Children in adoptive families: overview and update.

OBJECTIVE To summarize the past 10 years of published research concerning the 2% of American children younger than 18 years old who are adoptees. METHOD Review recent literature on developmental influences, placement outcome, psychopathology, and treatment. RESULTS Adoption carries developmental opportunities and risks. Many adoptees have remarkably good outcomes, but some subgroups have difficulties. Traditional infant, international, and transracial adoptions may complicate adoptees' identity formation. Those placed after infancy may have developmental delays, attachment disturbances, and posttraumatic stress disorder. Useful interventions include preventive counseling to foster attachment, postadoption supports, focused groups for parents and adoptees, and psychotherapy. CONCLUSIONS Variables specific to adoption affect an adopted child's developmental trajectory. Externalizing, internalizing, attachment, and posttraumatic stress disorder symptoms may arise. Child and adolescent psychiatrists can assist both adoptive parents and children.