Adoption and long-term wellbeing: what three studies found

Much of what is written about adoption stops at childhood. These three studies look further, into adolescence and adult life. I have summarized each one as its authors report it, with the limits that apply.

1. Suicide risk in adult adoptees, Sweden

Researchers used Sweden's national registers to follow 6,065 international adoptees, 7,340 national adoptees and about 1.27 million non-adopted people, all born between 1963 and 1973, until 2002.

After adjusting for sex, age and socio-economic factors, international adoptees had a risk ratio of 4.5 for suicide attempt (95% confidence interval 3.7 to 5.5) and 3.6 for suicide death (2.6 to 5.2). National adoptees had lower risks than international adoptees, and still raised ones: 2.8 for suicide attempt and 2.5 for suicide death.

The authors conclude that the raised risk is equally relevant to child and adult psychiatry.

2. Experiences before adoption, and behavior fourteen years on

The California Long-Range Adoption Study followed 522 adopted children across four waves of data. In that sample, 24.3% had experienced at least one form of maltreatment before adoption, and nearly half of those had experienced more than one type.

Fourteen years after adoption, sexual abuse before adoption was associated with an increase of nearly a full unit (0.92) on the measure of behavior problems the study used. Neglect was associated with about half a unit (0.48).

3. A group whose voice is rarely heard

Drawing on a larger study of post-adoption services, Perlita Harris writes about adults who were abused or neglected within their adoptive family, "a group whose voice is rarely heard". Her findings suggest that such abuse and neglect "may be more common historically than has been hitherto acknowledged". She argues that support will not improve unless services are truly hearing what people want.

What the numbers can and cannot tell us

A risk ratio compares groups. It does not describe any one person, and it does not predict any one life. Each of these studies describes a particular place and period: Sweden's registers, one Californian sample, a set of historical placements.

What they share is a developmental point. What happens early, and what happens after placement, continues to matter well into adult life. Behavior makes sense in context, and these findings are part of the context.

I read them as a reason to listen earlier and to understand more. They are not a verdict on adoption, and they are not a verdict on adopted people. Development remains possible.

If this is close to home

If you are struggling right now, call or text 988 to reach the Suicide & Crisis Lifeline, available 24/7 in the US.