February 27, 2013

Adopting a Child Who May be at Risk for Schizophrenia and Psychotic Disorders Pt.2

child and dadThe following is part 2 of a 2 part series examining Schizophrenia and Adopted Children. See Part 1.

In citing an earlier study from 1997, these same researchers also discussed how communication deviance (CD) (parents whose communication pattern is senseless and illogical) has a great impact on the healthy emotional development of a child (Tienari et al.). For adoptees who were at a high genetic risk for thought disorders, if they were reared by adoptive parents with a higher level of CD, these adoptees were also more likely to have thought disorders (Tienari et al.). Those high risk adoptees reared by adoptive parents who had low levels of CD were much less likely to have thought disorders (Tienari et al.). However, for those not at a genetic risk, the family environment of high or low CD rates had much less impact on the adult adoptees’ having a thought disorder (Tienari et al.). In a follow-up study 19 years later, it was found that those adult adoptees at higher genetic risk and reared by parents with high CD, there was a statistically significant increase in thought disorders (Tienari et al.).

In summary these researchers state that the genetic-environmental hypothesis of producing schizophrenia and other thought and psychotic disorders is supported in this and other studies. In these studies, it appears that if the adoptee has no known genetic risk and the child was reared in a positive environment, there appears to be no to little risk of a child developing these disorders (Tienari et al.).

In addition to a genetic predisposition and dysfunction within the home environment, there is also evidence that gestational stress can increase the risk for schizophrenia, including maternal viral infection (especially during mid-trimester); very traumatic events during pregnancy; pregnancy complications, such as toxemia and preeclampsia; abnormal prenatal development; malnutrition (two-fold risk during famines) and complications at birth (Kestler et al 2012.; St. Clair, et al., 2005).

When counseling a family regarding adopting a child with a possible genetic risk for schizophrenia or psychotic disorders , the family should consider the genetic family history of both the birth mother and father (if known); the birth mother’s type of psychosis and symptoms; and the child’s prenatal and birth history. In internationally adopted children these risk factors are seldom known. When families are matched with a birth mother here in the US, these risk factors are often known (at least based on the birth mother’s mental health history). Also, PAPs can find reassurance in knowing that a child would be at a very low risk of developing narrowly defined schizophrenia when reared in a highly functional home. In such a situation, the parents should be encouraged to provide a very narrow range of parenting style based on Trust-Based Relational Intervention (Purvis & Cross, 2011). Parents with a strong emotive style of parenting tend to produce children lower at risk for schizophrenia.

References

Ingraham, L. J., & Kev, S. S. (2000). Adoption studies of schizophrenia. American Journal of Medical Genetics, 97, 18-22. Retrieved from

http://onlinelibrary.wiley.com.ezproxy.liberty.edu:2048/doi/10.1002/%28SICI%291096-8628%28200021%2997:1%3C18::AID-AJMG4%3E3.0.CO;2-L/pdf

Kestler, L., Bollini, A., Hochman, K., Mittai, V. A., & Walker, E. (2012). Schizophrenia. In J. E. Maddux, & B. A. Winstead (Eds.), Psychopathology: Foundations for a contemporary understanding (third ed., pp. 247-276). New York: Routledge.

Purvis, K. B., & Cross, D. R. (2011, June). TPRI Professional Training Program presented by the TCU Institute of Child Development. . In K. B. Purvis (Chair), . Symposium conducted at the Trust-Based Relational Intervention, Texas Christian University , Fort Worth Texas

St. Clair, D., Xu, M., Wang, P., Yu, Y., Fang, Y., Xhang, F.,...He, L. (2005, August 3). Rates of adult schizophrenia following prenatal exposure to the Chinese famine of 1959-1961. Journal of American Medical Association, 294(5), 557-562. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16077049

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