Do Adoptees Have Lower Self Esteem? A Review of a 2007 Meta-Analysis Heidi Brocious

Why is this question important? Adoption, especially transracial and international adoption, have been controversial. Studies have long sought to make pro or anti adoption statements based on this question. In conducting a basic literature review, the answer to this question appears unclear, or at least not universally agreed on. It’s important to clarify if there are specific adoptee populations have lower self esteem.

Self esteem (scale data) Study Variables Adoptees (transracial, same-race, international, domestic) vs. non-adoptees (categorical data) Self esteem (scale data) “Types” of adoptees were described in the intro Self esteem was identified through the primary study’s use of a list of widely accepted, reliable self-esteem measures Studies that used the Harter Self-Esteem Scale, the Rosenburg Self Esteem Scale, the Coopersmith Self Esteem Inventory, were included. The authors also included studies that reported the use of broader measures if they included specific subscales on self-esteem. The authors state that all included measures report a reliability scores from moderate to high.

Initial Search Searched PubMed, ERIC and PsychLit using the key words adopt* and self-esteem or self-concept, self- confidence, self-worth, self-image self-assurance reviewed references of studies found in initial search for additional sources and grey literature Acknowledged “experts” in the field were asked for any additional resources

Inclusion/ Exclusion Criteria Studies that used reliable self esteem measures Studies that occurred between 1970 and 2007 Not limited to English language journals Open to participants of all ages Checked for studies that used the same data set Excluded studies where participants were in clinical settings, were all know to be exposed to ETOH in utero, or all had physical or mental disabilities.

Exclusion Criteria Studies were excluded if…….. No reliable standard measure of self-esteem score was reported If the population was a clinical population (i.e. adoptees seeking treatment for depression) Studies that exclusively sampled adoptees who had been exposed to alcohol and drugs in utero, or who were physically or mentally disabled. Studies that did not use a non-adopted comparison group (with the exception of studies that compared white adoptees to transracial adoptees).

Papers Included Sixty four studies comparing self-esteem in adopted and non- adopted groups were included Three papers comparing self-esteem in adopted vs. institutionalized children Thirteen papers comparing the self-esteem of transracial adoptees vs. same race adoptees

Evaluating Quality of the Studies Studies were coded based on publication outlet, with peer reviewed items given more weight. Does not appear that individual studies were reviewed for methodological concerns Statistical methods may be relevant in this process? The authors report that they coded studies based on publication outlet, and used this as a method for measuring study quality. Primary research published in referred journals appear to have been given more weight than book chapters, dissertations and reports, but it does not appear that the researchers reviewed each study themselves for quality or methodological concerns. The coding system they used appears to get at some of these issues, but their weighting system, if they had one is not clear. Over all, this appears to be a weakness of the review.

Statistical Techniques The Jackknife procedure Trim and Fill method Calculated the effect size of each study population using Cohen’s d Total effect’s were then measured using the Comprehensive Meta Analysis program For each study, the researchers calculated an effect size using Cohen’s d, and the standardized difference between the means of the adopted and non-adopted group. Effect sizes were computed using the Comprehensive Meta-Analysis program. Combined effect sizes and confidence boundaries were recomputed removing one study at a time to test for outcome stability using the Jackknife Procedure. The “Trim and Fill” method was used to estimate potential publication bias.

Study Outcomes Comparison One: Adopted (n= 10,977) vs. non-adopted (n=33,862) compared with no difference found Moderators considered Gender International vs. domestic Transracial vs. same race Age at adoptive placement Age at time of self esteem assessment Three separate meta-analysis conducted with different moderators considered

Study Outcomes Self-esteem of adopted and institutionalized children are compared using three studies. A large effect size (d= -.58) was found between these two groups, with adopted children scoring significantly higher than institutionalized children.

Interesting Comparisons Self esteem scores for transracial adoptions were compared to same race BUT non-white adoptions to manage self esteem associated with racism. Scores of “special groups” (groups found via adoption focused groups etc.) vs. general population were compared. Scores of studies from before 1990 were compared to studies after 1990

Interpreting the Evidence The study’s overwhelming “non-findings” are a significant contribution to adoption practice Findings support adoption as an intervention, at least in terms of self-esteem Findings may put to rest the question of self esteem and adoption, and allow research to focus on more pressing issues

Questions…… Were the search methods sufficient How did the researchers really assess the quality of each individual study? Is weighting based on outlet a strong enough criteria to assess the proper weight of a study and/or the need to exclude a study? Does the Trim and Fill or Jackknife method address this issue?