Læknablaðið - 15.01.2012, Qupperneq 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