Michael Bohman

Psychopathology in Adopted-out Children of Alcoholics The Stockholm Adoption Study

The inheritance of alcohol abuse and other psychopathology was studied in 862 men and 913 women adopted by nonrelatives at an early age in Sweden. Both male and female adoptees had a greater risk of alcohol abuse if their biologic, but not adoptive, parents were alcoholic. We distinguished two types of alcoholism that have distinct genetic and environmental causes and that differ in frequency of alcohol abuse and somatoform disorders in women. The combination of both genetic and environmental risk factors is required for development of alcoholism in the most common type. In contrast, in families with the less common type of susceptibility, alcohol abuse is highly heritable in the men, but the women have multiple somatic complaints without alcohol abuse. The implications of these findings of genetic heterogeneity and gene-environment interaction are discussed in relation to research, prevention, and treatment.

A prospective, longitudinal study of children registered for adoption : A 15-YEAR FOLLOW-UP

A cohort of 624 children, candidates for adoption as infants, were investigated at 11 and 15 years of age. At 11 years these children ran a greater risk than classmates of developing nervous disturbances and symptoms of maladjustment, regardless of whether they were growing up in adoptive home, a foster home or with their biological mother. At 15 years there was little difference in adjustment between the adopted children and their classmates, whereas children growing up in foster homes or with their biological mothers displayed a high proportion of social maladjustment and/or underachievement at school. The implications of these findings for child placement policies are discussed.

THE GENETICS OF ALCOHOLISMS AND RELATED DISORDERS

The inheritance of alcohol abuse and other psychopathology in 862 men and 913 women adopted by non-relatives, was studied. Both male and female adoptees were at greater risk to develop alcohol abuse if their biological, but not their adoptive, parents were alcoholic. Three types of families with alcoholism were distinguished that differed in frequency of alcohol abuse, somatoform disorders in women and in relation to antisocial behaviour in male adoptees. The combination of both genetic and environmental risk factors was necessary for the development of alcoholism in the most common, milieu-limited type of alcoholism. In families with a less common, male-limited, type of vulnerability, alcohol abuse was highly heritable in men, but women had multiple somatic complaints and seldom abuse. In a third type of family the common vulnerability was expressed as antisocial behavior with violent criminality and recurrent alcohol abuse in males, but as high frequency somatization in female relatives.

Psychiatric illness among adults adopted as infants

In an epidemiological study of 2,323 adopted adults, the registrations about sick‐leave, diagnoses and hospitalization (F‐cards) from the National Health Insurance were studied. There was a significantly higher frequency of psychiatric illness among the adoptees compared with non‐adopted controls. A classification into different diagnostic groups from the records of psychiatric hospitals showed an over‐representation due to alcohol and drug abuse and personality disorders in both male and female adoptee groups compared with non‐adopted controls. There was also an over‐representation in the male adoptee group due to neuroses.

Early life experiences and psychiatric disorders: An adoptee study

The aim of this study was to investigate whether there is any correlation between negative experiences in early infancy and the later occurrence of psychiatric disorders.

Autism: Diagnosis and Treatment. The State of the Art, May 1989

Autism (infantile autism, childhood autism, autistic syndrome, autistic disorder) which almost always has its onset before 36 months of age is a behaviourally defined syndrome of neurological impairments associated with multiple medical conditions. Pathophysiology and behavioural dynamics in this spectrum of disorders are not yet fully understood. The spectrum is developmental and is manifested early in childhood by impairments in social relatedness, communication and imagination. These impairments vary in degree and also in form over time. They constitute severe biological handicapping conditions in the child which can lead to deleterious secondary effects on the family and other close persons. The behaviour pattern seen in autism may or may not be associated with other disabilities/disorders, such as mental retardation, epilepsy, dysphasia, and hearing and visual deficits. Social deficits vary from severe to mild. If the child has severe social deficits, diagnosis is more likely to be made in the first few years of life. In cases with milder social deficits, diagnosis may be postponed for many years. Cognitive deficits too vary from profound mental retardation to normal and — in exceptional cases — high IQ. “High — level” autism and so called Asperger syndrome now appear to be clearly overlapping clinical entities.

Nature and Nurture Lessons from Swedish Adoption Surveys

The following article by Professor Michael Bohman begins with a brief historical analysis of child development theory in relation to adoption and fostering after the end of the Second World War. The author goes on to review research findings from a series of Swedish adoption surveys which began under his supervision in the 1960s and continue to this day. Much attention is given to the significance of genetic and environmental factors towards shaping the development of adopted children into adulthood. Problems of social and psychological adjustment are discussed, as are the genetic aspects of criminality and alcohol misuse in a group of adult adopted people.

Adoption och depression/ångest - en psykiatrisk studie av vuxna som bortadopterats som barn

Forsakringskassans statistik over sjukskrivningar och diagnoser har studerats i en epidemiologisk undersokning over 2215 adoptioner. Frekvensen psykiska sjukdomar bland de adopterade var signifikant hogre jamfort med de icke adopterade kontrollerna. En klassifikation i olika diagnostiska grupper, baserad pa journaler fran psykiatriska sjukhus, visar overrepresentation bade i de manliga och kvinnliga adoptionsgrupperna vad galler alkohol- och drogmissbruk samt personlighetsforandringar. I den manliga gruppen var aven neuroser overrepresenterade.Fran barnhalsovarden inhamtades information om de adopterades tidiga barndomsupplevelser. Har ingick alder vid placering i hemmen och typ av vard dessforinnan. Reaktiv neurotisk depression var signifikant korrelerad till placering vid en alder av 6-12 manader. Med detta enda undantag fann vi inget stod for hypotesen om ett samband mellan psykisk sjukdom och tidiga barndomsupplevelser.