The higher level of mental health problems in adolescent adoptees compared to non-adopted peers corresponds well with
previous studies reporting higher scores of ADHD, major depressive disorder (MDD) , OCDand higher prevalence of ADHD medication in adolescents who were adopted internationally. However, few studies have found differences for internalizing problems. This discrepancy might be explained by the way internalizingdisorders are measured. Most studies have used the CBCL where symptoms of anxiety and depression are combined in one sub scale (“anxious-depressed”). In the present study, where these disorders were examined separately, we found significant
differences in symptoms of depression, but not anxiety. It might therefore be argued that the combination of symptoms of
anxiety and depression in one scale hides potential differences in depressive symptoms.
The magnitude of differences in mental health problems between adopted and non-adopted adolescents was larger in the
present study than in most previous studies. One possible explanation for this discrepancy may be methodological differences, such as small samples or crude measures used in older studies. As the
majority of previous studies included adoptees born in the 1970s, it might be that adolescents who have been adopted
internationally experience more problems today than they did 20 years ago. This is in line with findings in a study based on a
more recent sample, where an effect size of Cohen's d ¼ 0.54 was found for externalizing behavior problems measured by the
CBCL (Roskam & Stievenart, 2014), similar to the effect sizes obtained for several of the mental health instruments in the
current study.
Interestingly, the adolescents who were adopted showed the same levels of resilience as their non-adopted peers, even
though they reported more symptoms of mental health problems. Of particular interest is the finding of no differences in
family cohesion compared to non-adopted peers, suggesting that the families have adapted well. This could be understood in
the light of research where parents of adoptees have been described as highly involved in the upbringing of the adopted child. It is further in line with previous research showing no differences inthe way adoptive and biological parents interact with their adolescents.The association between resilience scores and symptoms of mental health problems found in the present study is similar to previous studies using READ to measure resilience in Norwegian adolescents. It is further in line with studies showing that scores of family functioning and quality of peer relationships
is correlated to mental health outcomes among adolescents who have been adopted. However, these studies did not compare the associations found for adoptees with non-adopted peers. Our study is, to the best of our knowledge, the first study to examine the interaction between adoption status and resilience on mental health
outcomes. The findings support the assumption of the protective influence of resilience; however, no significant interaction
was found between resilience score and adoption status.
Contrary to previous studies, we did not find any differences in socioeconomic status
measured by parental education and perceived economic resources in the family between adopted and non-adopted
adolescents.
The higher level of mental health problems in adolescent adoptees compared to non-adopted peers corresponds well withprevious studies reporting higher scores of ADHD, major depressive disorder (MDD) , OCDand higher prevalence of ADHD medication in adolescents who were adopted internationally. However, few studies have found differences for internalizing problems. This discrepancy might be explained by the way internalizingdisorders are measured. Most studies have used the CBCL where symptoms of anxiety and depression are combined in one sub scale (“anxious-depressed”). In the present study, where these disorders were examined separately, we found significantdifferences in symptoms of depression, but not anxiety. It might therefore be argued that the combination of symptoms ofanxiety and depression in one scale hides potential differences in depressive symptoms.The magnitude of differences in mental health problems between adopted and non-adopted adolescents was larger in thepresent study than in most previous studies. One possible explanation for this discrepancy may be methodological differences, such as small samples or crude measures used in older studies. As themajority of previous studies included adoptees born in the 1970s, it might be that adolescents who have been adoptedinternationally experience more problems today than they did 20 years ago. This is in line with findings in a study based on amore recent sample, where an effect size of Cohen's d ¼ 0.54 was found for externalizing behavior problems measured by theCBCL (Roskam & Stievenart, 2014), similar to the effect sizes obtained for several of the mental health instruments in thecurrent study.Interestingly, the adolescents who were adopted showed the same levels of resilience as their non-adopted peers, eventhough they reported more symptoms of mental health problems. Of particular interest is the finding of no differences infamily cohesion compared to non-adopted peers, suggesting that the families have adapted well. This could be understood inthe light of research where parents of adoptees have been described as highly involved in the upbringing of the adopted child. It is further in line with previous research showing no differences inthe way adoptive and biological parents interact with their adolescents.The association between resilience scores and symptoms of mental health problems found in the present study is similar to previous studies using READ to measure resilience in Norwegian adolescents. It is further in line with studies showing that scores of family functioning and quality of peer relationshipsis correlated to mental health outcomes among adolescents who have been adopted. However, these studies did not compare the associations found for adoptees with non-adopted peers. Our study is, to the best of our knowledge, the first study to examine the interaction between adoption status and resilience on mental healthoutcomes. The findings support the assumption of the protective influence of resilience; however, no significant interactionwas found between resilience score and adoption status.Contrary to previous studies, we did not find any differences in socioeconomic statusmeasured by parental education and perceived economic resources in the family between adopted and non-adoptedadolescents.
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