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Wright AW, Wang D, Grotevant HD. Profiles of Adoptee Adjustment in Young Adulthood. ADOPTION QUARTERLY 2023; 26:251-280. [PMID: 37720359 PMCID: PMC10503943 DOI: 10.1080/10926755.2022.2156011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/17/2022] [Accepted: 09/28/2022] [Indexed: 09/19/2023]
Abstract
The developmental stage of young adulthood, the period from one's late twenties through thirties, has grown in attention and research focus among general populations. However, little is known about the adjustment of adopted individuals during this phase. The present study sought to expand our understanding of the various patterns of adoptee adjustment in young adulthood. Latent profile analysis was used to identify profiles across eight domains of functioning spanning physical and mental health to relationships, achievement, and engagement. Three profiles were identified, demonstrating varying levels of adult functioning. Adoption related and non-adoption related variables were explored using a series of multinomial logistic regressions to determine which factors differentiated between profiles. It appears that, although some adoption related variables remain significant in young adulthood, non-adoption related variables are more strongly linked to adoptee adjustment at this developmental stage. Implications and future directions for clinical care and research are discussed.
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Affiliation(s)
- Anna W. Wright
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst
| | - Dongwei Wang
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst
| | - Harold D. Grotevant
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst
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Baden AL, Sharma SM, Balducci S, Ellis L, Randall R, Kwon D, Harrington ES. A trauma-informed substance use disorder prevention program for transracially adopted children and adolescents. CHILD ABUSE & NEGLECT 2022; 130:105598. [PMID: 35370012 DOI: 10.1016/j.chiabu.2022.105598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 01/03/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Abstract
The prevalence of substance use among transracial and international adoptees is higher than that of non-adopted persons, and yet no specialized treatment modalities exist for this underserved population. Our purpose is to propose a substance use disorder (SUD) prevention program for transracial adoptive families that addresses the specific issues that face this community. There are several pre- and post-adoption factors which position transracial and international adoptees (TRIAs) to be at higher risk to develop SUDs. Some of these factors include adoption identity, trauma, loss, genetics, and racial discrimination. The biopsychosocial (BPS) model (Engel, 1977) is used to conceptualize SUDs in adoptees, and theories that focus on adoption-related development issues such as the Adoptee Stress and Coping Model (Brodzinsky, 1990) are also presented. Our proposed program, Strengthening Transracial Adoptive Families (STAF), utilizes the Guiding Good Choices (GGC) prevention program as its foundation to integrate a culturally responsive adoption-focused curriculum to best serve transracial adoptive families.
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Affiliation(s)
| | | | | | - Lisa Ellis
- Montclair State University, United States of America
| | | | - DaYeon Kwon
- Montclair State University, United States of America
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Holst C, Tolstrup JS, Becker U. Risk of somatic disease and mortality in individuals of parents with alcohol use disorder: a register-based cohort study. Addiction 2022; 117:905-912. [PMID: 34697856 DOI: 10.1111/add.15722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 09/28/2021] [Indexed: 12/20/2022]
Abstract
AIMS To estimate the risks of 12 types of somatic disease-alcohol-related, blood, cancer, circulatory, digestive, endocrine and metabolic, genitourinary, infectious, musculoskeletal, nervous, respiratory and skin-in individuals with parental alcohol use disorder (AUD) versus a reference population, and to estimate the risks of all-cause mortality and of death from an alcohol-related cause. DESIGN Matched cohort study followed-up through nation-wide health registries. Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). SETTING Denmark. PARTICIPANTS A total of 14 008 individuals born 1962-2003 of parents with AUD and 139 087 reference offspring randomly selected from the Danish Civil Registration System were followed from their 15th birthday and onward during 1970-2018. Follow-up time ranged between 2 423 955 and 3 208 366 person-years for somatic diseases and was 3 214 411 person-years for all-cause and alcohol-related mortality. MEASUREMENTS Information on somatic disease was obtained from the Danish National Patient Registry. Causes of death were obtained from the Danish Cause of Death Registry. FINDINGS Individuals of parents with AUD had a higher risk of alcohol-related diseases (HR = 2.70, 95% CI = 2.24-3.24) compared with the reference individuals. Higher HRs among individuals with parental AUD compared with reference individuals were also observed in all other somatic diseases except for cancer. All-cause mortality (HR = 1.80, 95% CI = 1.63-2.00) and alcohol-related mortality (HR = 3.28, 95% CI = 2.11-5.08) were higher among individuals of parents with AUD compared with the reference individuals. No significant differences were found in relation to the gender of either parents or offspring. CONCLUSIONS In Denmark, parental alcohol use disorder appears to predict alcohol-related and non-alcohol-related somatic morbidity and mortality in offspring.
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Affiliation(s)
- Charlotte Holst
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ulrik Becker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Guittard J. When the Good Object is also a Thief: A Memoir of Adoption. J Am Psychoanal Assoc 2022; 70:39-76. [PMID: 35451321 DOI: 10.1177/00030651221084598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This contemporary Kleinian memoir explores the possible existence of an intrapsychic, adoption-specific preoedipal triad including child, birth mother, and adoptive mother that can shape the emerging mind. As an intrapsychic construct, the adoption triad comes to exist in the infantile mind, requiring that adoptees contend with four additional part-object maternal representations: a villain (bad birth mother), a victim (good birth mother), a rescuer (good adoptive other), and a thief (bad adoptive mother). The psychic complexities of this possible adoption triad are explored, with an eye to how it might illuminate the psychosocial challenges experienced by some adoptees, including dysregulated behavior, rage, dissociation, and shame. To this end, Bion's ideas regarding presymbolic, nondefensive communication and Winnicott's understanding of use of the object are invoked. Expanding the preoedipal paradigm of adoption to include the possibility of an intrapsychic, adoption-specific maternal triad can enhance our understanding of the psychology of adoption, as well as highlight the need to consider the ways in which internal objects can exist simultaneously in both dyadic and triadic paradigms.
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Castner J, Foli KJ. Racial Identity and Transcultural Adoption. ONLINE JOURNAL OF ISSUES IN NURSING 2022; 27:5. [PMID: 36721853 PMCID: PMC9885821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Transracial/transcultural adoption is defined as a child of one race or ethnic group placed with parent(s) of a different race or ethnic group. An estimated 2 million children in the United States were identified as adopted in the 2010 census, and approximately one-fourth of these were transracial adoptions. Both a history of adoption and a strong ethnic or racial identity are specifically associated with health-related risk and protective factors for psychosocial, academic, and health behavior outcomes. A patient with a history of transracial adoption presents unique and important considerations for culturally responsive nursing care. This article begins with nursing practice considerations for transracially adoptive patients and provides an overview of epidemiology; relevant trauma informed nursing care;. laws and racial identity formation, and a mental model of health disparities to guide future directions. We synthesize information relevant to nursing care of individuals who are transracially adopted and racial/ethnic identity formation, including socialization and a merging model to conceptualize identities. The article also discusses principles of trauma informed care and health disparities and future improvements in the context of this population.
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Affiliation(s)
- Jessica Castner
- Dr. Castner is the Editor-in-Chief of the Journal of Emergency Nursing and President and Principal of Castner Incorporated, a research institute designed to provide a nursing lens on advanced data analytics, scientific dissemination, and organizational change and development. Dr. Castner’s primary research interest focus is environmental determinants of health and emergency outcomes and care
| | - Karen J. Foli
- Dr. Foli’s work is bound together by the lens of psychological trauma. With this theme, she builds theory and conducts investigations surrounding parental postadoption depression; relationships between trauma and substance use in nurses; and nurses’ trauma and cognitive control. As a nurse theorist, Dr. Foli conceptualized and disseminated two theories: a Middle Range Theory of Parental Postadoption Depression and a Middle Range Theory of Nurses’ Psychological Trauma. She is also the author of Nursing Care of Adoption and Kinship Families: A Clinical Guide for Advanced Practice Nurses and is co-author of The Influence of Psychological Trauma in Nursing (2019). This book received two first place Wolters Kluwer, Health, and the American Journal of Nursing Book of the Year Awards 2019 for psychiatric/mental health nursing and nursing education. Dr. Foli is an associate professor at the School of Nursing, Purdue University
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Rossman SM, Eddy KT, Franko DL, Rose J, DuBois R, Weissman RS, Dierker LC, Thomas JJ. Behavioral symptoms of eating disorders among adopted adolescents and young adults in the United States: Findings from the Add Health survey. Int J Eat Disord 2020; 53:1515-1525. [PMID: 32701179 DOI: 10.1002/eat.23334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE More adopted individuals report experiencing general psychopathology, poor parental attachment, and early childhood eating difficulties than nonadopted individuals, yet little is known about disordered eating in this population. This study sought to describe the relationship between adoption status and behavioral eating-disorder (ED) symptoms, and to examine potential correlates of ED symptoms that are unique to adopted individuals. METHOD We examined data from adolescents and young adults from Waves 1 (n adopted = 561, nonadopted = 20,184), 2 (n adopted = 211, nonadopted = 14,525), and 3 (n adopted = 416, nonadopted = 14,754) of the National Longitudinal Study of Adolescent to Adult Health. ED symptom items included dieting, breakfast skipping, binge eating, extreme weight loss behaviors (EWLBs; i.e., self-induced vomiting, laxative use, diet pill use) and lifetime ED diagnosis. RESULTS Compared to nonadopted individuals, adopted individuals were more likely to report EWLBs at Wave 2 and binge eating and lifetime ED diagnosis at Wave 3 (ps < .05). Among adopted individuals, contact with a biological parent was associated with higher rates of binge eating and lifetime ED diagnosis at Wave 3 (ps < .05), whereas age at adoption and having ever been in foster care were not associated with rates of ED symptoms. DISCUSSION This study provides preliminary evidence that being adopted may be a risk factor for certain behavioral symptoms of EDs. Given the benefits of early detection and treatment of ED symptoms, mental health professionals working with adopted individuals should assess for disordered eating.
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Affiliation(s)
- Setareh M Rossman
- Department of Psychology, Clark University, Worcester, Massachusetts, USA
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Debra L Franko
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Jennifer Rose
- Department of Psychology, Wesleyan University, Middletown, Connecticut, USA
| | - Russell DuBois
- Department of Clinical Research, Blueprint Health, Chicago, Illinois, USA
| | | | - Lisa C Dierker
- Department of Psychology, Wesleyan University, Middletown, Connecticut, USA
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Holst C, Tolstrup JS, Sørensen HJ, Pisinger VSC, Becker U. Parental alcohol use disorder with and without other mental disorders and offspring alcohol use disorder. Acta Psychiatr Scand 2019; 139:508-517. [PMID: 30689217 DOI: 10.1111/acps.13002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To examine the association between parental alcohol use disorder (AUD) with and without other mental disorders and offspring AUD. METHODS Using data from Danish nationwide registers, we identified 15 477 offspring with parental AUD and 154 392 reference individuals from the general population. Parental AUD was defined as registration for AUD treatment. Parental mental disorders were identified in medical registers and comprised psychotic, mood, anxiety, personality, drug use, and other non-alcohol-related mental disorders. AUD in offspring was identified from medical, pharmacy, treatment and cause of death registers. Hazard ratios (HRs) of AUD were estimated using Cox regression models. RESULTS AUD in one or both parents was associated with higher risks of AUD in offspring compared with reference individuals. Paternal AUD plus other mental disorder (HR = 2.27, 95% confidence interval (CI): 2.10-2.46) and paternal AUD alone (HR = 2.21, 95% CI: 2.07-2.36) were associated with higher offspring AUD risk. Similarly, maternal AUD plus other mental disorder (HR = 3.02, 95% CI: 2.66-3.43) and maternal AUD alone (HR = 2.57, 95% CI: 2.20-3.01) were associated with higher offspring AUD risk. CONCLUSIONS Offspring with parental AUD are at increased risk of AUD irrespective of exposure to other parental mental disorders.
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Affiliation(s)
- C Holst
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - J S Tolstrup
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - H J Sørensen
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Mental Health Centre Copenhagen, The Capital Region, Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark
| | - V S C Pisinger
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - U Becker
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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Leeman RF, Sun MQ, Bogart MD, Beseler CL, Sofuoglu M. Comparisons of Cocaine-Only, Opioid-Only, and Users of Both Substances in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Subst Use Misuse 2016; 51:553-64. [PMID: 27002858 PMCID: PMC5097614 DOI: 10.3109/10826084.2015.1122063] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Cocaine and opioid co-use is a notable public health concern, but little is known about correlates of this behavior. Most prior findings come from treatment samples and concern cocaine and heroin. Findings from a nationally representative sample involving primarily prescription opioid misuse would expand knowledge. METHODS Past-12-month cocaine and/or opioid users in Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) formed the sample (N = 839). Cocaine-only, opioid-only, and cocaine/opioid co-users were compared regarding sociodemographics, other substance involvement, psychiatric, and medical conditions/events. RESULTS Opioid-only users were the largest group (n = 622), followed by cocaine-only (n = 144) and co-users (n = 73). The vast majority of opioid misuse was of prescription opioids (1.4% with past-12-month use of heroin). Notably, co-users did not differ from single drug users in frequency of use of either drug. Co-users did not have significantly greater incidence of any psychiatric conditions, medial conditions, or events. In preliminary analyses, co-users were more likely than either single use group to report several classes of other drug use. However, for most comparisons, opioid use did not add substantial risk beyond cocaine use. Differences on multiple sociodemographic variables suggested opioid-only users were at lowest risk of negative outcomes. These results may relate to a finding that opioid-only users were less likely to have sought treatment. CONCLUSIONS/IMPORTANCE This sample of past-12-month cocaine and/or opioid users had greater involvement with other substances, more psychiatric and medical conditions compared to the general population. Co-users had greater involvement with other substances than opioid-only users in particular.
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Affiliation(s)
- Robert F Leeman
- Yale School of Medicine, Psychiatry, CMHC, 34 Park Street, New Haven, 06519 United States
| | | | | | | | - Mehmet Sofuoglu
- Yale School of Medicine, Psychiatry, New Haven, United States
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Abstract
This presentation describes the development of attachment between adopted children and their adoptive parents with a focus on the particular issues seen in international adoptions. The questions of settling in, trauma in the country of origin, and the motivations of the adoptive parents will be discussed. Diagnosis and various psychopathological manifestations will be examined, as will outpatient and inpatient modes of therapy. The treatment of children of various ages will be covered along with the necessity for intensive counseling and psychotherapy for the adoptive parents. This will enable the parents to work through early trauma, which will give them and their adopted child the basis for developing healthy attachment patterns. This in turn will enable the child to mature and integrate into society. Possibilities of prevention are discussed. Many of the approaches discussed here regarding attachment and adoption may be applied to foster children and their foster parents.
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10
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Abstract
SummaryMost individuals who have lived in foster homes, residential care or adoptive families for substantial periods (‘people affected by public care or adoption’) show normal psychological adjustment as adults, although rates of mental disorders, hospital admission and suicide are increased. Research focusing on the experiences of this group of people can help professionals better understand their behaviour and attitude towards help. Psychiatric symptoms can be multifaceted, including complex trauma presentations. The specific mental health needs of this population are increasingly being recognised in child and adolescent mental health services but less so in adult services. In this article we describe life experiences of people affected by public care or adoption, examine the lifelong impact of these experiences on mental health and functioning, and offer practical suggestions for clinical work with them.
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Personality disorders in adopted versus non-adopted adults. Psychiatry Res 2015; 226:446-50. [PMID: 25752207 DOI: 10.1016/j.psychres.2014.12.067] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 12/16/2014] [Accepted: 12/17/2014] [Indexed: 11/21/2022]
Abstract
The goal of this epidemiological study was to investigate lifetime history and odds ratios of personality disorders in adopted and non-adopted adults using a nationally representative sample. Data, drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), were compared in adopted (n=378) versus non-adopted (n=42,503) adults to estimate the odds of seven personality disorders using logistic regression analyses. The seven personality disorders were histrionic, antisocial, avoidant, paranoid, schizoid, obsessive-compulsive, and dependent personality disorder. Adoptees had a 1.81-fold increase in the odds of any personality disorder compared with non-adoptees. Adoptees had increased odds of histrionic, antisocial, avoidant, paranoid, schizoid, and obsessive-compulsive personality disorder compared with non-adoptees. Two risk factors associated with lifetime history of a personality disorder in adoptees compared to non-adoptees were (1) being in the age cohort 18-29 years (but no difference in the age 30-44 cohort), using the age 45 or older cohort as the reference and (2) having 12 years of education (but no difference in higher education groups), using the 0-11 years of education as the reference. These findings support the higher rates of personality disorders among adoptees compared to non-adoptees.
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Internalizing disorder in adopted versus non-adopted adults: a NESARC based study. Compr Psychiatry 2014; 55:1595-600. [PMID: 24974283 DOI: 10.1016/j.comppsych.2014.05.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 05/21/2014] [Accepted: 05/22/2014] [Indexed: 11/21/2022] Open
Abstract
The objective of the study consisted of comparing lifetime prevalence rates and odds ratios of anxiety, mood, and psychotic disorders in adopted-versus-non-adopted people in a nationally representative sample. The data were drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). The main outcome measure was the prevalence of lifetime internalizing psychiatric disorders in adopted (n=378) versus non-adopted (n=42,503) individuals. Adoptees and non-adoptees were compared to estimate the odds of lifetime internalizing disorders using logistic regression analyses. Adoptees had higher prevalence rates of several lifetime mood and anxiety disorders compared with non-adoptees, with a 1.61-fold increase (95% CI 1.29-2.02) in the odds of any mood disorder and a 1.49-fold increase (95% CI 1.18-1.89) in the odds of any anxiety disorder compared with non-adoptees. Regarding specific mood and anxiety disorders, adoptees had increased odds of major depressive disorder, bipolar I disorder, panic disorder without agoraphobia, specific phobia, and generalized anxiety disorder. Disorders not differing between adoptees and non-adoptees included dysthymia, bipolar II disorder, panic disorder with agoraphobia, social phobia, and psychotic disorder. One adoption-specific risk factor was associated with lifetime mood disorder (i.e., Asian/Pacific Island). In conclusion, adoptees in a large sample from the general population had higher rates of mood and anxiety disorders compared to non-adoptees.
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