Abstract

Background: Internationally adopted (IA) children are at a greater risk for emotional, behavioral and adaptation difficulties, relative to typically-developing youth due to the fact that many of them experience severe social-emotional deprivation and other adverse experiences preadoption. Importantly, a disproportionate number of IA children show insecure attachment with caregivers even post-adoption, which has been associated with later problems with affect and behavioral regulation. Notably, research has shown early mental health consultation and intervention for IA children have substantial positive effects in promoting healthy attachment and emotional development. At present, the prevalence of IA children seeking mental health consultations is greater than non-adopted youth. However, it is unclear the duration of time post-adoption before families seek such services, although such intervention is most effective in young children soon post-arrival to their new family, when attachment development is particularly sensitive. Moreover, the factors that prompt families to seek mental health consultations for IA children earlier versus later post-adoption are unknown. The aim of our investigation is to distinguish the presenting concerns and psychodiagnostic results of IA children who seek mental health consultation services earlier versus late post-adoption. Study: In the current study, we assessed/coded the primary concerns of caregivers of 93 IA children who sought a mental health consultation for diagnostic clarification and treatment recommendations. Families with IA children came for the consultation visit within one year post-adoption (early service, IA-ES, N = 54) or more (late service, IA-LS, N = 39). Additionally, we examined the proportion of IA-ES and IA-LS youth who met DSM-IV/V criteria for mental health diagnoses after a psychological evaluation. Results: IA-ES families sought mental health services markedly earlier than IA-LS youth, although IA-ES youth were adopted later than IA-LS children. The proportion of IA-ES patients who sought psychological consultation for intervention due to physical health concerns was marginally more than that of IA-LS youth (IA-ES: 70%, IA-LS: 51%), whereas IA-LS children sought such services due to mental health concerns more so than IA-ES patients (IA-LS internalizing symptoms: 48%, internalizing symptoms: 11%). Although IA-ES families sought therapy primarily due to psychosocial concerns secondary to a medical condition, 73% of these children met a mental health disorder according to DSM-IV/V. Discussion: Findings highlight the need to provide IA children with a mental health evaluation and their adoptive caregivers with psychoeducation on psychological health interventions early post adoption, in efforts to prevent more persistent forms of mental health ailments.

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