostility was associated with higher externalizing and internalizing behaviors for children whose birth mothers were non-use or rare use of illicit drugs during pregnancy. The results suggest that different from non- or rare drug-exposed children, higher levels of PDU may override the effects of paternal hostility, but not maternal hostility, on problem behaviors at Age 7. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Asunto(s)

RESUMEN

Adoption provides a unique opportunity to establish stable family relationships and enhance the social safety net. In India, adoptions are governed by the Hindu Adoption and Maintenance Act, 1956, and the Juvenile Justice (Care and Protection of Children) Act, 2015, each with distinct eligibility criteria. Currently, approximately 33,870 Indian couples are registered as prospective adoptive parents (PAPs), and this number is rising. The Central Adoption Resource Authority (CARA) website lists 2,140 children available for adoption, with 731 being categorized as normal and 1,409 as special needs. CARA, under the Ministry of Women and Child Development, oversees both domestic and international adoptions of legally free orphaned, abandoned, and surrendered children. The scope of adoption has expanded from primarily young infants to include older children, children with special needs, and foster care, in line with the National Child Policy. Pediatricians play a crucial role in the adoption process, understanding medical aspects within the legislative framework and acting in the child's best interests. This involves collaborating with multiple stakeholders, conducting comprehensive pre-adoption medical examinations, and providing ongoing medical and behavioral support post-adoption. This review emphasizes recent changes in adoption practices in India and highlights the evolving role of pediatricians as champions for these children and their adoptive families.

Asunto(s)

RESUMEN

Gestational surrogacy is ethically complex, generating very different responses in law and policy worldwide. This paper argues that contemporary surrogacy law and policy, across many jurisdictions, fail to give sufficient attention to the significance of the relationship between the child and the gestational surrogate. This failure risks repeating the mistakes of historical, discredited approaches to adoption and donor-assisted conception. This paper argues that proper recognition of the significance of gestation must be an organising principle in surrogacy law and policy. The paper begins by pointing to examples of surrogacy law and practice where the role of the gestator is unacceptably minimised, most notably the framing of the surrogate as a mere 'carrier'. It goes on to examine the nature of gestation, including consideration of contemporary scholarship on the metaphysics of pregnancy and emerging work in epigenetics, and argues that current evidence supports the view that the gestational relationship must be taken more seriously than it currently is. The paper then draws analogies with parenthood in donor-assisted conception and adoption to argue that approaches to parental status in novel family formations that fail to promote transparency and seek to deny the truth of familial relationships are doomed to fail. The paper concludes by suggesting some implications for law and policy that flow from placing sufficient emphasis on the gestational role. The overarching thesis of this paper is that gestational surrogacy is ethically permissible when these fundamental requirements are adhered to, and that surrogacy law should proceed on this basis.

Asunto(s)

RESUMEN

Importance: Twin studies have found that posttraumatic stress disorder (PTSD) is influenced by both genetic and environmental factors within a generation. No study has used an adoption design, which can address questions about the degree and sources of cross-generational transmission of adverse stress responses (ASRs) and PTSD. Objectives: To examine whether ASRs or PTSD are transmitted from parents to offspring, and to clarify the relative importance of genes and rearing. Design, Setting, and Participants: This cohort study used nationwide Swedish registry data from parents and offspring (n = 2 194 171, born 1960-1992) of 6 types of families (intact; had not lived with biological father; had not lived with biological mother; lived with stepfather; lived with stepmother; and adoptive). Follow-up occurred on December 31, 2018, and data were analyzed from March 3, 2023, to January 16, 2024. Exposures: Three sources of parent-offspring resemblance: genes plus rearing, genes only, and rearing only. Main Outcomes and Measures: Diagnoses of ASRs or PTSD were obtained from national inpatient, outpatient, and primary care medical registries. Parent-child resemblance was assessed by tetrachoric correlation. Sensitivity analyses were conducted to control for possible shared traumatic events. Results: The study population included 2 194 171 individuals of 6 family types (1 146 703 [52.3%] male; median [range] age, 42 [20-63] years). The weighted tetrachoric correlations across family types were 0.15 (95% CI, 0.15-0.16) for genes plus rearing, 0.08 (95% CI, 0.06-0.11) for genes only, and 0.10 (95% CI, 0.07-0.12) for rearing only. Controlling for potential shared traumatic events, sensitivity analyses found that the correlation for rearing decreased, with the most conservative control (exclusion of parent-offspring dyads with onset of ASRs or PTSD within 1 year) suggesting equal correlations with genes and rearing. Conclusions and Relevance: Diagnosis of ASRs or PTSD demonstrated cross-generational transmission, including both genetic and rearing correlations. Sensitivity analyses suggested that shared traumatic events partially accounted for the observed rearing correlations.

Asunto(s)

RESUMEN

A large number of children with cleft lip and palate (CLP) were adopted to Sweden in the last decade, mainly from China. Most of the children arrived with unoperated palates and at later ages than earlier years. This article aims to present an overview of ethical challenges within the practice of international adoption of children with CLP from the perspective of plastic surgery in a welfare health care system. An overview of CLP treatment is presented, followed by a normative discussion and ethical analysis using the 4 principles of Beauchamp and Childress: non-maleficence, beneficence, autonomy, and justice. The following themes and subthemes were analyzed: the search for normality and the potential challenge of being adopted and having CLP-treatment autonomy of the child and future preferences, adoptive parents' expectations of plastic surgery, the journey of the adoptee and the adoptive parents; and general issues-reconstructive possibilities and consequences of CLP in the country of origin, information to the adoptive parents, health care needs, and reconstructive possibilities for children with CLP in the receiving country. Clinical implications are discussed, and suggestions for future research are provided.

Asunto(s)

RESUMEN

Children reared in institutional settings experience early deprivation that has lasting implications for multiple aspects of neurocognitive functioning, including executive function (EF). Changes in brain development are thought to contribute to these persistent EF challenges, but little research has used fMRI to investigate EF-related brain activity in children with a history of early deprivation. This study examined behavioral and neural data from a response conflict task in 12-14-year-olds who spent varying lengths of time in institutional care prior to adoption (N = 84; age at adoption - mean: 15.85 months, median: 12 months, range: 4-60 months). In initial analyses, earlier- and later-adopted (EA, LA) youth were compared to a group of children raised in their biological families (non-adopted, NA). NA youth performed significantly more accurately than LA youth, with EA youth falling in between. Imaging data suggested that previously institutionalized (PI) youth activated additional frontoparietal regions, including dorsolateral prefrontal cortex, as compared to NA youth. In addition, EA youth uniquely activated medial prefrontal regions, and LA uniquely activated parietal regions during this task. A separate analysis in a larger group of PI youth examined whether behavioral or brain measures of EF varied with the duration of deprivation experienced. Duration of deprivation was negatively associated with activation of default mode network (DMN) regions. Overall, results suggest that there are lasting effects of deprivation on EF, but that those who are removed from institutional care earlier may be able to recruit additional neural resources as a compensatory mechanism.

Asunto(s)

Asunto(s)

RESUMEN

INTRODUCTION: There is a gap in the literature on the romantic relationships of adopted adolescents. To address this issue, the present study has three aims: (1) to explore differences between adopted and non-adopted adolescents in terms of their involvement in and the length of their romantic relationships; (2) to explore the quality of these relationships; and (3) to analyze associations between affective relationships and well-being in both groups. METHOD: The sample comprised 276 adopted (64.5% girls; mean age 16.3 years, 73.9% international adoptees) and 276 non-adopted (48.3% girls; mean age 16.3 years) adolescents, all of whom participated in the Spanish Health Behaviour in School-aged Children survey. RESULTS: Similar romantic relationship rates and lengths were found among adoptees and non-adoptees, as well as between international and domestic adoptees. Adoptees reported more emotional support and conflicts in their romantic relationships than their non-adopted peers. Finally, associations between the quality of the romantic relationships and well-being were similar for both groups, with more conflicts being linked to lower levels of well-being, and more emotional support and affection correlating with higher levels of well-being. DISCUSSION: The data suggest more similarities than differences between adopted and non-adopted adolescents. However, although this indicates that romantic relationships are yet another example of recovery for adopted boys and girls, further research is required, with larger and more diverse samples from multiple countries, to explore the differences observed in more detail.

Asunto(s)

RESUMEN

En el marco del acogimiento residencial, se ha desarrollado el programa Familias Colaboradoras con el fin de que los niños, niñas y adolescentes tutelados puedan disfrutar de períodos de convivencia en un ambiente familiar positivo, que les genere beneficios y complemente su atención residencial. En este trabajo, a través del instrumento Strengths and Difficulties Questionnaire (SDQ), estudiamos el ajuste psicológico de 37 menores de edad en acogimiento residencial con familias colaboradoras, contrastando las valoraciones de 185 informantes: los propios menores de edad, sus familias colaboradoras, los profesionales de referencia del centro, así como un grupo de comparación de iguales sin familias colaboradoras y sus profesionales de referencia. Además, analizamos si el ajuste psicológico de estas personas menores se relaciona con variables personales y la valoración que hacen de la colaboración familiar. Los resultados mostraron diferencias significativas entre el ajuste psicológico valorado por los distintos informantes. Además, los menores de edad con familias colaboradoras tendieron a mostrar un mejor ajuste psicológico frente al grupo de comparación, con tamaños de efecto considerables. Se encontraron también relaciones significativas entre el ajuste psicológico y la valoración de los menores sobre la colaboración familiar. Finalmente, se discuten algunas implicaciones prácticas para el desarrollo del programa.(AU)

In residential care, programs such as Collaborating Families have been developed so that children and adolescents can experience periods of cohabitation in a positive family environment, which generates benefits for them and complements their residential care. The present study used the Strengths and Difficulties Questionnaire(SDQ) to study the psychological ad-justment of 37 children and adolescents in residential care with collaborat-ing families, comparing the assessments of 185 informants: the children themselves, their collaborating families, their caregivers at the protection center, as well as a comparison group of peers without collaborating fami-lies and their caregivers. In addition, this study analyzed whether the psy-chological adjustment of these children is related to some of their personal variables and their experience in family collaboration. The results showed significant differences between the psychological adjustment assessed by the different informants. Also, children with collaborating families tended to present a better psychological adjustment compared to the comparison group, with considerable effect sizes. Moreover, significant relationships were found between psychological adjustment and the children’s ratings about their family collaboration. Finally, some practical implications for the development of the program are discussed.(AU)

Asunto(s)

RESUMEN

In this study, we explored racial microaggressions (RMAs) and adoption microaggressions (AMAs) experienced and committed by white adoptive parents of transracial adoptees. Two research questions guided this inquiry: (a) What types of RMAs and AMAs do white adoptive parents of children adopted from China experience and commit? and (b) how is white adoptive parental awareness of race and adoption related to their committing of microaggressions? Based on qualitative coding of interviews conducted with 39 white adoptive parents of Chinese adoptees, the most frequently coded AMA was Biology is Best for experienced AMAs and Phantom Birth Parents for committed AMAs. Alien in Own Land was the most experienced RMA, and Color Evasiveness was the most committed RMA. Parents tended to have high awareness of the AMAs (87%) and RMAs (89%) they experienced from others, yet this awareness did not preclude them from committing RMAs and AMAs within their transracially adoptive family. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Asunto(s)

RESUMEN

BACKGROUND: Internationally adopted children who suffered early institutionalization are at risk of a late onset of internalizing problems in adolescence. Both pre-adoption, adversity-related, and post-adoption factors predict variability in internalizing problems in this population. Previous studies have suggested different patterns of parent-adolescent informant discrepancies in adoptive dyads METHOD: We analyzed internalizing problems among 66 adolescents internationally adopted from Russia to Spanish families using both the parent- and self-report version of the Strengths and Difficulties Questionnaire and comparing them with a low-risk, community group (n = 30). We assessed pre-adoption and post-adoption factors and evaluated cross-informant discrepancies. RESULTS: Internationally adopted adolescents exhibited more internalizing problems by parent-report than community adolescents, but there were no differences by self-report. Adopted youth showed no discrepancies between parent and self-report, whereas community adolescents reported more internalizing symptoms than their parents. Pre-adoption adversity-related factors predicted parent-reported internalizing problems, while post-adoption factors predicted self-reported internalizing problems. CONCLUSIONS: Parent-adolescent informant discrepancies in adopted adolescents from Eastern Europe for internalizing symptoms were lower than in community adolescents. Both adversity-related factors and the lived experience of adoption may influence the development of internalizing symptoms in internationally adopted adolescents.

Asunto(s)

RESUMEN

The emergency department clinical environment is unique, and guidelines for promoting supportive and equitable workplace cultures ensure success and longevity for pregnant persons and parents in emergency medicine. There is paucity, variability, and dissatisfaction with current parental (historically referred to as maternity and paternity) leave policies. This paper describes the development of consensus-derived recommendations to serve as a framework for emergency departments across the country for incorporating family-friendly policies. Policies that foster a family-inclusive workplace by allowing for professional advancement without sacrificing personal values regardless of sex, gender, and gender identity are critical for emergency medicine recruitment and retention.

Asunto(s)

RESUMEN

One long-standing analytic approach in adoption studies is to examine correlations between features of adoptive homes and outcomes of adopted children (hereafter termed 'measured environment correlations') to illuminate environmental influences on those associations. Although results from such studies have almost uniformly suggested modest environmental influences on adopted children's academic achievement, other work has indicated that adopted children's achievement is routinely higher than that of their reared-apart family members, often substantially so. We sought to understand this discrepancy. We examined academic achievement and literacy-promotive features of the home in 424 yoked adoptive/biological families participating in the Early Growth and Development Study (EGDS; i.e., adopted children, adoptive mothers, birth mothers, and biological siblings of the adopted children remaining in the birth homes) using an exhaustive modeling approach. Results indicated that, as anticipated, adopted children scored up to a full standard deviation higher on standardized achievement tests relative to their birth mothers and reared-apart biological siblings. Moreover, these achievement differences were associated with differences in the literacy-promotive features of the adoptive and birth family homes, despite minimal measured environment correlations within adoptive families. A subsequent simulation study highlighted noise in measured environmental variables as an explanation for the decreased utility of measured environment correlations. We conclude that the field's heavy focus on measured environment correlations within adoptive families may have obscured detection of specific environmental effects on youth outcomes, and that future adoption studies should supplement their measured environment analyses with mean differences between reared-apart relatives.

Asunto(s)

RESUMEN

The present study examined early socioeconomic status (SES) and neighborhood disadvantage (ND) as independent predictors of antisocial behavior (ASB) and addressed the etiology of the associations (i.e., genes versus the environment) using a longitudinal adoption design. Prospective data from the Colorado Adoption Project (435 adoptees, 598 nonadopted children, 526 biological grandparents of adoptees, 481 adoptive parents, and 617 nonadoptive parents including biological parents of unrelated siblings of adoptees) were examined. SES and ND were assessed during infancy and ASB was evaluated from ages four through 16 using parent and teacher report. Associations between predictors and ASB were compared across adoptive and nonadoptive families and sex. Early SES was a nominally significant, independent predictor of antisocial ASB, such that lower SES predicted higher levels of ASB in nonadoptive families only. ND was not associated with ASB. Associations were consistent across aggression and delinquency, and neither SES nor ND was associated with change in ASB over time. Nominally significant associations did not remain significant after controlling for multiple testing. As such, despite nonsignificant differences in associations across sex or adoptive status, we were unable to make definitive conclusions regarding the genetic versus environmental etiology of or sex differences in the influence of SES and ND on ASB. Despite inconclusive findings, in nonadoptees, results were consistent-in effect size and direction-with previous studies in the literature indicating that lower SES is associated with increased risk for ASB.

Asunto(s)

RESUMEN

Female survivors of young adult (YA) cancers are at risk of fertility impacts following cancer treatment. For these women, fertility-related distress is both prevalent and persistent. Yet there is little research regarding survivors' perspectives on alternative family-building options, particularly adoption. This exploratory secondary data analysis analyzed semistructured interviews and explored survivors' views of adoption. Overall, female YA survivors reported openness to adoption as a possible substitute for biological conception and an alternative to fertility preservation. It is imperative that this population receives support in decision-making around and consideration of the unique barriers to adoption for cancer survivors.

Asunto(s)

RESUMEN

Considered until recently unfit to rear children, non-heterosexual people have been excluded from forming families in most countries. Many, worldwide, demand access to family formation, claiming the same aptitudes as heterosexual people for raising children. However, when non-heterosexual singles and couples want to become parents in Spain, they must consider transnational contexts, resorting to inter-country adoption or surrogacy abroad, processes that contribute to delay their family formation. They must consider not only Spanish sociocultural conditions, but other countries' legal restrictions regarding parents' gender, social status, and sexual identity. These families experience great difficulty in gaining access to reproductive health services. Based on multi-site ethnographic fieldwork, this text addresses how, despite legislative changes allowing homoparental family formation in Spain, these parents must overcome complex bureaucratic processes when they decide to have children, while facing homophobic attitudes and policies in their quests to become parents.

Asunto(s)

RESUMEN

The present theoretical essay is based on six reports concerning same-sex couples and gay and lesbian people in order to interconnect homoparenting and the adoption of children with disabilities, through the lenses of human and social sciences in public health. The reports were interpreted in light of studies on same-sex adoption and the adoption of children with disabilities. Feminist approaches related to care and disability were also included in the interpretative perspective, operating as expressive webs of grammars of ableism. It was found that media approaches endorse the right to family formation and the adoption of children with disabilities by homoparental families, but with little critical depth on the category of disability and without highlighting support for the adoption of all adoptee profiles. Moreover, the intersections between homophobia and ableism increase discriminatory and oppressive logics, with the union of social groups considered to be "undesirable" representing a strategy of governmentality that reveals the complexity of grammars of ableism, applied to the sexual and reproductive rights of LGBTQIA+ adopters and to the fundamental rights of children and adolescents with disabilities who are available for adoption.

O ensaio teórico parte de seis reportagens sobre casais homoafetivos e pessoas gays e lésbicas para interseccionar homoparentalidade e adoção de crianças com deficiência, pelas lentes das ciências humanas e sociais em saúde coletiva. As reportagens foram interpretadas à luz dos estudos sobre adoção homoparental e adoção de crianças com deficiência. Abordagens feministas sobre cuidado e deficiência também compuseram o olhar interpretativo, operando como teias expressivas das gramáticas do capacitismo. Verificou-se que as abordagens midiáticas endossam o direito à constituição familiar e à adoção de crianças com deficiência por famílias homoparentais, sem aprofundar criticamente a categoria deficiência e sem destacar apoio à adoção de todos os perfis de adotandos. E que as intersecções entre homofobia e capacitismo incrementam lógicas discriminatórias e de opressão, sendo a união de grupos considerados "indesejáveis" uma estratégia de governamentalidade que revela a complexidade das gramáticas do capacitismo aplicadas aos direitos sexuais e reprodutivos de adotantes LGBTQIA+ e aos direitos fundamentais de crianças e adolescentes com deficiência disponíveis para adoção.

Asunto(s)

RESUMEN

BACKGROUND AND AIMS: There is some evidence that offspring of patients with schizophrenia have higher somatic morbidity, which is thought to be partially due to genetic links between somatic disorders and schizophrenia. This study explored differences in somatic diseases and conditions of adoptees with high genetic risk (HR) or low genetic risk (LR) for schizophrenia spectrum disorders. MATERIAL AND METHODS: The study is part of the Finnish Adoptive Family Study of Schizophrenia. The adoptive research design used made it possible to examine how the somatic health of adoptees raised in similar adoptive families, is affected by their genetic susceptibility to schizophrenia. The study sample consisted of 373 adoptees, of whom 190 had HR and 183 had LR for schizophrenia spectrum disorders. Data on somatic morbidity were gathered from the hospital records and from the national registers of the Care Register of Health Care and the Social Insurance Institution. RESULTS: The only statistically significant difference found was in genitourinary diseases, the likelihood being twofold higher in HR adoptees compared to LR adoptees (16.8% vs. 8.2%; adj. OR = 2.13, 95% CI 1.06-4.25, p = .033). Adoptees who were female and aged over 40 had a higher prevalence of genitourinary illnesses than non-adoptees. CONCLUSION: The significant prevalence of genitourinary diseases in adoptees at risk for schizophrenia spectrum disorders suggests that some specific somatic diseases and schizophrenia may have a shared hereditary etiology. More research is required for specific somatic diseases in study populations that can differentiate between the effects of genetic and environmental factors.

Asunto(s)

RESUMEN

The children's mental health landscape is rapidly changing, and youth with mental health conditions (MHCs) are overrepresented in the child welfare system. Mental health is the largest unmet health need in child welfare, so MHCs may affect the likelihood of system reentry. Concerns regarding mental health contribute to calls for expanded supports, yet systems contact can also generate risk of continued child welfare involvement via surveillance. Still, we know little about how expanded supports at the state-level shape child welfare outcomes. Using the Adoption and Foster Care Analysis Reporting System (AFCARS), we examine the association between MHCs and system reentry within 36 months among youth who reunified with their families in 2016 (N = 41,860). We further examine whether this association varies across states and White, Black, and Latinx racial and ethnic groups via two- and three-way interactions. Results from multilevel models show that, net of individual and state-level factors, MHCs are associated with higher odds of reentry. This relationship is stronger for youth in states that expanded Medicaid by 2016 and with higher Medicaid/CHIP child participation rates. The results also show evidence of the moderating role of state-level factors, specifically student-to-school counselor ratio, diverging across racial and ethnic groups. Our results suggest a need for systems of care to better support youth mental health and counteract potential surveillance.

Asunto(s)