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KEY POINTS

  • The "adopted child syndrome" refers to an extreme form of adoption-related psychopathology, including provocative, antisocial behaviors as well as associated personality disturbances that-at least on the surface-are similar to those included in the DSM-IV diagnosis of conduct disorder.

  • The adopted child syndrome can be differentiated from the diagnosis of conduct disorder by underlying adoption-specific psychodynamics, greater emotional vulnerability, and better prognosis.

  • Adoption does not necessarily give rise to psychopathology; however, it must be considered a risk factor-perhaps a precipitating one-in some families who are dysfunctional in terms of key adoption issues and parent-child interactions.

  • Accessible vulnerability distinguishes the adopted child syndrome from conduct disorder and is crucial in the differential diagnosis. Typically, the child reveals an elaborate preoccupation with his or her origins and the circumstances of the adoption as well as a hypersensitivity to rejection of any kind.

  • The atmosphere within an adoptive family often discourages curiosity about adoption, thereby leading the child to conclude that something painful and bad-something pertaining to his or her own character-is being kept secret.

  • Feeling abandoned and rejected by his or her birth parents may lead to powerful feelings of ambivalence; as a consequence, the adopted child may act out against the adoptive parents as well as therapists, teachers, and other authority figures.

  • The current emphasis on anonymity in adoption proceedings encourages the denial of feelings and distorts understanding of the true complexities involved in this process. However, even full disclosure of the identity of the birth parents and the reasons for adoption may not entirely alleviate any pathogenic conditions.

 

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