Adopted Teens Face Higher Risk for ADHD

People have wondered for a long time whether children who were adopted in infancy are at increased risk for psychological problems. Now, the first study of its kind has found that most are psychologically healthy, though they're at "slightly increased risk" for behavioral problems such as attention deficit hyperactivity disorder or oppositional defiant disorder.

More than just "a negative teenager," a child with ODD is persistently hostile and disobedient.

"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," says Margaret Keyes, a University of Minnesota research psychologist who led the study. The findings were published this month in the journal Archives of Pediatric and Adolescent Medicine.

Keyes and her research team studied 692 adolescents who had been adopted before age 2. When Keyes tested them, they were roughly 15 years old. Researchers conducted in-depth psychological interviews to check them for depression, anxiety, ADHD and ODD. For comparison, Keyes and colleagues also interviewed a control group of teenagers raised by their biological parents.

"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." "There's a slightly increased risk for the adopted kids, especially [for] ADHD and oppositional defiant disorder," she says.

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.

But Keyes and her colleagues found the adopted youths had no increased risk for depression, anxiety or a form of serious delinquency that involves aggression and vandalism.

David Brodzinsky, a Rutgers University professor emeritus and a leader in the field of adoption research, says he's not surprised that some psychological problems were more common in a group of adopted children.

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

Genetic factors, the health of the biological parents, possible exposure to alcohol or drugs in utero — these "before factors" affect the mental health of a child.

In fact, Brodzinsky's own research finds that adopting parents are a special breed: highly motivated, better educated and better off financially than parents who do not adopt. Keyes adds that adopting parents were also more likely to get help from mental health professionals for their adopted child when behavioral problems arose.

The study revealed another provocative 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. It's not clear why.

The United States has more than 1.5 million adopted children under age 18, a number that is growing by more than 100,000 every year.