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Læknablaðið - 15.01.2012, Side 23

Læknablaðið - 15.01.2012, Side 23
RANNSÓKN Þau börn sem stríða við vanda af þessum toga þurfa oft víðtæka þjónustu, heilbrigðis-, félags- og menntakerfis og góð samvinna er nauðsynleg til að sem best sé hægt að mæta þörfum þeirra. Niðurstöður þessarar rannsóknar eru að börn ættleidd erlendis frá eru líklegri til að sýna einkenni geð- og hegðunarvanda en börn úr almennu viðmiðunarþýði. Hærri aldur við ættleiðingu sem og dvöl á stofnun áður en börnin koma til kjörforelda virð- ast vera áhættuþættir. Mikilvægt er að kjörforeldrar sem og aðrir sem umgangast ættleidd börn séu upplýstir um þetta, því íhlutun snemma gæti bætt stöðu barnanna. Heimildir 1. Hawk B, McCall RB. CBCL behavior problems of post-institutionalized intemational adoptees. Clin Child Fam Psychol Rev 2010;13:199-211. 2. Rutter M, Andersen-Wood L, Beckett C, Bredenkamp D, Castle J, Groothues C, et al. Quasi-autistic pattems following severe early global privation. English and Romanian Adoptees (ERA) Study Team. J Child Psychol Psychiatry 1999; 40: 537-49. 3. Zeanah CH, Keyes A, Settles L. Attachment relationship experiences and childhood psychopathology. Ann N Y Acad Sci 2003; 1008:22-30. 4. Zeanah CH, Smyke AT, Koga SF, Carlson E; Bucharest Early Intervention Project Core Group. Attachment in institutionalized and community children in Romania. Child Dev 2005; 76:1015-28. 5. Casat CD, Norton HJ, Boyle-Whitesel M. Identification of elementary school children at risk for disruptive behavioral disturbance: validation of a combined screening method. J Am Acad Child Adolesc Psychiatry 1999; 38:1246-53. 6. Rutter M, Kreppner J, Croft C, Murin M, Colvert E, Beckett C, et al. Early adolescent outcomes of institutionally deprived and non deprived adoptees. III Quasi-autism. J Child Psychol Psychiatry 2007;48:1200-7. 7. Rutter M, Beckett C, Castle J, Colvert E, Kreppner J, Metha M, et al. Effects of profound early institutional deprivation: An overview of findings from a UK longitudinal study of Romanian adoptees. Eur J Dev Psychol 2007; 4: 332-3-5. 8. Johnson D. How are the children doing? Intemational adoption project. University of Minnesota 2001. 9. Goodman R. The extended version of the Strenghts and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psychiatry 1999; 40: 791-801. 10. Hrafnsdóttir AH. Athugun á próffræðilegum eiginleikum Spuminga um styrk og vanda í hópi 5 ára bama á íslandi. Sálfræðiritið 2006; 10: 71-81. 11. Skarphéðinsson G, Magnússon P. Spumingar um styrk og vanda (Strenght and Difficulties Questionnaire). íslensk handbók. Bama- og unglingageðdeild Landspítala, Reykjavík 2005. 12. DuPauI GJ. ADHD Rating Scale - IV: Checklist, norms and clinical interpretation. Guildford Press, New York, NY 1998. 13. DuPaul GJ, Anastropoulos AD, Power TJ, Reid R, Ikeda MJ, McGoey M. Parent ratings of attention- deficit/ hyperactivity disorder: Factor stmcture, normative data and psychometric properties. J Psychopathol Behav Assmt 1998; 20: 83-102. 14. Skarphéðinsson G. Ofvirknikvarðinn (Attention - deficit hyperactivity disorder rating scale IV). Handbók, óútgefin 2008. 15. Magnusson P, Smari J, Gretarsdottir H, Thrandardottir H. Attention-deficit/hyperactivity symtoms in Icelandic schoolchildren: Assessment with the attention-deficit /-hyperactivity rating scale-IV. Scand J Psychol 1999; 40: 301-6. 16. Ehlers S, Gillberg C, Wing L.A screening questionnaire for Asperger syndrome and other high-functioning autism spectmm disorders in school age children. J Autism Dev Disord 1999; 29: 129-41. 17. Skarphéðinsson G. Skimunarlisti einhverfurófs (Austism spectmm screening questionnaire), Handbók, útgáfa 1.1. Landspítali, Reykjavík 2008. 18. Achenbach TM, Rescorla LA. Manual for the ASEBA school-age forms and profiles. University of Vermont, Research Center for Children; Youth and Families, Burlington VT, 2001. 19. Achenbach TM, Rescorla LA. Manual for the ASEBA preschool forms and profiles. University of Vermont, Research Center for Children; Youth and Families, Burlington VT, 2000. 20. Drotar D, Stein REK, Perrin EC. Methodological issues in using Child behavior checklist and its related instmments in clinical child psychology research. J Clin Child Psychol 1995; 24:184-92. 21. Smyke AT, Koga SF, Johnson DE, Fox NA, Marshall PJ, Nelson CA, et al. The caregiving context in institution reared and family reared infants and toddlers in Romania. J Child Psychol Psychiatry 2007; 48: 210-8. 22. Bowlby J. Attachment and loss. Vol. 1 Attachment. Basic Books, New York, NY 2000. 23. Ziegler D. Traumatic experience and the brain. A handbook for understanding and treating those traumatized as children. Acacia Publishing, Inc. Phoenix, Arizona 2002. ENGLISH SUMMARY Relationskip between pre-adoptive risk factors and psychopathological difficulties of internationally adopted children in lceland Lorange M', Kristmundsdottir K', Skarphedinsson G', Hermannsdottir BS2, Oddsdottir LB2, Sigurdardottir DB' Objective: In recent years a number of children have been adopted to lceland. The aim of our study was to evaluate which factors may affect their mental and behavioural health. Materials and methods: Information was collected on the health of inter- nationally adopted children in lceland as well as on pre-adoptive risk fac- tors. This was done using a survey developed by Dr. Dana Johnson from the International Adoption Project at the University of Minnesota in the United States. Other questionnaires include the Child Behavior Check- list (CBCL), Strenghts and Difficulties Questionnaires (SDQ), Attention Deficit/Hyper activity Rating Scale (ADHD-RS-IV) and Austism Spectrum Screening Questionaire (ASSQ). For the comparative analysis data from the general population was used. Results: Children adopted after 18 months of age and who have been institutionalised for 18 months or more showed higher risk for ADHD symptoms and behavioral and emotional problems than the general pop- ulation. In addition, those who were subject to severe emotional neglect had significantly higher scores on CBCL, SDQ and ADHD-RS. A trend was seen between risk factors and scores on ASSQ. Children adopted before 12 months of age scored within the normal range on all question- naires. Conclusion: These results suggest that children adopted after 18 months of age are at risk of psychopathological difficulties. These results empha- size the importance of early adoption and of minimizing the time spent in an institution. Key words: adoption, institution, neglect, behavioral and emotional problems. Correspondence: Dagbjorg B. Sigurdardottir, dagbjorg@landspitali.is 'Department of Child and Adolescent Psychiatry, Landspitali University Hospital, Reykjavik, iceiand, 2Faculty of Psychology, University of icetand, Reykjavik, lceland. LÆKNAblaðið 2012/98 23 L

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