PADS presentation

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Post Adoption DepressionMiranda Barker

+Postpartum Depression

Affects around 13% of women (O’Hara & Swain, 1996).

Strongly influenced and predicted by psychiatric history, marital stressors, poor social support, and stressful life events.

At four weeks postpartum, Fairbrother and Woody reported that 49% reported thoughts of harming their baby intentionally.

For a long time, researchers thought PPD was caused by hormones after giving birth. O’Hara & Swain found that they were minor factors.

Researchers are finding that many of the same stressors effecting birth mothers also cause depression in adoptive mothers (Mott, 2011).

+Post Adoption DepressionThe purpose of studying PADS is to better prepare and strengthen adoptive families.

+How much do you know about PADS? What percentage of adoptive parents are affected by

Post Adoption Depression?

+How much do you know about PADS? What percentage of adoptive parents are affected by

Post Adoption Depression? Between 11- and 32% of adoptive parents.

+How much do you know about PADS? What percentage of adoptive parents are affected by

Post Adoption Depression? Between 11- and 32% of adoptive parents.

What are some of the symptoms of PADS?

+How much do you know about PADS? What percentage of adoptive parents are affected by

Post Adoption Depression? Between 11- and 32% of adoptive parents.

What are some of the symptoms of PADS? Symptoms between women struggling with PPD and

PADS were not significantly different (Mott, 2011)

+How much do you know about PADS? What percentage of adoptive parents are affected by

Post Adoption Depression? Between 11- and 32% of adoptive parents.

What are some of the symptoms of PADS? Symptoms between women struggling with PPD and

PADS were not significantly different (Mott, 2011)

What are some of the main causes of PADS?

+Gair, 1999

Edinburgh Postnatal Depression Scale

Found that 32% scored at or above a 12 on the EPDS, which means that six of the 19 women were likely struggling with PADS.

Causes may be more physical than psychological: Bother birth mothers and adoptive mothers who lack sleep and have babies who are collicky and fussy had more depressive symptoms.

53% of adoptive mother indicated that they had never thought of harming their baby. 21%of participants said rarely, 10% said often, and 5% answered “quite often.”

+Payne, Fields, Meuchel, Jaffe, & Jha,2010 Used the EPDS testing Scored women at three different times: 0-4 weeks, 5-12

weeks, and 13-52 weeks postplacement. 27.9% of the participants scored at or above 12 on the

EPDS 0-4 weeks postplacement 25.6% at 5-12 weeks 12.8% at 13-52 weeks

+Senecky et al., 2009

Used the EPDS, the Beck Depression Inventory, and the Brief Symptom Inventory

Six weeks post placement 15.4% of participants were struggling with PADS

+Schwartz, Cody, Ayers-Lopez, McRoy & Fong, 2014 Most adoptive parents have had to deal with infertility

or other placements falling through. Both of these situations are considered loss, and may need to grieve.

Marriage troubles: Couples experiencing infertility may feel like their sex life is dominated by the pressure to conceive. Or one spouse may feel angry if the other is infertile. An infertile spouse may feel guilty.

Post adoption support groups should also focus on marital stressors and how adoption is affecting the parents’ marriages. (Schwartz, Cody, Ayers-Lopez, McRoy, & Fong, 2014)

In some cases, adoptions can reopen those wounds.

+Foli, South, Lim, & Hebdon, 2012Researched adoptive fathers using the

EPDS11% of adoptive fathers were likely

struggling with PADS

+Symptoms

Found that it looked similar to Postpartum Depression: weight loss or gain excessive sleeping difficulties sleeping decreased interest in activities and people irritability remorse depressive mood overly emotional feelings (Spielman, 2011; Foli, 2009)

Symptoms between women struggling with PPD and PADS were not significantly different (Mott, 2011)

+Expectations

Unmet expectations was found to be one of the main causes of Postadoption Depression (Foli, 2009; Foli et al., 2012).

Pre-adoptive expectations were predictive of stress during the transition to parenthood (Levy-Shiff et al., 1991).

Adoptive parents come into the process with expectations of themselves, the child or baby, and their support systems (Foli, 2010).

+Self Expectations

Adoptive parents have spent so much time convincing others that they will be a great parent, so they believe that they must be perfect (Foli, 2009; Thompson & Foli, 2004)

They have gone through a wait, many different trainings, and read all sorts of materials.

Oftentimes they were so focused on the process that their attention was not on the parenting part and the realities of bringing a new person into their family. (Spielman, 2011)

There is also an increased likelihood that they are parenting children with preexisting behavioral or emotional difficulties (Glidden, 2000).

It is also more likely that they are parenting children who are of a different race (McKay, Ross & Goldberg, 2010).

It is no question that adoptive parents have their own unique challenges.

+Self Expectations (cont.)

Demographically, adoptive mothers are more likely to be older, more highly educated, impressive women with a history of infertility and higher socio-economic status than biological mothers (Payne et al., 2010).

Adoptive parents may feel like they have their lives somewhat together and are ready.

Many of these parents are figuring out first-time parenthood at an older age and on average have been married longer (Levy-Shiff, Goldschmidt, & Har-Even, 1991; Ceballo et al., 2004).

+Expectations of the Child

Parents often expect that they will bond instantly and that they will be a perfect family (Foli, 2010).

Attachment issues can get in the way of parents and children forming a connection. Attachment issues can result in behavioral problems or rejecting of the new caregivers (Grant‐Marsney, Grotevant, & Sayer, 2015).

Often parents will have distorted expectations about integrating the child into the family (Schwartz, Cody, Ayers-Lopez, McRoy, & Fong, 2014).

This may cause adoptive parents will question if they are good parents or if they can really tackle it.

+Expectations of Support

In both Postnatal and Postadoption Depression, lack of support can be a major contributing factor (Foli et al., 2012; Thompson & Foli, 2004, Levy-Shiff, Goldschmidt, & Har-Even, 1991).

Adoptive parents may expect that extended family will welcome the new child into the family the same way that they would welcome a birth child such as with baby showers, bringing meals, and offering to watch the other children in the home.

Some adoptive families are surprised to learn that their new child is not as welcomes as they had hoped, and oftentimes extended family members and friends may withhold approval (Foli, 2009; Thompson & Foli, 2004).

+ Legal Risk Period

Parents felt anxiety and fearfulness during the legal risk period. (Spielman, 2011)

This legal risk period caused the adoptive parents to distance themselves emotionally from the child at first to protect themselves.

Sadness/Mourning/Guilt for the birth parent “I felt so much guilt that I was trying to “sell” myself to

an expecting mother as someone with more resources for parenting a child. Guilt that I would get to be called “Mommy” by a child she loved so much. Guilt that I would experience all the child’s firsts and milestones. Guilt that I would never understand how tough her decision was. Guilt that I would not be a perfect parent. Guilt that I would let down these people that were entrusting us with their child.” – an adoptive mother

+Resolution/Our Role

Every adoption social worker interviewed agreed that they have seen it in their adoptive families (Foli, 2009).

Adoptive parents that are struggling with this can feel alone in this experience. It can be such a relief to find out that this is a relatively common occurrence (Spielman, 2011).

Professionals can have a hard time getting the parents to reach out for help. Adoptive parents are afraid of feeling judgment or for the adoption to fall through.

Not receiving help only intensifies the shame and isolation (Spielman, 2011).

+Our Role

Social workers must be aware of this problem and talk openly about it with their clients during educational trainings, homestudies, and post-placement visits.

Social workers could refer families to: adoption-competent counselors adoption support groups helpful adoption and attachment literature journaling ideas respite care

+My Upcoming Research

The purpose of studying Post Adoption Depression is to better prepare and strengthen adoptive families.

Research How informed were the parents about PADS before

placement? Did their social worker openly talk about PADS with the

parents before the adoption, during the process, and at post-placement visits?

Did they feel like they could talk to their social worker about their struggle with PADS?

How adoption agencies and social workers use this information.