Externalizing behaviors among adopted children: A longitudinal comparison of preadoptive childhood sexual abuse and other forms of maltreatment.

Previous research has established that child sexual abuse (CSA) and other forms of child maltreatment can have lasting and profound implications for survivors in terms of externalizing symptomatology. Few studies, however, have examined long-term consequences of CSA and maltreatment among adopted children. Guided by a polyvictimization framework, the present study investigated: (a) rates of co-occurrence of pre-adoptive CSA and maltreatment among adopted children, and (b) the relative impact of pre-adoptive CSA and maltreatment on externalizing behaviors at 14 years post-adoption. Analyses were based on four waves of data from the California Long-Range Adoption Study (CLAS) (n = 522); outcomes were measured using an adapted version of the Behavioral Problems Index (BPI). The diverse sample (36% non-White) was evenly divided by gender (50% female/male) and included a large number of children adopted from foster care (42.1%). Results indicated that 24.3% (n = 127) of children experienced at least one form of maltreatment; of those children, nearly half (46.5%; n = 59) experienced multiple abuse types (e.g., neglect, sexual, physical). Among cases of CSA (7.7%; n = 40), the vast majority (92.5%; n = 37) occurred with other forms of maltreatment. Hierarchical linear mixed models indicated that pre-adoptive CSA was associated with nearly a full unit increase in BPI scores (.92; p<.01). Neglect was associated with nearly a half unit increase in BPI (.48; p<.05). Gender was also significant; girls had lower BPI scores than boys (-0.57; p< .001). Implications for future research and practice are discussed.