INTERNA TIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT, 1997, 20 (1), 109–129

International and Domestic Adoption: Child, Parents, and Family Adjustment Rachel Levy-Shiff, Naomi Zoran, and Shmuel Shulm an Bar-Ilan University, Ramat-Gan, Israel Adjustment of school-aged children, parents, and families in international versus domestic adoption was studied in 100 Israeli families. No signiŽ cant differences were found between the two groups of children in school adjustment, grades, IQ level, psychological adjustment (i.e. anxiety, depression, hyperactivity, self-concept) , observed behaviours at home, and coping with adoption issues. However, they perceived their parents to be more supportive but controlling. Marked differences were found in parents’ behaviours, especially fathers’, and family functioning: In the international adoption group, compared with the domestic adoption group, parents used more problem-focused and support-seeking ways of coping, viewed parenting more as a challenge, were more involved with their children; but were more intrusive, reported more cohesive family relations and better marital adjustment, and coped differently with adoption issues. Results are discussed in terms of the differences in the two types of adoption.

International adoption— the joining of parents and children from different countries together in adoptive families—has become, increasingly, a service for childless couples in the West and a second chance for children coming from countries ravaged by war and suffering from poor political, social, and economic conditions. International adoption is often controversial (e.g. Ngabonziza, 1988), and the opposition to the practice is on political and psychological grounds. There is an emerging body of knowledge that addresses the speciŽ c issues related to the international adoptees’ adjustment (for review see Alstein & Simon, 1991; Silverm an & Feigelm an, 1990; Tizard, 1991). These children have to contend with normative development al tasks, with those of adoption, and with placement in a family from a different ethnic and cultural background than their own. It is noteworthy that research to date has not yet

Requests for reprints should be sent to Rachel Levy-Shiff, Department of Psychology, Bar-Ilan University, Ramat-Gan 52900, Israel; E-mail: F41361 6 BARILAN. q 1997 The International Society for the Study of Behavioural Developmen t

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systematically explored patterns of parental adjustment and family functioning. From a theoretical point of view, we can expect several factors to jeopardise the adjustment of international adoptees. (1) Children placed in families with different racial, cultural, and religious characteristics from their own may be less easily integrated into their adoptive family and community. They may lose access to their own heritage and be exposed to some measure of racism. Consequently, they may have difŽ culties, especially in forming a positive self-concept and integrated identity (Bagley & Young, 1981; Loene & Hoksbergen, 1986; Simon & Alstein, 1987). (2) International adoptees are often older children, many of whom are physically and emotionally disabled. These children may have spent years in numerous foster homes or institutional settings, experiencing severe physical and emotional traumas. A review of the extant research reveals that pre-adoption traumatic experiences of the adoptees may have long-term effects on their adjustment patterns (e.g. Verhulst, Althus, & Versluis-DenBieman, 1990a). Some authors suggest that pre-adoptive history and delays in permanent placement are more signiŽ cant predictors of post-adoptive maladjustm ent than factors of racial antagonism . Furthermore, most studies report that the older the child at placement, the greater the probability of adaptative failure. (3) The process of international adoption is not approved, supported, regulated, or legalised by many governm ents. In addition, receiving countries are often unable to cope with the numerous political, legal, social, and psychologic al aspects involved in international adoption (Jaffe, 1990). The complications associated with international adoption processes may later project on the child’s adjustment and on family functioning. The empirical Žndings on international adoptees’ adjustment are inconclusive (Silverm an & Feigelm an, 1990; Tizard, 1991). Some studies showed that their levels of functioning were not signiŽ cantly different from those of control groups of nonadopted children or domestically adopted children (e.g. Bagley, 1992; Kuhl, 1985). Other studies demonstrated that they were likely to reveal adjustment problems; some researchers suggested that such difŽ culties were manifested primarily in the initial adoption period, whereas others found that the problem s were persistent (e.g. Harper, 1986; Verhulst, Althus, & Versluis-Den-Bieman, 1990b; Verhulst, Althus, & Versluis-Den-Biem an, 1992). These discrepancies emphasise the complexity of this Želd of study and may have a number of explanations. The researchers used different designs and measures; the chidren studied were of different ages at adoption and during data collection; the countries of origin and the adoptive countries had a wide range of culture, language, and ethnic diversity (e.g. Hoksbergen, 1990; Simon & Alstein, 1990). In addition, several studies present

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methodologica l problem s as no control group was used. This obviates the need to differentiate between the effects of distinctive characteristics on long-term adjustment and to investigate similarities and particularities of internationa l adoption in speciŽ c countries. International adoptions were virtually nonexistent in Israel until the late 1970s (Jaffe, 1990). In recent years, many couples have turned to independent adoption abroad for various reasons. Many are deterred by the long wait involved in the intrusive bureaucratic process of the governm ental adoption services. There are no private or independent adoption agencies in Israel. Some couples refuse to adopt older or handicapped children and prefer to adopt an infant. However, as in other Western countries, Israel does not have enough babies available for adoption to Žll these requests. Some couples may be found by adoption services as ineligible for reasons, such as family status or age (the maximum age of eligibility for adoption of infants in Israel is 42 years for fathers and 38 years for mothers). There are marked differences between internationa l and domestic adoption processes. The Israeli governm ent does not have adoption agreem ents with other contries. Furthermore, Israeli adoption laws do not enable children brought from abroad to be adopted in Israeli courts, and immigration authorities cannot issue visas for children to enter Israel to complete their adoption. Rather, the children are usually adopted in foreign courts and enter Israel together with the returning adoptive parents, using their own passport. Such foreign adoptions are often accompanied by severe legal difŽ culties (Pilloti, 1985). Israeli and foreign police have been involved in a number of such cases, following allegations of use of forged documents for adoption of babies and suspicions that some of the babies may have been kidnapped. Many parents who have gone through this process are particularly worried about the legality of their adoption procedures. Whereas Israeli domestic adoption is free of Žnancial cost, the expenses of internationa l adoption are prohibitive. These include air fare and lodging for weeks or months, as well as payments to local brokers, lawyers, doctors, and social workers. In addition, overseas adoption presents unique emotional burdens. For example, although most parents are able to see the child in advance, some are forced to return babies after a few days due to severe health problem s and get another child in exchange. In addition, couples cannot verify documents or information they receive pertaining to the child’s background . According to Israeli law, adopted children at the age of 18 can request the adoption services to open their records, provide information about their biological parents, and arrange a meeting between them if the latter give their consent. Such an experience helps them cope with adoption issues and integrate their identity. Although many children are ambivalent about doing so, the very knowledge that they have this possibility can help their coping

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(Shimi, 1990). In contrast, children of internationa l adoption have almost no possibility to obtain accurate information of their background or to locate their biological parents, as the contents of their records are usually incomplete or false. Foreign-born children adopted by Israelis have not only a different ethnic and cultural heritage, but also a religious one. Most children are converted to Judaism, but the conversion is often not recognised by the Rabbinate. This can create serious difŽ culties, as family law in Israel is under Rabbinate jurisdiction. Although international adoptees receive an Israeli identity card, many of them have a special preŽ x or number identifying them as adopted from abroad (i.e. their status in Judaism is in doubt). The present study was designed to explore adjustment of school-aged internationa l adoptees, their parents, and their families, using a control group of domestic adopted children. All the children were adopted at a very early age. Assessment of the children included: (1) psychological adjustment: anxiety, aggression, depression, hyperactive behaviour, and self-concept; (2) school adjustment: learning, emotional, and social adjustment at school, school grades, and IQ level; (3) behaviours at home; and (4) coping with adoption issues. Parental and family assessment included: (1) psychological distress; (2) parental behaviours and coping with parenting; (3) family relations and marital adjustment; and (4) coping with adoption issues.

METHOD Subjects The sample consisted of 100 Israeli children and their parents. Fifty children (23 boys and 27 girls) were internationa lly adopted in a South American country and 50 children (24 boys and 26 girls) were domestically adopted in Israel. The age of the children ranged from 7 to 13 years of age. The children in both groups were adopted as newborns or infants during the Žrst days or weeks of their lives (under 3 months of age). No signiŽ cant differences between the two groups were found with regard to maternal and paternal education as assessed by years of education, maternal and paternal professional status, as classiŽed according to an index of occupational prestige in Israel on a 9-point scale (1 = unemployed, 9 = lawyers, medical doctors), family income as assessed on a 5-point scale (5 = much more than the average salary in Israel, 1 = far less than the average salary in Israel), and density of living (i.e. number of rooms/number of persons living in the house). In both groups, most of the adoptive parents were born in Israel or in a Western country. All adoptive parents were Jewish. Yet, parents in the international adoption group were signiŽ cantly

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younger than the parents in the domestic adoption group and had been married for a shorter period. For samples’ characteristics see Table 1.

Procedure There is no ofŽ cial record of internationa l adoptions in Israel, and it is difŽ cult to create a list of names and addresses of potential participants. The families were recruited by advertisem ents published in the major Israeli newspapers and by word of mouth. We realise that this may not be a representative sample. Data were collected in the homes. During visits, parents and children were interviewed and Žlled out the questionnaires, and the observations and observers’ ratings were carried out.

Children’s Adjustment Measures Wechsler Intelligence Scale for Children-Revised (WISC-R). The standard Hebrew version of the WISC-R was administered (Wechsler, 1976). The full-scale IQ score is reported here. School adjustment. Data were obtained from the schoolteachers via the 18-item Rating Scale for School Adjustment (Smilansky & Shephatia, 1976). A factor analysis of the scale items revealed three main factors: (1) TABLE 1 Demographic Variables in International and Domestic Adoption

International

Children’s age Mothers’ age Fathers’ age Mothers’ education Fathers’ education Years of marriage Income Density of living

Mother’s ethnic origin Ashkenazi (%) Sephardi (%) Israel (%) Father’s ethnic origin Ashkenazi (%) Sephardi (%) Israel (%) *P ,

.05; ** P ,

.01.

Domestic

M

( SD)

M

( SD )

9.76 41.80 44.50 13.53 14.57 17.50 3.65 0.93

(2.32) (4.57) (3.90) (2.23) (3.47) (4.28) (0.55) (0.28)

9.96 45.12 47.29 14.73 14.07 21.33 3.79 1.02

(1.32) (3.24) (4.05) (3.50) (3.32) (3.33) (0.52) (0.37)

19 8 73

27 16 67

16 23 61

20 25 55

t – 2.94* 2.48* – – 3.51** – –

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Emotional Adjustment, which included discipline, appearance, honesty, emotional balance, moodiness, and likeability; (2) Social Adjustment, which included aggression, sociability, leadership, energy, activity, independenc e, and scapegoat role; and (3) Learning Adjustment, which included comprehension, interest, concentration, ambition, and self-conŽ dence. Responses on each item are given on a 5-point rating scale on which each point is assigned a descriptive label. For example, the points for sociability were: 1 = usually keeps to himself ; 2 = has trouble creating social ties; 3 = active to a certain degree in the company of children; 4 = possesses numerous social ties; and 5 = always spends time in company. Smilansky and Shephatia reported test-retest reliability of .91 for the whole scales, and internal stability of Cronbach’s alphas ranging from .66 to .77 for the separate factors. In this study, Cronbach’s alpha coefŽ cients were .85, .75, and .81 for the Learning Adjustment, Emotional Adjustment, and Social Adjustment subscales, respectively. In addition, teachers reported on the school grades in three main scholastic domains: mathematics, science, and Hebrew on 7-point scales (1 = 40 out of 100, 7 = 100 out of 100). The grades were found to be highly intercorrelated (above .80) and were, therefore, computed to create one composite score that reects school achievement. State-Trait Anxiety Inventory for Children (Spielberger , 1973). This self-report questionnaire was designed to assess state and trait anxiety in children. In the present study only the 20-item trait questionnaire was used. Children scored their answers on a 3-point scale (e.g. “I worry too much”; “Deep in my heart, I am afraid”). A higher score reects a higher level of anxiety. In the Hebrew adaptation of the questionnaire, the internal consistency was found to be .84, the test-retest reliability .85, and the validity as assessed by correlation with the Cattel questionnaire of anxiety was .76. In the present study, Cronbach’s alpha was .91. Children’s Depression Inventory (Kovacs, 1978; Kovacs & Beck, 1977). This self-report questionnaire consists of 27 items that assess depression manifested in four areas: emotional, cognitive, motivational, and physical. Within each item, there is a choice of three statements on a 3-point scale, the child choosing that which best describes him/herself (e.g. “I am sad sometimes, I am sad often, I am sad all the time”; “I sometimes feel like crying, I often feel like crying, I feel like crying every day”). A higher score reects a higher level of depression. In the Hebrew adaptation of the questionnaire, the internal consistency was found to be .80 and the test-retest reliability .84, and its current validity as measured by correlation with a psychiatric interview was .82. In the present study, Cronbach’s alpha coefŽ cient was .86. Children’s Aggression Inventory (Feshbach, 1966). This self-report 20item questionnaire was designed to assess aggressive behaviours in

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children. The answers are given on a 2-point scale (true-false) (e.g. “I sometimes get angry”; “Sometimes there are good reasons to beat another child”; “In comparison to others I bicker a lot”). A higher score reects a higher level of self-report aggression. In the Hebrew adaptation of the questionnaire, the internal consistency was found to be .85, the test-retest reliability .87, and the concurrent validity as assessed by correlation with teachers’ report of aggression was .78. In the present study, Cronbach’s alpha coefŽ cient was .82. Conners Symptoms Questionnaire (Conners, 1973). This rating scale was designed to assess mainly hyperactive behaviours among children (e.g. “Cries easily”; “Shows unpredictable behaviours” ). The various behaviours are rated by the teacher on a 4-point scale (0 = not at all, 3 = very much). In the Hebrew adaptation of the questionnaire, the internal consistency was found to be .85, the test-retest reliability .89, and the concurrent validity as assessed by correlation with the school psychologists’ report of the children’s behaviours was .87. The questionnaire was found to differentiate between clinical and nonclinical samples. Cronbach’s alpha was .91. Tennessee Self-Concept Scale (Fitts, 1967). This scale contains 90 items, equally divided into positive and negative. A system of classiŽcation permits the creation of Žve composite measures that relate to Žve dimensions of self-concept: (1) physical self, relating to the individual’ s perception of his or her state of health, physical appearance, physical skills, and sexuality; (2) moral-ethical frame of reference, such as moral worth and feelings of being a “good” or a “bad” person; (3) personal self, relating to the individual’ s sense of personal worth, feelings of adequacy as a person, and evaluation of the personality apart from the body of relationship s to others; (4) family self, relating to the individual’s feelings of need, adequacy, and value as a family member; (5) social self, relating to the individual’ s perception of the self in relation to others, and sense of adequacy and worth in the social interaction with them. The scores were rated on a 5-point scale. A higher score reects a higher self-concept and self-esteem. In the Hebrew adaptation of the questionnaire, the internal consistency ranged between .68 and .85, and the test-retest reliability ranged between .86 and .88. The questionnaire differentiate d signiŽ cantly between clinical samples. In the present study, Cronbach’s alpha coefŽ cient for the entire questionnaire was .92. The Cornell Parent Behavior Inventory (Devereux, Bronfenbrenner, & Rogers, 1969). This questionnaire was used to assess the way children perceived parental behaviours towards them. The answers were rated on a 5-point scale (1 = rarely, 5 = mostly). There are four factors of perceived parental behaviours: (1) Support (e.g. “Mother/father helps me with my homework if I do not understand” ); (2) Demands (e.g. “My mother/father demands that I will be a good pupil at school”; (3) Control (e.g. “My mother/father wants to know exactly where I go”); (4) Punitiveness (e.g.

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“My mother/father beats me”). Cronbach’s alpha coefŽ cients were .87, .77, .71, and .82, respectively. Coping with Adoption Questionnaire. Based on the theoretical literature, previous research, and interviews with children, a questionnaire was constructed to assess children’s coping with adoption issues. A factor analysis (varimax rotation) revealed three factors. The Žrst factor included 8 items (loading . .40) that were related to the willingness to know, inquire, and investigate about the biological parents (e.g. “Adopted children want to know who gave birth to them”). The second factor included 12 items (loading . .40) that were related to the children’s difŽ culties with the adoptive parents (e.g. “An adopted child was not born to his or her parents and, therefore, they are not the ‘real’ parents”). The third factor included 9 items (loading . .40) that were related to the children’s openness to discuss adoption issues with their friends (e.g. “Adopted children are afraid to tell their friends about their being adopted because they believe that their friends wil not understand them”). Cronbach’s alpha coefŽ cients for the three dimensions were .81, .74, and .79, respectively.

Parents’ Adjustment and Family Functioning Psychological distress. Parents’ psychologic al distress was assessed using the Burnout Questionnaire (Pines & Aronson, 1981) and subscales from the Symptom Distress Checklist-90-revised (SCL-90-R; Derogatis, 1983). The Burnout Questionnaire includes 21 items that refer to emotional and physical depletion and by the negation of one’s self, environm ent, work, and life. The items represent three aspects: (1) physical exhaustion (e.g. being tired); (2) emotional exhaustion (e.g. feeling depressed); (3) mental exhaustion (e.g. feeling disillusioned and resentful about people). The answers were rated on a 7-point scale (1 = never, 7 = always). Cronbach’s alpha was .88. As additional measures of parental psychological well-being, four subscales were selected from the SCL-90-R: Depression, Anxiety, Somatisation, and Interpersonal Sensitivity. Cronbach’s alphas for the subscales were .89, .91, .87, and .92, respectively. Cognitive Appraisal of Parenting (Folkman & Lazarus, 1984). This questionnaire comprised items related to two aspects of parenting as a threat and as a challenge. The responses were rated on a 5-point scale (1 = not at all, 5 = very much). In the current sample, a principal-component factor analysis (varimax rotation) yielded two main factors (eigenvalue . 1) that explained 61% of the variance. The Ž rst factor included nine items (loading . .40) denoting threat— that is, to what extent parenting presents a negative implication for their lives (e.g. “Being a mother/father jeopardizes my career”; “Being a mother/father takes my time when I badly need it for other

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purposes”). The second factor also included nine items (loading . .40) consisting of measures denoting challenge, that is, to what extent parenting is evaluated as a benign-posit ive in its implication for their lives (e.g. “Being a mother/father is a source of satisfaction”; “Being a mother/father gives special meaning to my life”). On this basis, a Challenge score and a Threat score were computed for each subject by averaging the items that loaded high on the given factor. Cronbach’s alphas were .74 and .87, respectively. Ways of Coping Checklist (Folkman & Lazarus, 1984). This scale was used to measure the parents’ coping strategies with parenting situations and events. The 68-item, self-report questionnair e includes a broad range of cognitive and behavioural strategies people use to manage demands. In the present study, subjects were asked to indicate on a 5-point Likert scale (1 = not used, 5 = used a very great deal) the extent to which they tended to act in the way described when confronted with parenting demands. In the current sample, a principal-component factor analysis (varimax rotation) yielded four main factors (eigenvalue . 1) that explained 64% of the variance. The Žrst factor included 13 items (loading . .40) denoting problem -focused coping (e.g. “I try to analyse the problem in order to understand it better”; “I am making a plan of action and following it”; “Just concentrate on what I have to do next”). The second factor included 10 items (loading . .40) denoting emotion-focused ways of coping (e.g. “Wish that I can change what is happening or how I feel”; “Criticising or lecturing myself ”; “Realise I brought the problem on myself ”). The third factor included eight items (loading . .40) denoting seeking support (e.g. “Seeking to talk to someone to Žnd out more about the situation”; “Seeking sympathy and understanding from someone”). The fourth factor included eight items (loading . .40) denoting escapism and denial (e.g. “Try to forget the whole thing”). On this basis, four scores were computed for each subject by averaging the items that loaded high on the given factor. Higher scores reect a higher reliance on a particular type of strategy. Cronbach’s alphas were .85, .83, .81, and .89, respectively. Dyadic Adjustment Scale (Spanier, 1976). This 32-item questionnaire was designed to assess the quality of marital relations. There are four subscales: (1) Consensus on matters of importance to dyadic functioning; (2) Dyadic satisfaction; (3) Dyadic cohesion; and (4) Affectional expression. Answers were rated on a 4-point scale and a higher score reects better marital adjustment. Cronbach’s alpha for the entire scale was .92. FACES III. Family Adaptability and Cohesion Scales (Olson, Pertner, & Lavee, 1985). This 20-item qustionnaire was used to assess two basic dimensions of family life: (1) Cohesion (e.g. “Family members ask help from one another”); and (2) Adaptability (e.g. “Rules change in our family”). The answers were rated on a 5-point scale (1 = never, 5 = always). In the present

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study, Cronbach’s alphas were .80 for the Cohesion scale and .81 for the Adaptability scale. Mother-father-child interactions. Observations of mother-father-child interactions were carried out at home. Behaviours were recorded in two 30-minute periods of free and unstructured situations. The participants were asked to behave as naturally as possible, to go about their daily routine, and to move about at will. No restrictions were imposed. The behavioural categories were culled from previous mother-father-child research and Žnal selection was done in a pilot study. The presence/absence of the various behaviours listed on a precoded checklist were recorded every 20 seconds. More than one category could be scored. A small cassette tape recorder was used to generate a time signal. Reliability was reassessed periodically during data collection and the coefŽ cients estimates based on intra-class correlations (Bartko & Carpenter, 1976) are given as follows. Parental observed behavioural categories were as follows: caregiving (.90), speaking (.94), teaching (.71), playing (.78), restricting (verbal, physical) (.86), expressing positive affection (.91), refusing/denying (.77), and aggressive manifestations (.79). The observational data were subjected to two separate factor analyses (for mothers and for fathers) yielding two main factors that explained 59% of the variance of maternal behaviours and 64% of the variance of paternal behaviours. The Žrst factor consisted of measures denoting caregiving and afŽ liative behaviours and the second factor consisted of measures denoting negative behaviours. Two composite scores were then computed for each subject by averaging the variables that were highly loaded on a factor. The observationa l data were supplem ented by ratings of the quality of parental interactions (e.g. Heinicke, Diskin, Ramsey-Klee, & Givenm, 1983). These ratings were completed by observers on a 5-point scale after each visit. Two separate factor analyses (for mothers and for fathers) yielded three main factors that explained 73% of the variance of maternal interactions and 68% of the variance of paternal interactions. The Žrst factor consisted of measures denoting support (e.g. supportive, taking child’s needs into consideration, accepting the child). The second factor consisted of measures denoting overprotection (e.g. overprotective, intrusive, anxious). The third factor consisted of measures denoting discipline and control (e.g. disciplining, controlling). Three composite scores were then computed for each subject by averaging the variables that were highly loaded on a factor. Child’s observed behavioural categories were as follows: involved in joint activity with parents (.89), showing/asking for affection (.88), talking with parent (.81), noncompliant, nonresponsive (.71), showing aggressive behaviours (.78), crying, showing dissatisŽ ed unhappy behaviours (.79). The behavioural data were subjected to a factor analysis (varimax rotation) that yielded two main factors that explained 65% of the variance. The Žrst factor

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consisted of measures denoting interactive and positive behaviours, and the second factor consisted of measures denoting negative behaviours. Two scores of positive interactive behaviours and negative reactions were then computed for each subject by averaging the items that were highly loaded on a factor. Wife-husband observed behavioural categories were as follows: childrelated interchanges (.87), nonchild-related interchanges (.85), positive affective interchanges (.80), and negative affective interchanges (.76). The factor analysis that was performed on the observed data indicated that the Žrst factor explained 48% of the variance and included items denoting positive marital communication. A composite score was created for each subject by averaging the items that were highly loaded on the factor. Social Support Questionnaire (Crnic & Greenberg, 1987). This comprises 16 items involving three types of support from three distinct ecological sources. The types of support are as follows: (1) emotional support which contributes to the feeling that one is loved or cared about (e.g. raises your spirits, makes you feel he/she cares); (2) tangible support which involves direct assistance in terms of service or material goods (e.g. helps you with chores, errands, etc.); and (3) informational support which includes information and advice (e.g. information, suggestions, guidance). The sources of social support are: (1) community agents (e.g. social workers, nurses, doctors); (2) close relations (i.e. neighbours, extended family members, friends). Each support question has essentially two parts, one that assesses availability or extent of support, and one that assesses the respondent’s satisfaction with the availability or extent of support. Answers were rated on a 5-point scale (1 = very little, 5 = not at all). Cronbach’s alphas were .89 and .81, respectively. Coping with adoption. To assess parental coping with adoption, three questionnaires were used. The Žrst Coping with Adoption Questionnaire included items that were related to being preoccupied with adoption issues. The responses were rated on a 5-point scale (1 = not preoccupied at all, 5 = very preoccupied). A principal-component factor analysis with varimax rotation yielded three main factors (eigenvalue . 1) that explained 78% of the variance. The Žrst factor included 13 items denoting preoccupation with the adoption triangulation : the biological parents, the adoptive parents, the adopted child, and the relationships among them (e.g. “To what extent are you preoccupied with the thought about the birth mother?”). The second factor included items denoting parental preoccupations with how their children cope with the adoption issues (i.e. “To what extent are you preoccupied with your child’s fantasies and thoughts regarding the adoption?” ). The third factor included four items denoting parental preoccupation with the differences between adoptive and biological families (e.g. “Many people do not understand the life of adoptive families”).

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Composite scores were created for each subject by averaging the items that were highly loaded on the factors. Cronbach’s alphas were .93 for preoccupation with adoption triangulation, .79 for preoccupation with children’s difŽ culties, and .79 for preoccupation with biological/adoptive family differences. The second 23-item questionnaire, the Feelings Questionnaire (Folkman & Lazarus, 1984), was used to assess parents’ feelings associated with the adoption experience, on a 5-point scale (1 = not at all, 5 = very often). A principal-component factor analysis with varimax rotation yielded two main factors (eigenvalue . 1) that explained 65% of the variance. The Žrst factor included 11 items (loading . .40) denoting positive feelings (e.g. satisfaction, joy) and the second factor included 9 items (loading . .40) denoting negative feelings (e.g. anger, disappointm ent). On this basis, a positive feelings score and a negative feelings score were computed for each subject by averaging the items that loaded high on the given factor. Cronbach’s alphas were .87 and .88, respectively. The third Loss and Deprivation Questionnaire (Achmon, 1984; LevyShiff, Goldsmith, & Har-Even, 1991) was used in order to assess the dimensions of loss and deprivation in life due to infertility. These include: (1) the loss related to not being a biological parent (e.g. “Not being able to have a biological child makes me feel I have been deprived”); (2) damage to self-image (e.g. “Not being able to have a biological child makes me feel handicapped ”); (3) sense of failure and guilt (e.g. “Not having a biological child makes me feel a failure”); and (4) frustration and loss related to family issues (e.g. “My inability to bear children disappoints my parents”). Answers were rated on a 5-point scale (1 = not at all, 5 = very much). A higher score reected difŽ culties in coping with infertility. Cronbach’s alpha for the entire scale was .93.

RESULTS To exam ine the differences between the internationa lly and the domestically adopted children as well as the differences between their parents, multivariate analyses of variance (MANOVAs) with one factorial (Adoption Status: international/ domestic) or two factorials with repeated measures (Adoption Status: internationa l/domestic; Parent Gender: mothers/fathers) were performed. When the MANOVA revealed a signiŽ cant main effect or a signiŽ cant interaction effect, it was followed by analyses of variance (ANOVAs) using a model identical to that used in the MANOVA.

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Children’s Adjustment A one-way MANOVA performed on the variables related to the children’s emotional, social, and learning adjustment in school and their school grades did not reveal any signiŽ cant difference between the two groups. Similarly, a one-way MANOVA performed on the variables related to the children’s psychological adjustment, namely, anxiety, depression, hyperactive behaviours, and self-concept, did not reveal a signiŽ cant difference between the two groups. Moreover, a one-way ANOVA indicated no signiŽ cant difference between the two groups with regard to their IQ level, although that of the internationa lly adopted children, as compared with that of the domestically adopted children, was somewhat lower [M = 111.57, SD = 13.13, range = 92–139, and M = 121.25, SD = 1.98, range = 94–147, respectively, F(1,98) = 1.03, P . .05]. In addition, no differences were found between the two groups in the Wechsler Intelligence subscales. With regard to the observed children’s behaviours at home, no signiŽ cant difference between the two groups was revealed by the MANOVA. However, with regard to the children’s perceptions of parental behaviours, a 2 × 2 MANOVA indicated signiŽ cant main effects for Adoption Status [F(4,95) = 3.27, P , .05], and for Parent Gender [F(4,95) = 3.35, P , .05]. The follow-up ANOVAs indicated that the internationa lly adopted children, as compared with the domestically adopted children, viewed their parents to be more supportive, M = 3.96 and M = 3.60, respectively [F(1,98) = 4.68, P , .05], and more controlling, M = 3.85 and M = 3.40, respectively [F(1,98) = 4.81, P , .05]. In addition, mothers, as compared with fathers, were perceived to be more supportive, M = 3.86 and M = 3.78, respectively [F (1,98) = 4.97, P , .05], and less controlling, M = 3.66 and M = 3.72, respectively [F(1,98) = 9.05, P , .01]. With regard to the children’s coping with adoption, no signiŽ cant difference between the two groups was revealed by a one-way MANOVA performed on the variables related to adoption issues.

Parents’ Adjustment and Family Functioning The 2 × 2 MANOVA performed on the parental psychological distress variables did not reveal a signiŽ cant difference between the internationall y and domestically adopting parents, or between mothers and fathers. The level of the psychological distress was quite similar and relatively low in both adopting groups, as reected in parental level of burnout, M = 1.96 and M = 1.91; anxiety, M = 1.35 and M = 1.42; depression, M = 1.47 and M = 1.55; insecurity, M = 1.43 and M = 1.40; and somatisation, M = 1.27 and M = 1.45, respectively. Yet, with regard to ways of coping with parenting issues, a 2 × 2 MANOVA indicated a signiŽ cant main effect for Adoption Status

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[F(4,95) = 2.57, P , .05], and a signiŽ cant main effect for Parent Gender [F(4,95) = 10.03, P , .001]. The follow-up ANOVAs indicated that the parents in the international adoption group, as compared with the parents in the domestic adoption group, used more problem -focused ways of coping, M = 3.30 and M = 2.93, respectively [F(1,98) = 3.88, P , .05], and more support-seeking strategies, M = 2.92 and M = 2.58, respectively [F(1,98) = 4.89, P , .05], but no signiŽ cant difference was found in the use of emotion-focused ways of coping or escapism and denial. In addition, mothers, as compared with fathers, used more support-seeking strategies, M = 3.16 and M = 2.35, respectively [F(1,98) = 11.42, P , .001]. Furthermore, with regard to cognitive assessment of parenting as a challenge and a threat, a 2 × 2 MANOVA indicated signiŽ cant main effects for Adoption Status [F (2,97) = 2.98, P , .05], and for Parent Gender [F(2,97) = 9.10, P , .001], as well as a signiŽ cant Adoption Status × Parent Gender interaction [F(2,97) = 2.88, P , .05]. The follow-up ANOVAs indicated that both the mothers and fathers in the internationa l adoption group viewed parenting as a challenge more than did the mothers and fathers in the domestic adoption group, M = 3.84, M = 3.81, M = 3.59, and M = 3.06, respectively [F (1,98) = 5.48, P , .05], yet the difference was more marked between fathers [F(1,98) = 4.27, P , .05]. No signiŽ cant difference was found between the two groups with regard to viewing parenting as a threat. In addition, mothers, more than fathers, viewed parenting as a challenge, M = 3.71 and M = 3.43, respectively [F(1,98) = 7.92, P , .01], and as a threat, M = 2.04 and M = 1.78 [F (1,98) = 11.84, P , .001]. With regard to parental observed and rated behaviours at home, the MANOVA revealed signiŽ cant main effects for Adoption Status [F(6,93) = 2.67, P , .05], and Parent Gender [F(6,93) = 5.51, P , .001], as well as signiŽ cant Adoption Status × Parent Gender interaction [F(6,93) = 2.45, P , .05]. The follow-up ANOVAs showed that the internationa lly adoptive parents, compared with the domestically adoptive parents, were more involved in caregiving, but were more overprotective and intrusive, as well as controlling, especially fathers. In addition, mothers more than fathers, were more involved in caregiving and positive behaviours, and were more supportive and overprotective (see Table 2). Family relations and marital adjustment were also found to differ in the two groups. A 2 × 2 MANOVA performed on family cohesion and adaptability variables, and on marital adjustment and communication variables indicated a signiŽ cant main effect for Adoption Status [F(4,95) = 4.76, P , .01]. The follow-up ANOVAs showed that the parents in the international adoption group, as compared with the parents in the domestic adoption group, found their family relations to be more cohesive, M = 41.08 and M = 36.66, respectively [F (1,98) = 11.23, P , .001], and reported more marital satisfaction and adjustment, M = 117.21 and

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TABLE 2 Parents’ Behaviours at Home in International and Domestic Adoption

International M Caregiving Positive behaviours Negative behaviours Supportive Overprotective Controlling *P ,

.05; ** P ,

F

5.48 3.82 15.24 11.99 2.84 3.04 4.12 3.75 2.45 2.04 3.01 3.18

.01; *** P ,

Domestic M

F

4.91 1.95 14.16 10.33 3.37 3.08 4.15 3.43 2.16 1.62 2.93 2.66

Adoption Parent Adoption Status Status Gender × Parent Gender 4.12* – – – 3.79* 3.95*

14.13*** 7.10** – 12.56*** 7.87** –

3.98* – – – – 4.15*

.001.

M = 107.91, respectively [F(1,98) = 3.88, P , .05]. Couples were also found to engage more in communication, M = 7.32 and M = 5.57, respectively [F(1,98) = 4.47, P , .05]. With regard to social support, no signiŽ cant difference was found between the international and domestic adoption groups. Both groups reported to receive a moderated level of social support from friends, extended family members, or neighbours, M = 3.11 and M = 3.13, respectively, and a similar level of professional help, M = 1.73 and M = 1.91, respectively. In addition, most adoptive parents reported seeking psychological advice during the years: 58% of the parents in the international adoption group and 51% in the domestic adoption group had psychologic al counselling of some kind. Substantial differences in parental coping with adoption were found between the two groups and between mothers and fathers. A 2 × 2 MANOVA revealed signiŽ cant main effects for Adoption Status [F(4,95) = 3.17, P , .05], and Parent Gender [F(4,95) = 9.51, P , .001], as well as signiŽ cant Adoption Status × Parent Gender interaction [F(4,95) = 2.98, P , .05]. The follow-up ANOVAs showed that the internationa lly adoptive parents, as compared with the domestically adoptive parents, were less concerned with the difference between biological and adoptive families, especially fathers, and had more positive feelings about adoption. In addition, mothers, as compared with fathers, were more preoccupied with the adoption triangulation issues and with their children’s difŽ culties in coping with adoption issues, had more positive feelings about adoption, and felt more deprived because of the couple’s infertility. However, in the internationa l adoption group, fathers felt more deprived because of the couple’s infertility than fathers in the domestic group, whereas mothers in the international adoption group felt less deprived than mothers in the domestic group (see Table 3).

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TABLE 3 Parental Coping with Adoption Issues in International and Domestic Adoption

International

.05; ** P ,

Adoption Parent Adoption Status Status Gender × Parent Gender

M

F

M

F

1.83 2.31

1.58 2.04

2.00 2.36

1.83 1.82

– –

5.26** 10.46***

– –

2.10

2.01

2.53

2.11

4.12*

–

3.88*

3.95 1.32 2.91

3.54 1.34 2.63

3.71 1.53 3.37

3.11 1.28 2.49

3.96* – –

10.78*** – 11.50***

– – 4.78*

.01; *** P ,

.001.

Adoption triangulation Child’s difŽculties with adoption Biological/adoptive family differences Positive feelings Negative feelings Infertility deprivation *P ,

Domestic

DISCUSSION The present study was designed to investigate the effects of international adoption on adjustment patterns of school-aged children and their parents, using a control group of domestically adopted children. In addition, unlike previous research that included older adopted children, this study focused on children adopted at a very young age. Thus, this study controlled for negative long-term effects of pre-adoptive traumatic experiences and of late placement that often characterise inter-country adoption (Feigelm an & Silverm an, 1984), and enabled exploration of the speciŽ c characteristics of internationa l adoption. A comparison of the international and domestic adoption groups suggests marked differences in parental functioning and family relations, but similar levels of children’s adjustment in all areas. Thus, no signiŽ cant differences were found in the children’s emotional, social, and learning adjustment in school, or in their scholastic achievement manifested in their school grades. Moreover, although the IQ level was on the average somewhat lower in the internationa l adoption group, the difference was not statistically signiŽ cant. The relatively high average IQ level in both groups may be explained by two reasons: Žrst, the children were adopted by parents who generally had above-average education and income and who highly invested in their children; second, there is a standardisation problem of the Hebrew version of the Wechsler Intelligence Test which results in an overestimation of the IQ scores. In addition, some authors have addressed the issue of language mastery by internationa lly adopted children (Hene, 1988). No signiŽ cant differences were found in the present study between the two groups in the Wechsler’s Intelligence subscales involving language skills (e.g. Vocabulary). The fact that they were adopted as infants may account for their ability to master Hebrew as well as the domestically adopted children.

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In addition, the results did not reveal a signiŽ cant difference between the two groups in psychologic al adjustment as re ected in their levels of anxiety, depression, hyperactive behaviours, and self-concept. These results do not corroborate the premise, central in interracial and interethnic adoption literature, that the children have difŽ culties forging their identity and self-concept. It is possible that the formation of an appropriate self-concept was facilitated by the families’ positive view of the child’s ethnic origin and cultural heritage, manifested in the interviews conducted by us and also reported in other studies (Golan & Friedman, 1990). Parents raised questions regarding both the place of the country of origin in the child’s and family’s life, and moral-value questions such as overturning social, national, and religious backgrounds without their child’s consent. None of the parents sought to deny the child’s ties to his or her background. Although some parents did not emphasise the country of origin in order to avoid identity conicts within the child, others hoped that the child would ultimately be able to integrate an Israeli identity with the connection to the child’s country of origin. All the parents were reported to be supportive of the children’s identiŽ cation with their culture. This Žnding is consistent with previous research that indicated that, despite disparate ethnic and racial identity, self-esteem and self-concept are not necessarily impaired (e.g. McRoy & Zurcher, 1983). As noted previously, international adoption created difŽ culties beyond those inherent in adoption in general. Nevertheless , no signiŽ cant difference between the two groups was found regarding their coping with adoption issues, such as the need to know about their biological parents and their willingness to discuss adoption issues with parents and peers. Although no signiŽ cant difference between the two groups was revealed in the children’s behaviour at home or in their interactions with their parents, the international adoptees viewed their parents as both more supportive and more controlling. This Ž nding is congruent with other measures of parental functioning. The most striking and consistent differences between the two groups were found with regard to coping strategies for parenting demands, marital and family functioning, and their attitudes towards adoption issues. In both groups, parental levels of psychologic al distress were low, despite the fact that adoptive parents contend with numerous difŽ culties. However, parents in the internationa l group evaluated parenting experiences as more positive and challenging than did parents in the domestic group. In addition, they tended to be more active when coping with parenting issues, employing more problem-focused and support-seeking strategies. Finally, although they were more involved in caregiving aspects than the domestic group, they were also more overprotective, intrusive, and controlling in their interactions with their children.

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The differences between the groups’ parental involvement were even more pronounced for fathers than mothers. Two possible explanations can be proposed. Traditional adoption literature has emphasised a number of differences between men and women regarding adoption in general (Kirk, 1985). When couples are infertile, the burden of infertility deprivation falls primarily on the women. The women’s motivation to adopt a child is therefore greater, whereas men tend to have more reservations about adoption. Recent Žndings emphasise that men, too, suffer from their inability to bear children (e.g. Edelmann & Connolly, 1988), and their partnership in the adoptive process can encourage functional and emotional involvement in the process of raising the child, giving rise to the concept of adoptive enhanced fatherhood (e.g. Greenbaum, Auerbach, & Shavit, 1995). The phenom enon of enhanced fatherhood seems to be even stronger in internationa l adoption; men are required to take an extended leave of absence from their workplace and stay with the spouse and adopted child abroad, to carry out complicated Žnancial and legal procedures, and to struggle with social and emotional concerns related to the foreign adoption. Thus, their increased participation in the adoptive process projects on their future paternal roles. It is also possible that their greater involvem ent is partially related to their stronger sense of deprivation. In the internationa l adoption group, fathers felt more deprived because of the couple’s infertility than fathers in domestic adoption. Beyond differences in parental involvem ent, the two groups differed in aspects of family relations and marital adjustment. Couples in the internationa l adoption group, as compared with those of the domestic group, found their family relations to be more cohesive and supportive. Similarly, they reported a higher degree of marital adjustment, and were observed to have more frequent spousal communication. Finally, substantial differences between the groups were found regarding coping with adoption. The international ly adoptive parents, as compared with the domestically adoptive parents, were found to be less concerned with the differences between biological and adoptive families, and had more positive feelings about adoption. An integrative view of the results suggests a relatively coherent proŽ le of internationa lly adoptive parents. They seem to have more psychological and familial resources to tap; they evaluate parenting as an important contribution to their lives and view adoption in a highly positive light. Supposedly, the only couples who can turn to internationa l private adoption are those who possess the substantial resources required to contend with the adversities involved. The very process of internationa l adoption taps on their resources and a more active problem -solving approach. In contrast to institutional adoption in Israel where couples’ dependence on externally

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imposed decisions may foster feelings of helplessness, anger, and bitterness, internationa l adoption creates a positive psychologic al process. Both the decision to adopt a child and the independent process restore lost feelings of control and power. Thus, although those who turn to international adoption must have the resources needed, the very process may strengthen the couples and their family relations. Although the internationall y adopted children have been assumed to be more vulnerable than domestically adopted children, this has not been reected in their adjustment. It is possible that the greater parental and familial resources of the internationa lly adoptive families have compensated for the children’s greater vulnerability and helped them cope with the greater difŽ culties of foreign adoption. Finally, an additional concern has been raised in regard to the interethnic and interracial adoptive families’ social isolation. Yet, the results showed no signiŽ cant difference between the two groups with regard to received support. Both groups reported to receive a moderated level of social support from friends, extended family members, or neighbours. The Žndings of the present study must, however, be qualiŽ ed as only reecting the Israeli facets of internationa l adoption and the experience of children adopted at a very young age. Manuscript received March 1995 Revised manuscript received June 1995

REFERENCES Achmon, J. (1984). Loss and deprivation questionnaire. Unpublished manuscript (Hebrew); available from the author, Outpatient Clinic of Infertility, Beilinson Hospital, Petah-Tikva, Israel. Alstein, H., & Simon, R.J. (Eds.). (1991). Intercountry adoption: A multinational perspective (pp. 161–181). New York: Praeger. Bagley, C. (1992). The psychology of adoption: Case studies of national and international adoptions. Bulletin of the Hong Kong Psychological Society , 28/29 , 95–115. Bagley, C., & Young, L. (1981). The long-term adjustment and identity of a sample of inter-county adopted children. International Social Work, 23 , 16–22. Bartko, J.J., & Carpenter, W.T. (1976). On the methods and theory of reliability. Journal of Nervous and Mental Disease, 163 , 307–316. Conners, C.K. (1973). Rating scale for use in drug studies with children. Psychopharmacology Bulletin , 12 , 24–84. Crnic, K.A., & Greenberg, M.T. (1987). Transactional relationships between perceived family style, risk status, and mother-child interactions in two-year-olds. Journal of Pediatric Psychology, 12 , 343–362. Derogatis, L.L. (1983). SCL-90-R: Administration, scoring, and procedures manual: II. Baltimore, MD: Johns Hopkins University School of Medicine. Devereux, E., Bronfenbrenner, U., & Rogers, R. (1969). Child-rearing in England and the United States: A cross-national comparison. Journal of Marriage and the Family , 31, 257–270.

128

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Edelmann, R.J., & Connolly, K.J. (1988). Psychologica l aspects of infertility. British Journal of Medical Psychology, 59, 209–219. Feigelman, W., & Silverman, A.R. (1984). The long-term effects of transracial adoption. Social Services Review, 58, 588–602. Feshbach, S. (1966). Child Aggression Scale. Los Angeles, CA: University of California. Fitts, W.H. (1967). Tennessee Self-Concept Scale Manual. Nashville, TN: Counselor Recordings and Tests. Folkman, S., & Lazarus, S. (1984). If it changes it must be a process: A study of emotion and coping during the stages of a college examination. Journal of Personality and Social Psychology, 48 , 150–170. Golan, M., & Friedman, A. (1990). International adoption in Israel: Issues in group work with couples who adopted abroad. Society and Welfare, 13 , 364–373. (In Hebrew) Greenbaum , C., Auerbach, J.G., & Shavit, R. (1995, March). Adopted kibbutz school children in Israel. Paper presented at the SRCD, Indianapolis, Indiana. Harper, J. (1986). Intercountry adoption of older children in Australia. Adoption and Fostering , 10 , 27–31. Heinicke, C.M., Diskin, S., Ramsey-Klee, D., & Givenm, K. (1983). Prebirth characteristics and family development in the Žrst year of life. Child Development , 54 , 194–208. Hene, B. (1988). Language development of inter-country adoptees. Spring Report No. 39. University of Göteborg, Sweden. Hoksbergen, R. (1990). Intercountry adoption coming of age in The Netherlands. In H. Alstein & R.J. Simon (Eds.), Intercountry adoption: A multinational perspective (pp. 141– 160). New York: Praeger. Jaffe, E.D. (1990). Foreign adoptions in Israel: Private paths to parenthood. In H. Alstein & R.J. Simon (Eds.), Intercountry adoption: A multinational perspective (pp. 161–181). New York: Praeger. Johnson, A.K., Edwards, R., & Puwakm, H. (1993). Foster care and adoption policy in Romania: Suggestions for international intervention. Social Welfare, 32, 489–506. Kirk, D. (1985). Adoption kinship. New York: Ben-Simon Publications. Kovacs, M. (1978). Rating scales to assess depression in school-aged children. Acta Paedopsychiatrica, 46 , 305–315. Kovacs, M., & Beck, A.T. (1977). An empirical clinical approach toward a deŽnition of childhood depression. In J. Schutterbrand & A. Raskin (Eds.), Depression in childhood: Diagnosis, treatment, and conceptual models (pp. 25–38). New York: Raven. Kuhl, W. (1985). When adopted children of foreign origin grow up. Osnabrück: Terre des Hommes. Levy-Shiff, R., Goldsmith, I., & Har-Even, D. (1991). Transition to parenthood in adoptive families. Developmental Psychology, 27 , 131–140. Loene, A., & Hoksbergen, R. (1986). Intercountry adoption: The Netherlands attachment relations and identity. Adoption and Fostering , 10 , 22–26. McRoy, R., & Zurcher, L. (1983). Transracial and interracial adoptees. SpringŽ eld, IL: Charles C. Thomas. Ngabonziza, D. (1988). Intercountry adoption: In whose best interests? Adoption and Fostering , 12 , 35–40. Olson, D.H., Pertner, J., & Lavee, Y. (1985). FACES III. Family Adaptability and Cohesion Scales: III. St. Paul, MN: Family Social Science, University of Minnesota Press. Pilloti, F.J. (1985). Intercountry adoption: View from Latin America. Child Welfare, 64, 22–26. Pines, A., & Aronson, E. (1981). Burnout: From tedium to personal growth . New York: Wiley. Shimi, T. (1990). Adoptees open the adoption records and their adjustment. Unpublished master’s thesis, Bar-Ilan University, Ramat-Gan, Israel.

INTERNATIONAL AND DOMESTIC ADOPTION

129

Silverman, A.R., & Feigelman, W. (1990). Adjustment in interracial adoptees: An overview. In D.M. Brodzinsky & M.D. Schechter (Eds.), The psychology of adoption (pp. 187–200). New York: Oxford University Press. Simon, R.J., & Alstein, H. (1987). Transracial adoptees and their families: A study of identity and commitment. New York: Praeger. Simon, R.J., & Alstein, H. (Eds.). (1990). Transracial adoption in different societies. New York: Praeger. Smilansky, S., & Shephatia, L. (1976). Manual for teachers (Research Report No. 181, Publication No. 534). Jerusalem: Szold Institute. (In Hebrew) Spanier, G.B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family , 38 , 15–28. Spielberger, C.D. (1973). State, Trait Anxiety for Children: Preliminary Manual. Palo Alto, CA: Consulting Psychologists Press. Tizard, B. (1991). Intercountry adoption: A review of the evidence. Journal of Child Psychology and Psychiatry, 32, 743–753. Verhulst, F.C., Althus, M., & Versluis-Den-Bieman, H. (1990a). Problem behavior in international adoptees: I. Epidemiological study. Journal of the American Academy of Child and Adolescent Psychiatry, 29 , 94–103. Verhulst, F.C., Althus, M., & Versluis-Den-Bieman, H. (1990b). Problem behavior in international adoptees: II. Age at placement. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 104–111. Verhulst, F.C., Althus, M., & Versluis-Den-Bieman, H. (1992). Damaging backgrounds: Later adjustment of international adoptees. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 94–103. Wechsler, D. (1976). Wechsler Intelligence Scale for Children-Revised: Hebrew Standardization . Jerusalem: Hebrew University. (In Hebrew)