The 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

by Laura Godwin

The following is part 1 of a 2 part series examining Schizophrenia and Adopted Children. Stay tuned for Part 2 early next week.

Families considering adoption often wonder about the genetic risk a child may have for a mental illness. One of the most frightening of all the mental illnesses is schizophrenia, and if a child is at what may be considered a genetic risk for the disorder, families are often not prepared to take this risk and proceed with the adoption (Kestler, Bollini, Hochman, Mittai, & Walker, 2012). But a birth mother, birth father or other close relative having the condition does not necessarily mean the child is very likely to have the disorder. There is no one identified cause or even one common trait that is characteristic of all those with schizophrenia.“Schizophrenia patients vary in symptom profiles, developmental histories, family backgrounds, cognitive functions, and even brain morphology and neurochemistry” (Kestler et al., p. 247).

Even with this lack of understanding of schizophrenia, it is known that genetics do play a role. For example, identical twins have the highest concordance rates of any two family members; yet the rate is only 25 to 50% (Kestler et al.) that if one twin has schizophrenia the other one will as well. Considering that identical twins share 100% of the same genetic material, there are obviously other factors that contribute to the expression of schizophrenia (Kestler et al.).

Older studies of those adopted, indicate that the disease appears to be more strongly linked to genetic rather than environmental factors (Kestler et al.). In an adoption study published in 2000, researchers noted that genetics played a significant factor in placing a person at risk (Ingraham & Kev, 2000). Of the 190 adult adoptees who had a biological mother with narrowly defined schizophrenia, the adoptees had a 5.34% risk of schizophrenia compared to 1.74% of those in which the adoptee had low genetic risk for schizophrenia (Tienari et al., 2006). For adoptees whose birth mother had broad spectrum schizophrenia, the rate among the adoptees for schizophrenia spectrum disorder, including Schizotypal personality disorder, was 22.36% (Tienari et al). These differences are statistically significant (Tienari et al.).

A more recently published 21-year follow-up adoption study, in which adoptees were assessed for the prevalence of schizophrenia based on the adoptive family’s level of dysfunction and the adoptees’ genetic risk for schizophrenia, it was found that for those adopted with a genetic predisposition to schizophrenia, the adoptive home environment could be a contributing factor to or a protective factor against having schizophrenia (Tienari et al). The authors of this study note that former studies that demonstrated a genetic link to schizophrenia among adoptees did not take into consideration the adoptive families’ levels of function. This study found that adoptees with no known genetic risk of schizophrenia as defined by the DSM-III-TR and reared in functional adoptive families showed 0% risk of schizophrenia (Tienari et al.). Adoptees who were considered at high genetic risk but reared in healthy adoptive families, there was a 1.49% risk of schizophrenia (Tienari et al.). On the other hand, low risk adoptees reared in dysfunctional families had a nearly 5.0% risk of schizophrenia, and adoptees who were at a high genetic risk and raised in dysfunctional families were at a 13% risk for the disorder (Tienari et al.).