Adopted Child Syndrome: The Mental Health Effects of Adoption

What Is Adopted Child Syndrome?

Adopted child syndrome is a phrase used to quickly and conveniently group together a combination of symptoms an adopted person may experience. These symptoms may be triggered by the adoption itself, from the situations and stressors that led to the adoption, or from the unique situations that present after the adoption.¹ The American Psychiatric Association (APA) does not officially accept the term “adopted child syndrome,” so mental health professionals will likely not recognize or use it as a diagnosis.²

Like similar conditions, such as “middle child syndrome,” there could be some controversy surrounding the use of this term in practice. Many mental health professionals may take issue with this, as it can cause confusion. Others may passionately believe this set of symptoms deserves attention and status from governing bodies, including laypeople or those with close ties to adoption.

It is thought that because of their adoptive status, people will have adopted child syndrome with symptoms that may include:

• A sense of loss
• Feelings of rejection
• Shame and guilt
• Grief and loss
• Problems with identity
• Intimacy and attachment issues
• Control issues 
• Adoption trauma-related problems

Because mental health experts may focus on the neglect, abuse, or trauma that preceded a person’s adoption, adopted child syndrome faces an uphill battle becoming an official condition.²

History of the Term “Adopted Child Syndrome”

The term “adopted child syndrome” is believed to have originated around the early 1990s and is usually associated with psychologist David Kirchner.³ Kirchner worked to outline observed symptoms and risks of this potential condition. His approach views adoption from a psychodynamic base, mentioning issues of transference and countertransference between children and their parents. Presently, it seems that there is no substantial movement being made to validate the condition.

Mental Health Issues Faced by Adoptees

Regardless of the controversy regarding adopted child syndrome, those who have been adopted face many struggles throughout childhood and into adulthood. Scenarios leading up to an adoption can leave a lasting impression on an individual, and require a lifetime to successfully manage. Of course, many adoptees go on to lead perfectly happy and fulfilling lives. There is no evidence saying all adopted people will experience problems.

Some of the most common mental health issues faced by those who have been adopted include:⁴

Struggle Forming Attachment

Two of the main issues a person may experience after being adopted revolve around reactive attachment disorder (RAD) and disinhibited social engagement disorder.¹
Both of these conditions are triggered by inconsistent, abusive, or neglectful caregiver relationships during early childhood. Without the ability to form meaningful attachments with caregivers during the foundational stage of life, a person can struggle to form attachment throughout their life.

“The DSM-5 has two diagnoses relating to child attachment. Reactive attachment disorder (RAD) requires a severely undeveloped or non-existent relationship between a child and caregiver and is evidenced when a child fails to seek comfort from and is emotionally withdrawn from a caregiver. Disinhibited social engagement disorder (DSED), requires overfamiliarity with strangers and violation of social boundaries. Both are grounded in the lack of a secure attachment with an adult caregiver (American Psychiatric Association, 2013). RAD is thought to occur in less than 10% and DSED less than 20% of severely neglected children placed in foster or institutionalized care (American Psychiatric Association, 2013). As such, internationally adopted children who were institutionalized or children adopted from foster care are at greater risk.” – Shelley A. Steenrod, Ph.D., LICSW

Without building crucial connections with others, healthy and secure relationships can seem impossible to obtain. Childhood attachment disorders can affect a person’s happiness, relationships, and overall well-being for a lifetime.

Concerns About Identity

While being adopted may remove a person from an unstable or dangerous setting, it also displaces them from their biological family and cultural background, which can greatly impact their identity. An adopted person may feel like they do not belong with their adoptive family, or that they do not know who they really are. They might notice that they look different, have different mannerisms, or have different tastes than their new caretakers. In this case, feeling disconnected can be a very uncomfortable situation, possibly resulting in an identity crisis. Because of this, they may insist on reconnecting with their biological family members.

Abandonment Issues

Abandonment can impact someone later on in life. It is common for an adopted person to experience abandonment issues; these feelings may be worse for those who were physically or emotionally abandoned by their birth parents. For example, a person might be too fearful to initiate relationships, as they are afraid of being hurt again. Alternatively, they may become overly committed to new relationships and clingy. Of course, this need for attachment may produce the opposite effect, making the other person uncomfortable. Still, both responses are employed to limit the risk of being abandoned again.

Rejection

People who were adopted commonly report feelings of rejection; this may stem from birth parents, families who did not adopt them, or society as a whole. This can have serious effects on a person’s self-esteem and sense of worth. They may believe that they have no value if their own parents didn’t “want” them, resulting in anger, hostility, and sadness.

Shame & Guilt

A person may be ashamed of or try to hide their adoption, believing that it is a defect others will judge them for. Similar to feelings of rejection, this shame will further damage their self-esteem; they will struggle to feel good about themselves and prevent themselves from loving or receiving love from others.

Additionally, an adoptee may feel guilty for being adopted, while so many are still without families. They could feel like others deserve to be placed in a loving home more than they do, or that they didn’t “earn” their adoption.

Control Issues

Adoption is a process that a child has no little control over. They may have no interest in being adopted or feel frustrated at how the process is unfolding. Witnessing others make life-changing decisions for them can create control and self-determination issues. As a result, adopted individuals may lash out against authority figures in an attempt to regain this control over their lives. Unfortunately, these actions may only result in a heightened power struggle between parents and children.

Grief & Loss

Most of the issues experienced by people who were adopted revolve around grief and loss. When someone is adopted, there is plenty to appreciate and celebrate, but often the focus shifts towards what was lost. When grief is not addressed, it can develop into anger, sadness, and self-destructive behaviors.

After being adopted, a person may grieve:

• Connections with biological family
• Their innocence and childhood
• Feeling connected to their culture
• The life they could have had
• A sense of normalcy

When to Seek Professional Help

For individuals and families of adoption, it is never too early to pursue professional treatment. Individual, family, and couples therapy can help build resilience and sense of control for everyone involved. Receiving treatment early can help minimize or prevent problems later on as a person develops.

“Adoptees may seek therapy to unpack issues specific to adoption. The first issue adoptees struggle with is loss including the loss of birth family, history, culture, vital information, safety and love. The second issue, rejection, results in feelings of abandonment and unworthiness. The third issue, grief, results from multiple losses. The fourth issue, shame and guilt, as adoptees wonder “What’s wrong with me?” and “What did I do?” to be relinquished for adoption. The fifth issue, identity, asks “Who am I?” and “Who do I really belong to?” The sixth issue, intimacy, requires authenticity in relationships and adoptees may be unable to achieve this without resolution of previous issues. Finally, mastery and control, may feel elusive to adoptees after having experienced previous powerlessness (Roszia & Mason, 2019).” – Shelley A. Steenrod, Ph.D., LICSW

Receiving counseling services could be extremely helpful for all parties involved including:

• Parents who adopted a child
• A child who was adopted
• A parent who placed their child for adoption
• Extended family members

Finding a therapist doesn’t have to be a challenge and can be done using a therapist directory for a comprehensive listing of professionals.

Final Thoughts

Adopted child syndrome may not be a recognized psychological diagnosis, but that does not mean that issues do not present in those who have been adopted. Like other mental health conditions, working to identify and treat the condition as early as possible can improve its outcomes.