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Adoption Research: An Assessment of Empirical Contributions to the Advancement of Adoption Practice

• Published: April 2002
• Volume 11 , pages 143–166, ( 2002 )

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• Madelyn Freundlich 1  

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This article examines the current state of adoption research as it applies to each member of the adoption triad. It includes a review of the research that has focused on birth mothers and fathers in both domestic and international adoptions; adopted children, adolescents, and adults; and adoptive parents. The paper also examines the areas of research in which a paucity of studies currently exist, and suggests that although major contributions to clinical practice and policy have been made, the dialogue should continue to seek to study issues such as international adoption and the adoption of children in foster care.

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Andujo, E. (1988). Ethnic identity of transethnically adopted Hispanic adolescents. Social Work , 37, 531-535.

Google Scholar  

Appell, A. R. (1996). The move toward legally sanctioned cooperative adoption: Can it survive the Uniform Adoption Act? Family Law Quarterly , 30, 483-518.

Aronson, J. E. (2000). Alcohol related disorders and children adopted from abroad. In R. P. Barth, M. Freundlich, & D. Brodzinsky (Eds.), Adoption and prenatal alcohol and drug exposure: Research, policy and practice (pp. 147-170). Washington, DC: CWLA Press.

Aumend, S., & Barrett, M. (1984). Self-concept and attitudes toward adoption: A comparison of searching and non-searching adult adoptees. Child Welfare , 63, 251-259.

Bachrach, C. A. (1986). Adoption plans, adopted children, and adoptive mothers. Journal of Marriage and the Family , 48, 243-253.

Bachrach, C. A., Adams, P. F., Sambrano, S., & London, K. A. (1990). Adoption in the 1980s . Advance data from vital and health statistics, No. 181 . Hyattsville, MD: National Center for Health Statistics.

Bachrach, C. A., Stolley, K. S., & London, K. A. (1992). Relinquishment of premarital births: Evidence from national survey data. Family Planning Perspectives , 24, 27-32.

Barker, S., Byrne, S., Morrison, M., & Spenser, M. (1998). Preparing for permanence. Assessment: Points to consider for those assessing potential adopters and foster carers . London: British Agencies for Adoption and Fostering.

Barth, R. P., & Berry, M. (1988). Adoption and disruption: Rates, risks, and responses . New York: Aldine De Gruyter.

Belbas, N. (1987). Staying in touch: Empathy in open adoptions. Smith College Studies in Social Work , 57, 184-198.

Berry, M. (1991). The effects of open adoption on biological and adoptive parents and the children: The arguments and the evidence. Child Welfare , 70, 637-651.

Berry, M., Barth, R. P.,& Needell, B. (1996). Preparation, support and satisfaction of adoptive families in agency and independent adoptions. Child and Adolescent Social Work Journal , 13, 157-183.

Blum, L. H. (1976). When adoptive families ask for help. Primary Care , 3, 241-249.

Blum, R. W., Resnick, M. D., & Stark, T. (1987). The impact of a parental notification law on adolescent abortion decision-making. American Journal of Public Health , 77, 619-620.

Bohman, M. (1970). Adopted children and their families: A follow-up study of adopted children, their background environment, and adjustment . Stockholm, Sweden: Proprius.

Bohman, M., & Sigvardsson, S. (1990). Outcome in adoption: Lessons from longitudinal studies. In D. M. Brodzinsky & M. D. Schechter (Eds.), The psychology of adoption (pp. 93-106). New York: Oxford University Press.

Bohman, M., & Von Knorring, A. L. (1979). Psychiatric illness among adults adopted as infants. Acia Paediatrica Scandinavica , 60, 106-112.

Borgman, R. (1981). Antecedents and consequences of parental rights termination for abused and neglected children. Child Welfare , 60, 391-404.

Bouchier, P., Lambert, L., & Triseliotis, J. (1991). Parting with a child for adoption: The mother's perspective . London: British Association of Adoption and Fostering.

Brodzinksy, D. M. (1987). Adjustment to adoption: A psychosocial perspective. Clinical Psychology Review , 7, 25-47.

Brodzinsky, D. M. (1993). Long term outcomes in adoption. The Future of Children , 3, 153-166.

Brodzinsky, D., Smith, D. W., & Brodzinsky, A. B. (1998). Children's adjustment to adoption: Developmental and clinical issues . Thousands Oaks, CA: Sage.

Brown, E. G., & Brieland, D. (1975). Adoptive screening: New data, new dilemmas. Social Work , 20, 291-295.

Byrd, D. (1999). Open adoption: Who benefits? In C. Marshner & W. L. Pierce (Eds.), Adoption Factbook III (pp. 413-416). Washington, DC: National Council for Adoption.

Cadoret, R. J. (1990). Biologic perspectives of adoptee adjustment. In D. M. Brodzinsky & M. D. Schechter (Eds.), The psychology of adoption (pp. 25-41). New York: Oxford University Press.

Carey, W. B., Lipton, W. L., & Myers, R. A. (1974). Temperament in adopted and foster babies. Child Welfare , 53, 352-359.

Chandra, A., Abma, J., Maza, P., & Bachrach, C. (1999). Adoption, Adoption Seeking, and Relinquishment for Adoption in the United States. Advance Data, 306 . Washington, DC: U.S. Department of Health and Human Services, Centers for Disease Control, National Center for Health Statistics.

Charlton, L., Crank, M., Kansara, K., & Oliver, C. (1998). Still Screaming: Birthparents compulsorily separated from their children . Manchester, England: After Adoption.

Chippindale-Bakker, V., & Foster, L. (1996). Adoption in the 1990s: Sociodemographic determinants of biological parents choosing adoption. Child Welfare , 75, 337-355.

Cicchini, M. (1993). The development of responsibility: The experience of birth fathers in adoption . Sydney, Australia: Adoption Research and Counseling Services, Inc.

Clapton, G. (1997). Birth fathers, the adoption process and fatherhood. Adoption & Fostering , 21, 29-36.

Condon, J. T. (1986). Psychological disability in women who relinquish a baby for adoption. Medical Journal of Australia , 144, 117-119.

Curtis, P. A. (1990). An ethnographic study of pregnancy counseling. Clinical Social Work Journal , 18, 243-256.

Cushman, L. F., Kalmuss, D., & Namerow, P. B. (1993). Placing an infant for adoption: The experiences of young birth mothers. Social Work , 38, 264-272.

Dalby, J. T., Fox, S., & Haslam, R. H. (1982). Adoption and foster care rates in pediatric disorders. Developmental and Behavioral Pediatrics , 3, 61-64.

Day, C., & Leeding, A. (1980). Access to birth records: The impact of section 26 of the children Act 1975 (Research Series No. 1) . London: Association of British Adoption and Fostering Agencies.

Deykin, E. Y., Campbell, L., & Patti, P. (1984). The post adoption experience of surrendering parents. American Journal of Orthopsychiatry , 54, 271-280.

Deykin, E. Y., Patti, P., & Ryan, J. (1988). Fathers of adopted children: A study on the impact of child surrender on birthfathers. American Journal of Orthopsychiatry , 58, 240-248.

Dickson, I. R., Heffron, W. M., & Parker, C. (1990). Children from disrupted and adoptive homes on an inpatient unit. American Journal of Orthopsychiatry , 60, 594-602.

Duncan, G. J., & Hoffman, S. D. (1990). Teenage welfare receipt and subsequent dependence among black adolescent mothers. Family Planning Perspectives , 22, 16-20.

Dworkin, R. J., Harding, J. T., & Schreiber, N. B. (1993). Parenting or placing: Decision-making by pregnant teens. Youth & Society , 25, 75-92.

Edwards, D. S. (1995). Transformation of motherhood in adoption: The experiences of relinquishing mothers . Unpublished doctoral dissertation, University of North Florida, Jacksonville.

Etter, J. (1993). Levels of cooperation and satisfaction in 56 open adoptions. Child Welfare , 72, 257-267.

Evan B. Donaldson Adoption Institute. (1999). Survey of adult Korean adoptees: Report on the findings . New York: Evan B. Donaldson Adoption Institute.

Evan B. Donaldson Adoption Institute. (2000). Survey of adult Vietnamese adoptees . New York: Evan B. Donaldson Adoption Institute.

Finley, G. E. (1999). Children of adoptive families. In W. K. Silverman & T. H. Ollendick (Eds.), Developmental Issues in Clinical Treatment of Children (pp. 359-370). Boston: Allyn and Bacon.

Fratter, J. (1991). Parties in the triangle. Adoption and Fostering , 15, 91-98.

Freundlich, M., & Lieberthal, J. K. (2000). The impact of adoption on members of the triad. Washington, DC: CWLA Press.

Frisk, M. (1964). Identity problems and confused conceptions of the genetic ego in adopted children during adolescence. Acta Paedo Psychiatrica , 31, 6-12.

Furstenberg, F., Jr., Brooks-Gunn, J., & Morgan, S. P. (1987). Adolescent mothers in later life . Cambridge, MA: Cambridge University Press.

Garrison, M. (1983). Why terminate parental rights. Stanford Law Review , 35, 423-437.

Geber, G., & Resnick, M. D. (1988). Family functioning of adolescents who parent and place for adoption. Adolescence , 23, 417-428.

Goebels, B., & Lott, S. L. (1986, August 23). Adoptees' resolution of the adolescent identity crisis: Where are the taproots ? Paper presented at the meeting of the American Psychological Association, Washington, DC.

Gross, H. E. (1993). Open adoption: A research-based literature review and new data. Child Welfare , 72, 269-284.

Grotevant, H. D., & McRoy, R. G. (1997). The Minnesota/Texas Adoption Research Project: Implications of openness in adoption for development and relationships. Applied Developmental Science , 1, 168-188.

Grotevant, H. D., & McRoy, R. G. (1998). Openness in adoption: Exploring family connections . Thousand Oaks, CA: Sage.

Hajal, F., & Rosenberg, E. B. (1991). The family life cycle in adoptive families. American Journal of Orthopsychiatry , 61, 78-85.

Hodges, J., & Tizard, B. (1989). IQ and behavioral adjustment of ex-institutional adolescents. Journal of Psychiatry , 30, 53-75.

Hofferth, S. L. (1987). Social and economic consequences of teenage childbearing. In S. L. Hofferth & C. D. Hayes (Eds.), Risking the future: Adolescent sexuality, pregnancy and childbearing (Vol. 2, pp. 123-144). Washington, DC: National Academy Press.

Holden, N. L. (1991). Adoption and eating disorders: A high-risk group? British Journal of Psychiatry , 158, 829-833.

Hollinger, J. H. (1998). Openness and adoptive family autonomy: Implications for adoption law & practice. Paper presented at the Conference of the Association of Administrators of the Interstate Compact on Adoption and Medical Assistance, Oklahoma City, OK.

Hollinger, J. H. (2000). Authenticity and identity in contemporary adoptive families. Journal of Gender Specific Medicine , 18, 36-42.

Hoopes, J. L. (1990). Adoption and identity formation. In D. Brodzinsky & M. Schechter (Eds.), The psychology of adoption (pp. 144-166). New York: Oxford University Press.

Hughes, B. (1995). Openness and contact in adoption: A child-centered perspective. British Journal of Social Work , 25, 729-747.

Hughes, B., & Logan, J. (1993). Birth parents: The hidden dimension . Manchester, England: University of Manchester, Department of Social Policy and Social Work.

Johnson, K., Banghan, H., & Liyao, W. (1998). Infant abandonment and adoption in China. Population and Development Review , 24, 469-510.

Kalmuss, D. (1992). Adoption and black teenagers: The viability of a pregnancy resolution strategy. Journal of Marriage and the Family , 54, 485-495.

Kowal, K. A., & Schilling, K. M. (1985). Adoption through the eyes of adult adoptees. American Journal of Orthopsychiatry , 55, 354-362.

Lawton, J., & Gross, S. (1964). Review of the psychiatric literature on adopted children. Archives of General Psychiatry , 11, 663-694.

Levy-Shiff, R., Bar, O., & Har-Even, D. (1990). Psychological adjustment of adoptive parents-to-be. American Journal of Orthopsychiatry , 60, 258-267.

Leynes, C. (1980). Keep or adopt: A study of factors influencing pregnant adolescents' plans for their babies. Child Psychiatry and Human Development , 11, 105-113.

Lifton, B. J. (1994). Journey of the adopted self: A quest for wholeness . New York: Basic Books.

Lightman, E., & Schlesinger, B. (1982). Pregnant adolescents in maternity homes: Some professional concerns. In R. R. Stuart & C. F. Wells (Eds.), Pregnancy in adolescence: Needs, problems, and management (pp. 363-406). New York: Van Nostrand Reinhold Company.

Lipman, E. L., Offord, D. R., Boyle, M. H., & Racine, Y. A. (1993). Follow-up of psychiatric and educational morbidity among adopted children. Journal of the American Academy of Child and Adolescent Psychiatry , 32, 1007-1012.

Lücker-Babel, M. F. (1990). Intercountry adoption and trafficking in children: An initial assessment of the adequacy of the international protection of children and their rights. Geneva, Switzerland: Defence for Children International.

McHutchinson, J. (1986). Relinquishing a child: The circumstances and effects of loss. Unpublished paper, University of New South Wales, Australia.

McRoy, R. G., Zurcher, L. A., Lauderdale, M. L., & Anderson, R. E. (1982). Self-esteem and racial identity in transracial and inracial adoptees. Social Work , 27, 522-526.

McRoy, R. G., & Grotevant, H. D. (1988). Open adoptions: Practice and policy issues. Journal of Social Work and Human Sexuality , 6, 119-132.

McRoy, R. G., Grotevant, H. D., & Zurcher, L. A. (1988). The development of emotional disturbance in adopted adolescents: Origins and development . New York: Praeger.

McWhinnie, A. M. (1969). The adopted child in adolescence. In G. Caplan & S. Lebovice (Eds.), Adolescence (pp. 122-143). New York: Basic Books.

McWhinnie, A. M. (1994). The concept of open adoption-how valid is it. In A. McWhinnie & J. Smith (Eds.), Current human dilemmas in adoption (pp. 112-132).Dundee, Scotland. University of Dundee.

Marquis, K. S., & Detweiler, R. A. (1985). Does adoption mean different? An attributional analysis. Journal of Personality and Social Psychology , 48, 1054-1066.

Mason, M. M. (1995a). Bringing birthfathers into the adoption loop. Roots and Wings , October-December, 27-30.

Mason, M. M. (1995b). Out of the shadows: Birthfathers' stories . Edina, MN: O. J. Howard Publishing.

Mason, K., & Selman, P. (1997). Birth parents' experiences of contested adoption. Adoption & Fostering , 21, 21-28.

Mikawa, J. K., & Boston, J. A. (1968). Psychological characteristics of adopted children. Psychiatric Quarterly Supplement , 42, 274-281.

Moore, J., & Fombonne, E. (1999). Psychopathology in adopted and nonadopted children: A clinical sample. American Journal of Orthopsychiatry , 69, 403-409.

Mott, F., & Marsiglio, W. (1985). Early childbearing and completion of high school. Family Planning Perspectives , 17, 234-237.

Namerow, P. B., Kalmuss, D. S., & Cushman, L. F. (1993). The determinants of young women's pregnancy-resolutionchoices. Journal of Research on Adolescence , 3, 193-215.

Norvell, M., & Guy, R. F. (1977). A comparison of self-concept in adopted and nonadopted adolescents. Adolescence , 12, 274-448.

Pilotti, F. J. (1993). Intercountry adoption pp Trends, issues and policy implications for the 1990s. In F. J. Pilotti (Ed.), Childhood (Vol. I, pp. 165-177). Montevideo, Uruguay: Instituto Interamericano del Niño.

Plomin, R., & DeFries, J. C. (1985). Origins of individual differences in infancy: The Colorado Adoption Project . New York: Academic Press.

Resnick, M. D. (1984). Studying adolescent mothers' decision making about adoption and parenting. Social Work , 29, 5-10.

Reynolds, W. F., Eisnitz, M. F., Chiappise, D., &Walsh, M. (1976). Personality factors differentiating searching and non-searching adoptees. Paper presented at the 84th Annual Convention of the American Psychological Association, Washington, DC.

Rickarby, G. A., & Egan, P. (1980). Issues of preventive work with adopted adolescents. Medical Journal of Australia , 1, 470-472.

Rogeness, G. A., Hoppe, S. K., Macedo, C. A., Fischer, C., & Harris, W. R. (1988). Psychopathology in hospitalized adopted children. Journal of the American Academy of Child and Adolescent Psychiatry , 27, 628-631.

Rohner, R. P. (1986). The warmth dimension: Foundations of parental acceptance-rejection theory. Bevety Hills, CA: Sage.

Rosenberg, E. B. (1992). The adoption life cycle: The children and their families through the years . New York: Free Press.

Rotundo, E. A. (1985). American fatherhood: A historical perspective. American Behavioral Scientist , 29, 7-24.

Rycus, J. S., Hughes, R. C., & Goodman, D. A. (1998). Adoption. In J. S. Rycus & R. C. Hughes (Eds.), Field guide to child welfare (Vol. 4, pp. 881-1038). Washington, DC: CWLA Press.

Sabalis, R. F.,& Burch, E. A. (1980). Comparisons of psychiatric problems of adopted and nonadopted patients. Southern Medical Journal , 73, 867-868.

Sandelowski, M. (1995). A theory of the transition to parenthood of infertile couples. Research in Nursing & Health , 18, 123-132.

Sants, H. J. (1964). Genealogical bewilderment in children with substitute parents. British Journal of Medical Psychology , 37, 133-141.

Schechter, M. (1960). Observations on adopted children. Archives of General Psychiatry , 3, 21-32.

Schechter, M., & Bertocci, D. (1990). The meaning of search. In D. Brodzinsky & M. Schechter (Eds.), The psychology of adoption (pp. 62-92). New York/Oxford: Oxford University Press.

Schechter, M. D., Carlson, P., Simmons, J., & Work, H. (1964). Emotional problems in the adoptee. Archives in General Psychiatry , 10, 37-46.

Schoenberg, C. (1974). On adoption and identity. Child Welfare , 53, 549.

Sellick, C., & Thoburn, J. (1996). What works in family placement ? Essex, England: Barnardo's.

Sharma, A. R., McGue, M. K., & Benson, P. L. (1996a). The emotional and behavioral adjustment of United States adopted adolescents. Part I: A comparison study. Children and Youth Services Review , 18, 77-94.

Sharma, A. R., McGue, M. K., & Benson, P. L. (1996b). The emotional and behavioral adjustment of United States adopted adolescents. Part II: Age at adoption. Children and Youth Services Review , 18, 95-108.

Sharma, A. R., McGue, M. K., & Benson, P. L. (1998). The psychological adjustment of United States adopted adolescents and their nonadopted siblings. Child Development , 69, 791-802.

Siegel, D. H. (1993). Open adoption of infants: Adoptive parents' perceptions of advantages and disadvantages. Social Work , 38, 15-23.

Silver, L. B. (1970). Frequency of adoption in children with neurological learning disability syndrome. Journal of Learning Disabilities , 3, 10-14.

Silver, L. B. (1989). Frequency of adoption of children and adolescents with learning disabilities. Journal of Learning Disabilities , 22, 325-328.

Silverstein, D. R., & Demick, J. (1994). Toward and organizational-relational model of open adoption. Family Process , 33, 111-124.

Simon, R. J., & Alstein, H. (1992). Adoption, race and identity: From infancy through adolescence . New York: Praeger.

Simon, N. M., & Senturia, A. G. (1966). Adoption and psychiatric illness. American Journal of Psychiatry , 122, 858-867.

Singer, I. M., Brodzinsky, D. M., Ramsey, D. R., Steir, M., & Waters, E. (1985). Mother-infant attachment in adoptive families. Child Development , 56 , 1543-1551.

Smith, S. L., & Howard, J. A. (1994). The adoption preservation project. Normal, IL: Illinois State University Department of Social Work.

Sobol, M. P., & Cardiff, J. (1983). A sociopsychological investigation of adult adoptees' search for birth parents. Family Relations , 32, 477-483.

Sorosky, A. D., Baran, A., & Pannor, R. (1975). Identity conflicts in adoptees. American Journal of Orthopsychiatry , 45, 18-27.

Sorosky, A. D., Baran, A., & Pannor, R. (1984). The adoption triangle . Garden City, NY: Anchor Books.

Stein, L. M., & Hoopes, J. L. (1985). Identity formation in the adopted adolescent . New York: Child Welfare League of America.

Strobino, D. M. (1987). The health and medical consequences of adolescent sexuality and pregnancy: A review of the literature. In S. L. Hoffert & C. D. Hayes (Eds.), Risking the future: Adolescent sexuality, pregnancy and childbearing (Vol. 2, pp. 93-122). Washington, DC: National Academy Press.

Thompson, L. A., & Plomin, R. (1988). The sequenced inventory of communication development: An adoption study of two and three-year olds. International Journal of Behavioral Development , 11, 219-231.

Triseliotis, J. (1973). In search of origins: The experience of adopted people . London: Routledge.

Triseliotis, J., & Hill, M. (1990). Contrasting adoption, foster care, and residential rearing. In D. M. Brodzinsky & M. D. Schechter (Eds.), The psychology of adoption (pp. 107-120). New York: Oxford University Press.

Van Keppel. M., & Winkler, R. (1983). The adjustment of relinquishing mothers in adoption-the results of a national study. Paper presented to the First NSCMC and ARMS conference, Melbourne, Australia.

Verhulst, F. C., Althaus, M. S., & Versluisden Bieman, H. J. M. (1990a). Problem behavior in international adoptees: I. An epidemiological study. Journal of the American Academy of Child and Adolescent Psychiatry , 29, 94-103.

Verhulst, F. C., Althaus, M., & Versluisden Bieman, H. J. M. (1990b). Problem behavior in international adoptees: II. Age at placement. Journal of the American Academy of Child and Adolescent Psychiatry , 31, 518-524.

Verhulst, F. C., & Versluisden Bieman, H. J. M. (1992). Damaging backgrounds: Later adjustment of international adoptees. Journal of the American Academy of Child and Adolescent Psychiatry , 31, 518-524.

Verhulst, F. C., & Versluisden Bieman, H. J. M. (1995). Developmental course of problem behaviors in adolescent adoptees. Journal of the American Academy of Child and Adolescent Psychiatry , 34, 151-158.

Warren, S. B. (1992). Lower threshold for referral for psychiatric treatment for adopted adolescents. Journal of the American Academy of Child and Adolescent Psychiatry , 31 , 512-517.

Wegar, K. (1997). Adoption, identity, and kinship: The debate over sealed birth records . New Haven: Yale University Press.

Weintraub, M., & Konstam, V. (1995). Birthmothers: Silent relationships. Affilia , 10, 315-327.

Wells, S. (1993). Posttraumatic stress disorder in birth mothers. Adoption & Fostering , 17, 22-26.

Winkler, R., & Van Keppel, M. (1984). Relinquishing mothers in adoption: Their long term adjustment (Monograph #3). Melbourne, Australia: Institute of Family Studies.

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Freundlich, M. Adoption Research: An Assessment of Empirical Contributions to the Advancement of Adoption Practice. Journal of Social Distress and the Homeless 11 , 143–166 (2002). https://doi.org/10.1023/A:1014363901799

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Contact Between Adoptive and Birth Families: Perspectives from the Minnesota Texas Adoption Research Project

Harold d grotevant, ruth g mcroy, gretchen m wrobel, susan ayers-lopez.

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Address correspondence to Harold D. Grotevant, Department of Psychology, University of Massachusetts Amherst, 135 Hicks Way, Amherst, MA 01003. [email protected]

Issue date 2013 Sep 1.

A growing number of adoptive families have contact with their children’s birth relatives. The Minnesota Texas Adoption Research Project is examining longitudinally the consequences of variations in contact arrangements for birth mothers, adoptive parents, and adopted children in domestic infant adoptions, and is studying the dynamics of relationships within these family systems. Individuals who had contact were more satisfied with their arrangements than those who did not have contact. Satisfaction with contact predicted more optimal adjustment among adopted adolescents and emerging adults. Adoption-related communication predicted identity development among adopted adolescents and emerging adults. Birth mothers who were more satisfied with their contact arrangements, regardless of level of contact, had less unresolved grief 12 to 20 years after placement. Adoptive and birth relatives who engage in contact need flexibility, strong interpersonal skills, and commitment to the relationship. These skills can be learned, and they can be supported by others, through informal, psychoeducational, and therapeutic means.

Keywords: adoption, contact, identity, adjustment, grief, loss

Adoption is becoming increasingly complex, involving children with diverse characteristics and histories, adoptive parents of different backgrounds, and birth parents whose reasons for placement vary. One clear trend is movement toward open or fully disclosed adoption, which involves contact, communication, and/or information sharing between a child’s adoptive and birth families. In contrast, closed or confidential adoption involves no communication between adoptive and birth family members ( Grotevant, 2012 ).

Open adoption arrangements vary widely in type, frequency, and directness of the contact as well as the people involved. Type of contact can include the exchange of pictures or gifts; communication via e-mail, letters, Skype, or telephone; and face-to-face meetings. Frequency of contact can vary from initial contacts made only around the time of the adoptive placement to frequent, ongoing contact. Frequency and type of contact can ebb and flow over time as participants’ life circumstances change. Contact can be direct (involving sharing identifying information) or indirect, in which the contact goes through the adoption agency without sharing identifying information. People involved can include the adopted child and any combination of adoptive and birth family members, which we call collectively the adoptive kinship network ( Grotevant & McRoy, 1998 ).

Historical Context

Several factors in the early 1970s stimulated the contemporary movement toward open adoption of infants. For birth mothers, single parenting became more accepted; for adoptive parents, diverse family forms (especially step-families) were more widely known; and for children, stigmatizing labels such as illegitimate were heard less often. Adopted individuals’ interests in biological connections and kinship were stimulated by discoveries about the importance of genetics in health promotion. With the increased acceptance of single parenting and the availability of reliable contraception and legal abortion, the number of babies available for adoption declined ( Carp, 1998 ; Kahan, 2006 ).

Adoption agencies had to reconsider their practices to stay in business. Many wondered whether unmarried pregnant women would be more likely to make adoption plans for their babies if they could have contact with the child after placement. Responding to these pressures, some agencies began offering birth mothers the opportunity to select the child’s adoptive parents from couples who were preapproved for adoption ( Henney, McRoy, Ayers-Lopez, & Grotevant, 2003 ). These new practices were very controversial. However, few studies addressed these changing adoption practices and policies or answered basic questions about the dynamics of adoptive kinship networks or the outcomes of different contact arrangements 1 ( Palacios & Brodzinsky, 2010 ).

The Minnesota Texas Adoption Research Project

In the mid-1980s, this gap in research led us to design the Minnesota Texas Adoption Research Project (MTARP). Our primary objectives were 1) to examine longitudinally the consequences of variations in contact arrangements for all members of the adoptive kinship network—birth mothers, adoptive parents, and adopted children—and 2) to understand the dynamics of relationships within these complex family systems over time ( Grotevant & McRoy, 1998 ).

The study began with 190 adoptive families and 169 birth mothers whose adoptions varied in the type of post-adoption contact arrangements. Participants were recruited from 35 adoption agencies across the United States to yield a homogeneous sample that varied by contact arrangement. We sought families in which at least one adopted child was between the ages of 4 and 12 years; the focal child had been adopted through a private agency before his or her first birthday; the adoption was not transracial, international, or special needs; and both adoptive parents were still married to each other. We simultaneously sought birth mothers whose placed children met the same criteria: They had been placed in infancy through a private domestic agency with adoptive parents of the same racial background as the baby ( Grotevant & McRoy, 1998 ).

At Wave 1 (1987–1992), participants included 720 individuals: both parents in 190 adoptive families, one focal adopted child in 171 of the families (90 males, 81 females; mean age = 7.8 years), and 169 birth mothers. Nineteen of the families had children too young to participate or refused to participate; however, parents provided data about these focal children. The original sample included 77 children for whom data were collected from both their adoptive parents and their birth mothers. Virtually all parents adopted because of infertility, and most birth mothers placed their children for adoption because they wanted them to be raised in two-parent families that could provide more opportunities than they felt they could. None of the children had been removed from their birth mothers and placed into foster care because of maltreatment.

We collected three waves of data from the adoptive families and the first two waves of data from the birth mothers (see Table 1 for details about the sample and Table 2 for details about contact arrangements). For more information about project methods and measures, see Grotevant and McRoy (1998) , Grotevant, Perry, and McRoy (2005) , and the project website http://www.psych.umass.edu/adoption/

Characteristics of the Minnesota Texas Adoption Research Project Sample, by Wave

Note: AC = adopted child, AM = adoptive mother, AF = adoptive father, APs = adoptive parents, BMo = birth mother, YA = adopted young adult (at Wave 3). W1 = Wave 1, W3 = Wave 3.

Contact Arrangements of Adoptive Families and Birth Mothers, by Wave

Note: Wave 3 data for adopted young adults are not included in these tables because they are not directly comparable. At Waves 1 and 2, categorization of contact arrangements for adoptive families was based on contact between any adoptive family member and the child’s birth mother. At Wave 3, the percentages of young adult adoptees having current contact and face-to-face meetings were 34.7%, 7.8%, and 29.9% for birth mother, birth father, and additional birth family member(s) (typically sibling or grandparent), respectively. An additional 7.2%, 3.6%, and 4.8% were having contact without face-to-face meetings with birth mother, birth father, and additional birth family member(s), respectively.

Key Findings

Adopted children, adjustment outcomes.

Adjustment, usually focusing on externalizing behaviors such as physical, verbal, or relational aggression, has been widely studied in adopted children (see Juffer & van IJzendoorn, 2005 , for meta-analysis showing that adoptees were more likely to exhibit externalizing problem behaviors than nonadoptees, with small effect size). Was the secrecy associated with closed adoptions responsible for less optimal adjustment and if so, would contact with the birth family reduce the likelihood of adjustment problems? No significant differences in externalizing behavior were found between adolescents who never had contact with birth relatives and those who had ongoing contact since early childhood ( Von Korff, Grotevant, & McRoy, 2006 ). This is consistent with other studies ( Brodzinsky, 2006 ; Ge et al., 2008 ; Neil, 2009 ).

However, participants had varying experiences with contact and interpreted those experiences in differing ways. Satisfaction with contact rather than the existence or type of contact predicted less externalizing behavior among adoptees in adolescence and into emerging adulthood ( Grotevant, Rueter, Von Korff, & Gonzalez, 2011 ). Childhood externalizing was controlled in the analyses and did not predict satisfaction with contact during adolescence. These findings suggest the importance of examining perceptions of contact, such as satisfaction. How parents and their adopted children make meaning of their contact appears to be more important for adjustment than simply having contact.

Curiosity and information seeking

Some adopted youths were content with the information they had about their birth families, while others were highly motivated to uncover more. The Adoption Curiosity Pathway Model (ACP; Wrobel & Dillon, 2009 ) suggests that once desired information is identified, intensity of curiosity provides the motivation to seek out that information. Perceived barriers and facilitators to obtaining the information provide context that influences the process ( Wrobel & Dillon, 2009 ). Facilitators can include adoptive parents providing support for information seeking; barriers include lack of funds to engage in a search ( Wrobel, Grotevant, Samek, & Von Korff, in press ). Participants who thought more about their adoptions and had less contact with birth parents were more likely to identify a gap in their adoption-related knowledge ( Wrobel & Grotevant, 2013 ). Most adopted participants, regardless of age and across all contact arrangements, expressed curiosity about their adoptions. At adolescence, they wondered most about why their birth parents had placed them for adoption ( Wrobel & Dillon, 2009 ); at emerging adulthood, their biggest questions concerned birth parents’ health histories ( Grotevant & Wrobel, 2013 ). Participants with no contact had more questions about basic facts such as what their birth parents looked like and where they lived; participants with direct contact already knew that information.

Using a narrative approach to adoptive identity ( Grotevant & Von Korff, 2011 ), research assistants rated adolescents’ interviews for markers of internal consistency of the narrative, flexibility in taking perspectives, and depth of identity exploration. These indicators contributed to a latent variable, adoptive identity. Frequency of adoption-related communication within the adoptive family mediated the association between contact with birth relatives and adoptive identity during adolescence, with the effects of contact and adoption-related communication on adoptive identity extending into emerging adulthood ( Von Korff & Grotevant, 2011 ). Families with contact talked about the logistics of contact and birth relatives’ roles in the adolescent’s lives—interactions that stimulated thinking about the meaning of adoption and contributed to the construction of adoptive identity. Such opportunities are rare in closed adoptions, where the topic of adoption may not come up as often since little new information is available to discuss.

Adoptive Parents

Adoptive parents’ attitudes and values shaped their contact with birth relatives. At Wave 1 (4–12 years after placement), adoptive parents’ fear that the birth mother might try to reclaim her child was strongest in families with no contact and was based on negative stereotypes about birth parents rather than actual experiences ( Grotevant & McRoy, 1998 ). At Wave 2 (12–20 years after placement), adoptive mothers’ communicative openness about adoption was positively associated with adolescents’ information seeking; the effect carried into emerging adulthood ( Skinner-Drawz, Wrobel, Grotevant, & Von Korff, 2011 ). Adoptive parents who had contact with the child’s birth relatives were more satisfied with their contact arrangements than were those who did not have contact. In turn, family satisfaction with contact arrangements predicted less externalizing behavior among adopted adolescents and emerging adults ( Grotevant et al., 2011 ). Thus, like their adopted children, adoptive parents make meaning of their family relationships, and those attitudes and values have consequences that are reflected in family dynamics and psychosocial outcomes for their adopted children.

Birth Mothers

Our findings contradicted assumptions that birth mothers in open adoptions experience high levels of grief that prevent them from being able to move on with their lives. Birth mothers’ interviews were rated for evidence of unresolved grief, such as feelings of guilt, sadness, regret, and anger about the placement. At Wave 1, birth mothers who had contact with the adoptive family experienced less unresolved grief than did those with no contact. The greatest unresolved grief was among birth mothers who had early contact that stopped ( Christian, McRoy, Grotevant, & Bryant, 1997 ). By Wave 2, birth mothers in fully disclosed adoptions continued to have less adoption-related grief than those in confidential adoptions, but the difference was no longer statistically significant ( Henney, Ayers-Lopez, McRoy, & Grotevant, 2007 ). Birth mothers who were more satisfied with their current contact arrangements, regardless of the amount of contact, had less unresolved grief ( Henney et al., 2007 ).

Relationships with partners and parented children

Although adoptive families’ lives became more complex with contact, birth mothers’ lives became more complex in additional ways. By Wave 2, 66% of the birth mothers were married (very few to the placed child’s birth father) and 20% were divorced; 73.2% were parenting at least one biological child, most of whom were younger than the child placed for adoption.

By Wave 2, all but one of the birth mothers had disclosed the adoption to their current partners or spouses; few partners had negative responses to the disclosure. Among birth mothers who had fully disclosed contact with the adoptive family, more than half of their partners participated actively in the contact ( Henney, French, Ayers-Lopez, McRoy, & Grotevant, 2011 ). Most birth mothers disclosed the adoption to the children they were parenting, and a number of those children had direct contact with their older half-sibling who had been placed for adoption. Most of the parented children viewed this contact positively and wanted to maintain or increase it ( Henney, Ayers-Lopez, Mack, McRoy, & Grotevant, 2007 ).

Our findings also contradicted assumptions that birth mothers would not welcome contact with their placed children. At Wave 2, 78% of birth mothers said they believed that their placed child would or might search for them if they lost contact; 80% of these birth mothers felt positively about being contacted, 5% felt neutral, 15% felt ambivalent, and none felt negatively about a child-initiated search (Ayers-Lopez, Henney, McRoy, Hanna, & Grotevant, 2008).

Management of Contact in Open Adoptions

Participants involved in ongoing contact said their relationships were dynamic and had to be renegotiated over time. Early in the adoption, meetings were especially important for the birth mothers, who were concerned about whether they had made the right decision and whether their children were in good hands. Later, birth mothers’ interest in contact sometimes waned, after they felt assured that their children were thriving. Many birth mothers subsequently became involved in new romantic relationships, which sometimes took attention from the adoptive relationships. In contrast, adoptive parents tended to become more interested in contact as they became more secure as parents ( Grotevant & McRoy, 1998 ). As the children grew older and understood the meaning of adoption more fully, their questions pressured the adoptive parents to converse more about the children’s birth relatives ( Wrobel, Kohler, Grotevant, & McRoy, 1998 ).

Open adoptions were very diverse in type and intensity of contact ( Grotevant, et al., 2007 ). Simple group differences (e.g., open vs. closed adoptions) are not very informative because of the considerable variation in contact arrangements found within the open adoption group. However, as shown, satisfaction with contact arrangements predicted certain outcomes, such as decreased externalizing behavior ( Grotevant et al., 2011 ).

Through interpersonal processes involving emotional distance regulation, members of adoptive kinship networks work out, over time, a level of contact that suits them ( Grotevant, 2009 ). These processes, which may be neither explicit nor consciously intentional, involve participants’ assessments about how much they trust each other and how comfortable they are being together. This process may involve increases or decreases in contact over time as participants’ relationships and circumstances change.

An account from an adoptive mother illustrates what we mean by emotional distance regulation. Here, she explains how the contact in her adoptive kinship network evolved as the relationship between the birth and adoptive mothers grew in comfort and trust:

We used to write daily and call each other weekly … When our son was real little, you know, it was tremendous intensity. And I think as our birthmother became more secure in herself and went on to finish college, her need to have to see him once a week or once a month became less and less. And you know, she feels more comfortable with us, we feel more comfortable with her and you know, we just know that we always have access … You just take it a day at a time … If you want it to work, you’ll work at it. And you know, we feel it’s healthy and want it to work because of our son.

MTARP interviews reveal the complexities of managing contact over time. Each participant in an adoptive kinship network brings his or her own developmental history, expectations of adoption, values, and relationship skills to the family system; these combine in unique ways across members ( Grotevant, 2009 ). Mutually satisfying relationships hinge on participants’ flexibility, communication skills, ability to maintain boundaries, and commitment to the relationships ( Grotevant, 2009 ). These skills can be learned, and they can be supported by others through informal, psychoeducational, and therapeutic means.

Those who succeed in creating positive open relationships typically feel it has been well worth it. However, in some circumstances, one or more family members are unable or unwilling to participate. When the child’s best interests are given primary consideration, chances are improved that the adults will be able to determine how best to meet those needs, even if it means that the contact involves some but not all family members or that the extent of the contact is less than hoped for. Because contact arrangements evolve over time, temporary setbacks or disappointments should not discourage families from pursuing new opportunities, nor should well-functioning relationships be taken for granted. Like any relationship, arrangements involving contact require effort and attention.

Implications

Children in our study were placed as infants through private adoption agencies that handled voluntary placements. None of the children had been removed from their birth families and placed into care because of maltreatment. Most birth mothers who voluntarily place their infants for adoption are similar to those who placed children in this sample, but they are different from birth mothers whose children are removed because of maltreatment. When a child is adopted from care, decisions about contact require assessment of whether the child could be at risk for re-experiencing maltreatment by birth relatives. Our findings demonstrate the potential benefits and challenges of contact for adoptions that are considered low risk, take place under optimal circumstances, and thus are more likely to result in positive relationships across birth and adoptive family members.

Contact between adoptive and birth families is becoming more common across all types of adoption, accelerated by social media and new technologies ( Smith & Siegel, 2012 ). MTARP has clearly shown that with regard to contact, one size does not fit all. We must continue learning from the participants how these relationships evolve in order to support healthy contexts for all in the adoptive kinship network.

Acknowledgments

Special thanks to our participants, students, and collaborators. The project is named for the two states where the investigators were located by Wave 2: Minnesota (Grotevant, Wrobel) and Texas (McRoy, Ayers-Lopez).

Primary funding for MTARP has come from the National Institute of Child Health and Human Development (R01-HD-028296, R01-HD-049859), National Science Foundation (BCS-0443590), William T. Grant Foundation (7146), Office of Population Affairs - U.S. Department of Health and Human Services, and Rudd Family Foundation Chair in Psychology at the University of Massachusetts Amherst.

We use the term contact arrangement to refer broadly to the varying types and degrees of connections between adoptive and birth families, ranging from confidential or closed adoptions (in which no contact exists and no identifying information is shared) to fully disclosed open adoptions.

Contributor Information

Harold D. Grotevant, Department of Psychology, University of Massachusetts Amherst

Ruth G. McRoy, Graduate School of Social Work, Boston College

Gretchen M. Wrobel, Department of Psychology, Bethel University, St. Paul, Minnesota

Susan Ayers-Lopez, School of Social Work, University of Texas at Austin.

• Brodzinsky D. Family structure openness and communication openness as predictors in the adjustment of adopted children. Adoption Quarterly. 2006;9:1–18. [ Google Scholar ]
• Carp EW. Family matters: Secrecy and disclosure in the history of adoptions. Cambridge: Harvard University Press; 1998. [ Google Scholar ]
• Christian CL, McRoy RG, Grotevant HD, Bryant C. Grief resolution of birthmothers in confidential, time-limited mediated, ongoing mediated, and fully disclosed adoptions. Adoption Quarterly. 1997;1(2):35–58. doi: 10.1300/J145v01n02_03. [ DOI ] [ Google Scholar ]
• Ge X, Natsuaki MN, Martin DM, Leve LD, Neiderhiser JM, Shaw DS, Villareal G, Scaramella L, Reid JB, Reiss D. Bridging the divide: Openness in adoption and postadoption psychosocial adjustment among birth and adoptive parents. Journal of Family Psychology. 2008;22:529–540. doi: 10.1037/a0012817. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Grotevant HD. Emotional distance regulation over the life course in adoptive kinship networks. In: Wrobel G, Neil E, editors. International advances in adoption research for practice. Chichester, UK: Wiley; 2009. pp. 295–316. [ Google Scholar ]
• Grotevant HD. What works in open adoption. In: Curtis PA, Alexander G, editors. What works in child welfare. 2. Washington, DC: Child Welfare League of America; 2012. [ Google Scholar ]
• Grotevant HD, McRoy RG. Openness in Adoption: Exploring Family Connections. Thousand Oaks, CA: Sage; 1998. [ Google Scholar ]
• Grotevant HD, Perry Y, McRoy RG. Openness in adoption: Outcomes for adolescents within their adoptive kinship networks. In: Brodzinsky D, Palacios J, editors. Psychological issues in adoption: Research and practice. Westport, CT: Praeger; 2005. pp. 167–186. [ Google Scholar ]
• Grotevant HD, Rueter M, Von Korff L, Gonzalez C. Post-adoption contact, adoption communicative openness, and satisfaction with contact as predictors of externalizing behavior in adolescence and emerging adulthood. Journal of Child Psychology and Psychiatry. 2011;52:529–536. doi: 10.1111/j.1469-7610.2010.02330.x. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Grotevant HD, Wrobel GM, Von Korff L, Skinner B, Newell J, Friese S, McRoy RG. Many faces of openness in adoption: Perspectives of adopted adolescents and their parents. Adoption Quarterly. 2007;10(3–4):79–101. doi: 10.1080/10926750802163204. doi: 0.1080/10926750802163204. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Henney SM, Ayers-Lopez S, Mack JM, McRoy RG, Grotevant HD. Birth mothers’ perceptions of their parented children’s knowledge of and involvement in adoption. Adoption Quarterly. 2007;10(3–4):103–129. doi: 10.1080/10926750802163212. [ DOI ] [ Google Scholar ]
• Henney SM, French CA, Ayers-Lopez S, McRoy RG, Grotevant HD. Post-placement relationships between birth mothers and their romantic partners. Journal of Family Psychology. 2011;25:620–624. doi: 10.1037/a0024540. [ DOI ] [ PubMed ] [ Google Scholar ]
• Henney SM, McRoy RG, Ayers-Lopez S, Grotevant HD. The impact of openness on adoption agency practices: A longitudinal perspective. Adoption Quarterly. 2003;6(3):31–51. doi: 10.1300/J145v06n03_03. [ DOI ] [ Google Scholar ]
• Juffer F, van IJzendoorn M. Behavior problems and mental health referrals of international adoptees: A meta-analysis. Journal of the American Medical Association. 2005;203:2501–2515. doi: 10.1001/jama.293.20.2501. [ DOI ] [ PubMed ] [ Google Scholar ]
• Kahan M. “Put Up” on platforms: A history of twentieth century adoption policy in the United Sates. Journal of Sociology and Social Welfare. 2006;33(3):51–72. [ Google Scholar ]
• Neil E. Post-adoption contact and openness in adoptive parents’ minds: Consequences for children’s development. British Journal of Social Work. 2009;3:5–23. [ Google Scholar ]
• Palacios J, Brodzinsky D. Adoption research: Trends, topics, outcomes. International Journal of Behavioral Development. 2010;34:270–284. [ Google Scholar ]
• Siegel DH, Smith SL. Openness in adoption: From secrecy and stigma to knowledge and connections. New York: Evan B. Donaldson Adoption Institute; 2012. Retrieved from http://adoptioninstitute.org/publications/2012_03_OpennessInAdoption.pdf . [ Google Scholar ]
• Skinner-Drawz BA, Wrobel GM, Grotevant HD, Von Korff L. The role of adoption communicative openness in information seeking among adoptees from adolescence to emerging adulthood. Journal of Family Communication. 2011;11:181–197. doi: 10.1080/15267431003656587. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Von Korff L, Grotevant HD. Contact in adoption and adoptive identity formation: The mediating role of family conversation. Journal of Family Psychology. 2011;25:393–401. doi: 10.1037/a0023388. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Von Korff L, Grotevant HD, McRoy RG. Openness arrangements and psychological adjustment in adolescent adoptees. Journal of Family Psychology. 2006;20:531–534. doi: 10.1037/0893-3200.20.3.531. [ DOI ] [ PubMed ] [ Google Scholar ]
• Wrobel GM, Dillon K. Adopted adolescents: Who and what are they curious about? In: Wrobel G, Neil E, editors. International advances in adoption research for practice. Chichester, UK: Wiley; 2009. pp. 217–244. [ Google Scholar ]
• Wrobel GM, Grotevant HD. Adoption-related curiosity in emerging adulthood. 2013. Manuscript submitted for publication. [ Google Scholar ]
• Wrobel GM, Grotevant HD, Samek D, Von Korff L. Adoptees’ curiosity and information seeking about birth parents in emerging adulthood: Context, motivation, and behavior. International Journal of Behavioral Development. doi: 10.1177/0165025413486420. (in press) [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Wrobel GM, Kohler JK, Grotevant HD, McRoy RG. Factors related to patterns of information exchange between adoptive parents and children in mediated adoptions. Journal of Applied Developmental Psychology. 1998;19:641–657. doi: 10.1016/S0193-3973(99)80060-4. [ DOI ] [ Google Scholar ]
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Adoption and trauma: Risks, recovery, and the lived experience of adoption

Affiliations.

• 1 Rutgers University, United States of America. Electronic address: [email protected].
• 2 University of Minnesota, United States of America.
• 3 University of Seville, Spain.
• PMID: 34544593
• PMCID: PMC8926933
• DOI: 10.1016/j.chiabu.2021.105309

Background: Although a very heterogeneous group, adopted persons may present developmental and mental health problems of varying severity. Pre-placement adversity and trauma have often been linked to these problems. It has been also suggested that adoption itself is a psychological trauma, predisposing the individual to emotional difficulties.

Objectives: This article examines the links between early adversity, trauma, and adoption. We begin by defining trauma and then describe the way in which pre-placement adversity can undermine neurobehavioral and interpersonal functioning, increasing the risk for long-term psychological difficulties. Next, we examine children's recovery when placed in a stable adoptive home. Finally, we explore adoption as a lived experience, highlighting contextual and developmental factors that facilitate the person's positive or negative attributions about being adopted, leading to varying patterns of emotional adjustment.

Conclusions: Although pre-placement adversity increases adopted individuals' risk for maladjustment, the human brain and behavior are malleable, and placement in a nurturing adoptive home often facilitates recovery from early adversity, with significant heterogeneity in the extent of recovery within and across domains of functioning. While there is no evidence that early adoption is a trauma for the individual, ongoing negative life circumstances, attachment difficulties, and developmentally-mediated attributions about adoption can undermine the person's self-esteem, identity, relationships, and sense of well-being. Conclusions and suggestions for future research are offered.

Keywords: Adoption; Adoption as a lived experience; Developmental recovery; Early life adversity; Neuroplasticity; Trauma.

Copyright © 2021 Elsevier Ltd. All rights reserved.

Publication types

• Research Support, N.I.H., Extramural
• Adoption* / psychology
• Emotional Adjustment*
• Longitudinal Studies

Grants and funding

• R01 HD095904/HD/NICHD NIH HHS/United States
• R01 HL149709/HL/NHLBI NIH HHS/United States

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Research Article

Adoption of the voluntary conflict of interest statement on PubMed

Roles Conceptualization, Data curation, Formal analysis, Methodology, Writing – original draft, Writing – review & editing

Affiliation Center for Science in the Public Interest, Washington, DC, United States of America

Roles Conceptualization, Methodology, Writing – review & editing

Affiliations Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, United States of America, Section of General Internal Medicine and the National Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America, Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, United States of America

Roles Conceptualization, Funding acquisition, Methodology, Supervision, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

• Stephanie Rogus, 
• Joseph S. Ross, 
• Peter Lurie

• Published: October 30, 2024
• https://doi.org/10.1371/journal.pone.0308782
• Peer Review
• Reader Comments

In 2017, the National Library of Medicine (NLM) added a voluntary field for conflict of interest (COI) statements (“posted COI”) on the abstract page of PubMed, but the extent to which it is used is unknown. This repeated cross-sectional study examined journals and articles indexed on PubMed from 2016 through 2021. We described the proportion of all journals with at least one article that included a posted COI and the percentage of all articles that included a posted COI over time. We also examined 100 randomly selected articles published between June 2021 and May 2022 from each of the 40 highest impact journals. For these, we established whether the articles had published COIs, and, of these, the proportion that included a posted COI. Among approximately 7,000 journals publishing articles each year, the proportion of journals with at least one article with a posted COI statement increased from 25.9% in 2016 to 33.2% in 2021. Among nearly 400,000 articles published each year, the proportion of articles that included a posted COI also increased from 9.0% in 2016 to 43.0% in 2021. Among 3,888 articles published in the 40 highest impact journals in 2021–2022, 30.2% (95% CI: 28.7%-31.6%) had published COIs; of these, 63.3% (95% CI: 60.4%-66.0%) included a posted COI. Use of the PubMed COI statement has increased since it became available in 2017, but adoption is still limited, even among high impact journals. NLM should carry out additional outreach to journals that are not using the statement to promote greater transparency of COIs.

Citation: Rogus S, Ross JS, Lurie P (2024) Adoption of the voluntary conflict of interest statement on PubMed. PLoS ONE 19(10): e0308782. https://doi.org/10.1371/journal.pone.0308782

Editor: Tope Michael Ipinnimo, Federal Teaching Hospital, Ido-Ekiti, NIGERIA

Received: April 26, 2024; Accepted: July 29, 2024; Published: October 30, 2024

Copyright: © 2024 Rogus et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All data files are available from the Dryad database (reviewer URL: https://datadryad.org/stash/share/zZLdgW-pVjwxzhH6Y07sk-eUee_Egzrq_Q3dwK0pGDc ; DOI: doi: 10.5061/dryad.h70rxwds8 ).

Funding: This research was supported by the Harvey Motulsky and Lisa Norton-Motulsky fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: SR and PL have declared that no competing interests exist. JR has read the journal’s policy and has the following competing interests: currently receives research support through Yale University from Johnson and Johnson to develop methods of clinical trial data sharing, from the Food and Drug Administration for the Yale-Mayo Clinic Center for Excellence in Regulatory Science and Innovation (CERSI) program (U01FD005938), from the Agency for Healthcare Research and Quality (R01HS022882), and from Arnold Ventures; formerly received research support from the Medical Device Innovation Consortium as part of the National Evaluation System for Health Technology (NEST) and from the National Heart, Lung and Blood Institute of the National Institutes of Health (NIH) (R01HS025164, R01HL144644); was an expert witness at the request of Relator’s attorneys, the Greene Law Firm, in a qui tam suit alleging violations of the False Claims Act and Anti-Kickback Statute against Biogen Inc. that was settled September 2022; and is currently a Deputy Editor at JAMA, was formerly the U.S. Outreach and Research Editor at the BMJ from 2020-2023, and was formerly an Associate Editor at JAMA Internal Medicine from 2013-2019. This does not alter our adherence to PLOS One policies on sharing data and materials. There are no patents, products in development, or marketed products associated with this research to declare.

Introduction

Every year, industry spends an estimated $60 billion funding research on drugs, biotechnology, and medical devices [ 1 ]; commercial company expenditures on phase 1–3 clinical drug trials outstrip the National Institutes of Health’s spending on trials [ 2 ]. Disclosure of such funding is important in part because a Cochrane systematic review on industry sponsorship of research found that industry-funded studies tend to produce results favorable to their company sponsors more often than studies not funded by industry [ 3 ]. It concluded that this finding may be partly caused by the choice and dosing of comparators, selection of outcomes, and selective analysis, reporting, and publication. It is also possible that industry is successfully identifying research projects that are more likely to yield results favorable to their products.

The National Academy of Medicine defines a conflict of interest (COI) as “circumstances that create a risk that professional judgements or actions regarding a primary interest will be unduly influenced by a secondary interest [ 4 ].” In the case of research COIs, the primary interest is typically research integrity, while the secondary interest is generally financial gain. The conflict may not necessarily compromise research integrity, but conflicts increase that risk or create an appearance of risk [ 5 ]. Disclosing COIs in biomedical research may allow scientists, medical professionals, and the public to better assess the credibility of scientific findings and explicitly consider the potential impact of funding on the research.

PubMed is a free resource that provides access to a database of citations to published research, along with their abstracts, primarily in the biomedical and health fields, though it includes related disciplines like behavioral and life sciences and bioengineering. It was developed and is maintained by the National Center for Biotechnology Information at the National Library of Medicine (NLM), an institute within the National Institutes of Health [ 6 ].

In March 2016, the Center for Science in the Public Interest, along with five other organizations, 62 scientists and physicians, and 5 U.S. senators, asked the NLM to list researchers’ COIs in a standardized statement as part of the abstracts indexed on PubMed [ 7 , 8 ]. Including COIs in the abstract page on PubMed is important because readers may not have access to the full article and many readers rely on the abstract alone to decide whether to read the full text of the article, to draw conclusions about a study, and/or to guide clinical care decisions [ 9 , 10 ]. A year later, NLM announced it would begin including voluntary COI statements on PubMed, when these statements are provided by the journal, for inclusion in a “Conflict of Interest statement,” located just below the abstract on PubMed [ 11 ]. These statements may also include declarations of “no conflict.” The changes were implemented on March 8, 2017.

Although most journals have COI disclosure policies for authors [ 12 , 13 ], the onus is on journals to ensure that information from each article is included on PubMed. When journals add their articles to PubMed electronically, they are required to submit and tag 13 pieces of information (e.g., article title, journal, and publisher), whereas 37 other tags are optional or required only if applicable (e.g., COI statement and abstract) [ 14 ]. The prevalence of use of the COI statement on PubMed remains unknown. To address this research gap, this study aims to describe the prevalence of the voluntary COI statement in articles indexed on PubMed.

Study design

We conducted a repeated cross-sectional study to assess: 1) the proportion of journals with at least one article that included a COI statement on PubMed and the proportion of articles that included a COI statement on PubMed from 2016–2021; 2) among high impact journals that disclosed a COI anywhere in the published version of the article, the proportion that posted a COI statement on PubMed and article characteristics associated with such posting. IRB review was not required for this study because it is not considered human subjects research according to the U.S. Department of Health and Human Services guidelines.

Study sample

With assistance from a staff scientist at NLM, we first identified journals indexed on PubMed from January 1, 2016, through December 31, 2021, that published original research (e.g., clinical trials, observational studies, and validation studies), reviews (e.g., systematic reviews, meta-analyses, and narrative reviews), and comments (e.g., letters, editorials, consensus statements, case reports, and guidelines). We excluded books and documents, legislation and government publications, article preprints, news articles, and datasets on the ground that journal COI disclosure standards for these are less well developed. For each year, we recorded the total number of journals indexed and the number of journals with at least one article that included a COI statement on PubMed (hereafter, “posted COI statement”), indicating that the journal at least sometimes used the COI field. A posted COI statement included any stated COIs or any affirmative statement that there were no COIs in the paper. We also recorded the total number of published articles and the number of those that included a posted COI statement by year. The year 2016 was included to examine the change in use of the COI statement after it was added to PubMed in 2017. These data were collected in January 2023.

We then identified the 40 highest impact journals in 2021, based on Journal Citation Reports [ 15 ], that were indexed on PubMed and had published at least 50 articles meeting the study inclusion criteria from June 1, 2021, through May 31, 2022. We collected characteristics of these journals by searching journal, International Committee of Medical Journal Editors (ICMJE) [ 16 ], and Committee on Publication Ethics (COPE) websites [ 17 ]. Journal characteristics included whether the journal was associated with a professional society or not (society-based/other), journal type (predominantly basic science/predominantly clinical/review/other), journal publication country (U.S./U.K./other), impact factor (continuous), ICMJE and COPE membership (yes/no), and publisher (professional society/Elsevier/Springer/other).

We used a random number generator [ 18 ] to randomly select 100 articles from each of the 40 highest impact journals. We examined articles from the top 10 journals (993 articles, as one journal had only published 93 articles) to inform our final sample size, revealing that 33% included a COI in the article itself and 54% of those included a posted COI statement. With about 4,000 articles (40 journals) overall, we would be able to detect that prevalence of posted COI statement use among those with a published COI with a margin of error of +/- 3% at a 95% confidence level [ 19 ].

To determine what fraction of all COIs were reflected in posted COI statements, we downloaded and manually searched articles for COIs (a financial link with the topic under investigation) anywhere in the main text of the article, including in the funding, disclosures, and acknowledgements fields (hereafter, “published COIs”) and documented the location of all disclosures. We downloaded these articles between June 2022 and August 2022. Published COIs located in a disclosures field or COI statement in the article were coded as “COI statement” and those located in the acknowledgements or funding fields were coded separately. We included relevant published COIs regardless of when they took place. If the article declared “no conflict of interest” and there were no published COIs found in the main text of the article, we did not consider the article to have published COIs. We also recorded the study type of each article (comment/original research/review). We then assessed the PubMed entry corresponding to each article with published COIs to determine if the published COIs were described in a posted statement. A flow chart that shows how the samples were selected is included in Fig 1 .

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https://doi.org/10.1371/journal.pone.0308782.g001

Two members of the research team reviewed all articles in the first seven of the 40 journals to establish consistency in coding (about 700 articles). The reviewers then compared notes to identify inconsistencies in their identification of COIs and reached consensus through discussion. With the exception of about 10 articles, there was agreement between the two reviewers on identifying articles with published COIs and posted COIs, COI location, and study type. Thereafter, to conserve resources, one reviewer examined the remaining journals.

Statistical analysis

We reported descriptive statistics showing the prevalence of all journals with at least one article that included a posted COI statement and of all articles that included a posted COI statement each year. Failure to publish at least one article that used the posted COI statement in a given year is indicative of non-use of the statement by that journal.

We described the number and proportion of articles from the top 40 high impact journal subset with published COIs that also included a posted COI statement and calculated their exact 95% confidence intervals (CIs), providing one-sided CIs when the prevalence was 0% or 100%. We also examined the correlation between this proportion and journal impact factor with a Spearman’s Rank Correlation Test. Finally, we constructed bivariate odds ratios and a multivariate logistic regression to examine whether published COI location and study type (independent variables) were associated with the inclusion of a posted COI statement (dependent variable).

We conducted the analysis using STATA version 17 [ 20 ], and differences were considered statistically significant if the P-value (2-sided) was less than 0.05.

1. Analysis of the full dataset (2016–2021)

Although the COI policy only went into effect in 2017, some posted COI statements were added retroactively (Jeff Beck (NLM), oral communication, April 8, 2022). The proportion of journals on PubMed with at least one article with a posted COI statement increased from 25.9% in 2016 (1,790/6,894 journals) to 33.2% in 2021 (2,511/7,550 journals), although that increase has not been monotonic ( Fig 2 ). At the article level, the percentage with a posted COI statement steadily increased, from 9.0% in 2016 (31,718/350,587 articles) to 43.0% in 2021 (186,500/433,386 articles).

https://doi.org/10.1371/journal.pone.0308782.g002

2. Analysis of the 40 highest impact journals

Journal characteristics (june 2021 –may 2022)..

Most of the 40 highest impact journals were not run by a society (72.5%) and most published predominantly clinical research (42.5%) and reviews (35.0%) ( Table 1 ). All but one was based in the U.S. (32.5%) or the U.K. (65.0%) and the median 2021 impact factor was 65.9 (range: 43.4–202.7). Most journals were not ICMJE members (60.0%) but 95.0% of journals were members of COPE. Seventy-five percent of journals were published by Elsevier (32.5%) or Springer (42.5%).

https://doi.org/10.1371/journal.pone.0308782.t001

Between June 1, 2021, and May 31, 2022, all of the 40 highest impact journals published at least one article with a posted COI statement, indicating widespread awareness and ability to use the COI field.

Prevalence of posted COI statements (2016–2021).

Of the 40 highest impact journals in 2021, the number that published at least one article with a posted COI statement ranged from 84.6% (33/39 journals) in 2016 (one journal did not publish any articles that year) to all 40 in 2021 ( Fig 3 ). At the article level, the percentage with a posted COI statement increased over time from 5.9% in 2016 (706/11,936 articles) to 35.1% in 2021 (3,725/10,598 articles).

https://doi.org/10.1371/journal.pone.0308782.g003

COI posting prevalence (June 2021 –May 2022).

Table 2 lists the 40 journals with the highest impact factors in 2021, along with the percentages of the randomly selected 100 articles per journal that contained published COIs and, among those, the percentage that included posted COIs. Six of the 40 journals published fewer than 100 articles between June 1, 2021, and May 31, 2022, for a total of 3,888 articles. The percentage of articles with published COIs by journal ranged from 5.0% to 83.0% [median: 26.0%; interquartile range: 12%-37.5%] and the percentage of articles with published COIs that also included a posted COI statement ranged from 0.0% (Science [7 articles with published COIs] and Nature Materials [5 articles with published COIs]) to 100.0% (BMJ, Lancet Psychiatry, Lancet Public Health, Cell, Cell Research, and Immunity) [median: 48.1%; interquartile range: 25.9%-94.0%]. A Spearman’s Rank Correlation Test indicated that there was no correlation between journal impact factor and the percentage of articles with published COIs that included a posted COI statement within this subset (r = -0.0854; p = 0.6001).

https://doi.org/10.1371/journal.pone.0308782.t002

Of all 3,888 randomly selected articles across the 40 highest impact journals, 69.8% [95% CI: 68.3%-71.2%] did not have published COIs. Of the 1,174 articles with published COIs, 63.3% [95% CI: 60.4%-66.0%] included a posted COI statement ( Fig 4 ). (An analysis of posting and publication rates weighted by impact factor provided essentially identical results and is not presented).

https://doi.org/10.1371/journal.pone.0308782.g004

Characteristics and predictors of COI posting (June 2021 –May 2022).

Of the subset of articles with published COIs (n = 1,174), 27.0% were original research, 33.0% were review articles, and 39.9% were comments ( Table 3 ). Most (n = 1,036, 88.2%) of these articles had published COIs in only the COI statement in the main text of the article, 7 (0.6%) had published COIs in only the acknowledgements, and 131 (11.2%) had published COIs in more than one location. None of the conflicts that appeared in an acknowledgements or funding section in the paper appeared in a posted COI statement.

https://doi.org/10.1371/journal.pone.0308782.t003

The bivariate regression results show that, among articles with published COIs, the odds of original research articles including a posted COI statement were over 3 times those odds for comment articles (OR: 3.74; 95% CI: 2.63, 5.32), an association that rose to over 5-fold (OR: 5.40; 95% CI: 3.51, 8.32) in the multivariate analysis. In the multivariate analysis, articles with published COIs in more than one location in the article text were 60% less likely than articles with published COIs in one location only to have a posted COI (OR: 0.40; 95% CI: 0.24, 0.68) ( Table 3 ).

This examination of the adoption of the COI statement on PubMed since its inception in 2017 found that, while the use of the posted COI statement on PubMed has increased fairly steadily, overall use of the statement could be improved. In 2021, only 33% of journals used the statement for at least one article. Among the 40 highest impact journals, use of the COI statement on PubMed was higher, with all journals posting COI statements for at least one article in 2021 but only 58% of articles with known COIs using the posted COI statement. Based on whether journals used the posted COI statement at least once per year, higher impact journals seem to be utilizing the posted statement more often than lower impact journals, but all journals could improve their consistent use of the posted COI statement.

The underutilization of the posted COI statement is a combination of journals that do not use the statement, journals that are using the statement inconsistently, and journals that are using the posted COI statement but failing to transfer conflicts from the acknowledgements or funding sections of their papers.

The first, and largest, problem is that most journals, particularly those with lower impact factors, do not use the posted COI statement at all. Journals have to transfer and tag over a dozen pieces of information for each article, yet many choose not to transfer COI information. Given that journals had five years to adopt the COI statement on PubMed at the time of our analysis, the relatively low adoption rate raises questions about whether all journals are aware of the option. According to the NLM, requiring the use of the posted COI statement as a mandatory condition of listing on PubMed is not advisable because it could limit submissions of journal articles, which does not align with PubMed’s mission as a comprehensive resource for finding and indexing publications (Jeff Beck (NLM), email communication, June 15, 2023).

NLM can, however, strongly encourage use of the statement. When the statement was first made available, the agency notified publishers through email and included information about the statement in a technical bulletin (Jeff Beck (NLM), oral communication, April 8, 2022) [ 13 ]. The group JATSforReuse, a voluntary collaboration of publishers and NLM [ 21 ], published technical recommendations for pulling COI statements from article metadata in 2020 [ 22 ], and, according to NLM, the agency continues to encourage publishers to include COI statements on PubMed (Jeff Beck (NLM), email communication, June 15, 2023). But NLM should go further and individually notify journals that did not use the posted COI statement in the most recent year.

We examined the second problem, that of inconsistent posted COI statement use, through our collection of a random subset of articles from the 40 highest impact journals. Journals varied in their use of the posted COI statement. In our sample, Science and Nature Materials never used the posted statement, although they have used the statement in articles not included in our sample, while only five journals used posted COI statements every time there was a published COI.

The third problem, which is much less common than the first two and the most difficult to remedy, relates to the transfer of conflicts located in an acknowledgements or funding section of an article to the posted COI statement. Of the articles in the top 40 journals, none with published COIs in an acknowledgements or funding section in the paper included those COIs in the posted COI statement, suggesting that journals pull data only from the COI statement in the article. In some instances, study funding was included within the abstract itself on the abstract page of PubMed. But this study was focused on the use of the COI statement, so these disclosures were not included in our analysis. Currently, including disclosures from acknowledgements and funding sections of published articles would require some degree of manual curation and may therefore be difficult to accomplish in practice. Standardization of disclosure practices to use a single field across all journals would greatly facilitate data transfer.

This study had several limitations. First, for the full dataset, we established the prevalence of posted COI statement use in part by determining whether the journal used the COI field at least once in a given year. Measuring the actual number of postings, as we also did, is dependent upon both the underlying prevalence of COIs and the rate of posting. In contrast, measuring whether journals posted at least once per year eliminates the first factor as long as journals are likely to include at least one published COI in a year. Most journals publish dozens of articles each year and our analysis of the 40 highest impact journals showed that all had at least five articles with a published COI in the year studied. Thus, all journals appear to have had ample opportunity to use the field at least once in any given year and failure to do so likely indicates non-use of the field. Second, we were only able to assess the prevalence of use of the posted COI statement by articles with published COIs in the 40 highest impact journals in a single year due to the large number of articles that would have been required individual assessment had we included more journals. While this provided sufficient precision for the purposes of this study, it precludes generalization of our findings on posting rate per conflict to other journals. Third, our study reflects posted COI statements as of 2022 when we collected the data, not as of the year on which we are reporting, because posted COI statements may have been added retroactively. Fourth, while we examined the 40 highest impact journals in 2021, our findings may not be generalizable to the highest impact journals in other years. Fifth, our regression only included two covariates; additional article-level variables that were not available in this study may also be associated with the posting of COIs.

Conclusions

Use of the PubMed COI statement has increased since it became available in 2017, but adoption is still limited, even among high impact journals. One consequence is that users of PubMed are currently unable to distinguish between a published COI that was not posted and an article with no COIs. NLM should carry out additional outreach to journals that are both not using the statement at all and using it erratically, and journals should use the statement for all COIs, regardless of where a COI is located in the paper. Until use of the statement reaches full adoption, NLM could improve the user experience through additional education of PubMed users about what is included and excluded from the COI statement and the importance of reviewing COI disclosures in the published articles.

Acknowledgments

We would like to thank Eva Greenthal for her work on an early draft of the study protocol and Kate Peglow for her assistance with data collection. We would also like to thank staff from the National Library of Medicine for their assistance in downloading data from PubMed and for added context on the voluntary COI statement.

• View Article
• PubMed/NCBI
• Google Scholar
• 4. Conflict of interest in medical research, education, and practice, pg 46. Institute of Medicine. 2009 [cited 2023 Aug 10]. Available from: https://nap.nationalacademies.org/catalog/12598/conflict-of-interest-in-medical-research-education-and-practice .
• 5. Conflict of interest in medical research, education, and practice. Institute of Medicine. 2009 [cited 2023 Aug 10]. Available from: https://nap.nationalacademies.org/catalog/12598/conflict-of-interest-in-medical-research-education-and-practice .
• 6. PubMed overview. 2022 [cited 2023 Aug 10]. In: PubMed [Internet]. Bethesda: National Library of Medicine. [about 1 screen]. Available from: https://pubmed.ncbi.nlm.nih.gov/about/ .
• 7. PubMed urged to include funding info, conflicts of interest with study abstracts. 2016 [cited 2023 Aug 10]. In: CSPI media [Internet]. Washington DC: Center for Science in the Public Interest. [about 2 screens]. Available from: https://cspinet.org/new/201603301.html .
• 8. Joint letter to National Library of Medicine. 2016 [cited 2023 Aug 10]. In: CSPI resource [Internet]. Washington DC: Center for Science in the Public Interest. [about 1 screen]. Available from: https://www.cspinet.org/resource/joint-letter-national-library-medicine .
• 11. Collins M. PubMed updates March 2017. 2017 [cited 2023 Aug 12]. In: NLM Technical Bulletin no. 415 [Internet]. Bethesda: National Library of Medicine. [about 2 screens]. Available from: https://www.nlm.nih.gov/pubs/techbull/ma17/ma17_pm_update.html#fig1 .
• 14. XML help for PubMed data providers. 2008 [cited 2023 Aug 15]. In: PubMed Help [Internet]. Bethesda: National Library of Medicine. [about 20 screens]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK3828/#publisherhelp.Article_R .
• 15. Journal citation reports. 2023 [cited 2023 Aug 15]. In: Clarivate [Internet]. [about 1 screen]. Available from: https://clarivate.com/products/scientific-and-academic-research/research-analytics-evaluation-and-management-solutions/journal-citation-reports/ .
• 16. ICMJE recommendations (“the uniform requirements”). 2023 [cited 2023 Aug 15]. In: ICMJE FAQs [Internet]. [about 1 screen]. Available from: https://www.icmje.org/about-icmje/faqs/icmje-recommendations/#5 .
• 17. Promoting integrity in research and its publication. 2023 [cited 2023 Aug 18]. United Kingdom: Committee on Publication Ethics. [about 2 screens]. Available from: https://publicationethics.org/ .
• 18. True random number generator. 2023 [cited 2023 Aug 18]. Dublin: Random.org. [about 1 screen]. Available from: https://www.random.org/ .
• 19. Power and sample size determination. 2020 [cited 2023 Aug 18]. Boston: Boston University School of Public Health. [about 1 screen]. Available from: https://sphweb.bumc.bu.edu/otlt/mph-modules/bs/bs704_power/BS704_Power4.html .
• 20. Your data tell a story. 2023 [cited 2023 Aug 20]. College Station: Stata. [about 1 screen]. Available from: https://www.stata.com/ .
• 21. Who’s involved. 2020 [cited 2024 July 10]. In: JATS4R [Internet]. [about 3 screens]. Available from: https://jats4r.niso.org/whos-involved/ .
• 22. Conflict-of-interest (COI) statements. 2020 [cited 2023 Aug 20]. In: JATS4R Recommendations [Internet]. [about 3 screens]. Available from: https://jats4r.niso.org/conflict-of-interest-coi-statements/ .

Passkeys are more popular than ever. This research explains why

Have you started adopting passkeys  for more of your online accounts? If so, you're far from alone. According to a new survey from the FIDO Alliance, passkey awareness and adoption have grown since being introduced two years ago.

For its fourth annual Online Authentication Barometer , the FIDO Alliance commissioned Sapio Research to run an online survey in August to elicit feedback about passkeys, passwords, and online security. The survey reached 10,000 consumers across the US, UK, France, Germany, Australia, Singapore, Japan, South Korea, India, and China.

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More than half (57%) of those polled said they're aware of passkeys, up from the 39% who reported awareness of them in 2022. Only 16% of respondents said they're unaware of passkeys, down from 28% two years ago. Among those who know what passkeys are, 62% said they use them to secure their website and app accounts.

At the same time, password use has been dropping. The average percentage of respondents who manually entered a password over the last two months fell to 28% this year from 38% in 2022. The need to manually enter a password is down across various sites and apps, including financial services, work accounts, social media accounts, media and streaming services, and smart home assistants.

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"Individuals are becoming more aware of passkeys and prioritizing their personal cybersecurity by increasingly implementing passkeys into their digital routines," Darren Guccione, CEO, and co-founder at Keeper Security told ZDNET. 

"Passkeys work by using public key cryptography, where each passkey consists of a private key stored locally on the device you used to create the passkey, as well as a public key that is stored with the company you created your account with. This means that even if there is a breach, cybercriminals can only access the public key, which is essentially useless without the private key."

Security is one of the main reasons people are gravitating toward passkeys and away from passwords. Passkeys typically rely on some form of biometric authentication , which is considered safer and less hackable than passwords.

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Asked which methods of authentication they consider the most secure, 29% of those polled named biometrics . Just 15% cited a complex password that only they will remember, while 14% pointed to a one-time passcode sent to their mobile device.

Methods considered less secure include a browser's auto form-fill to enter a password, an authentication application, a password manager , a physical security key, and a QR Code. Respondents also cited these methods in the same order as their preferred way of logging into their accounts.

"Passwords along with multi-factor authentication (MFA) set the bar higher in terms of making life difficult for the attacker but are not perfect," Jason Soroko, senior fellow at Sectigo , told ZDNET. 

"Passkeys help to get rid of the shared secrets we utilize for authentication and move us closer to a world where our authentication is based on asymmetric secrets [private keys used to encrypt and decrypt data]. The nature of asymmetric secrets is that they are harder to harvest, whether through social engineering or the means of a compromised endpoint."

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Based on the survey, online scams and threats are more of a concern for consumers. More than half (53%) of those polled said they've seen an increase in suspicious messages and online scams this year. 

Some areas cited as more risky include SMS messages, email, phone and voice messages, social media, instant messaging, Facebook Messenger, fake ads, and fake articles. In addition, more than half said they've witnessed greater sophistication concerning suspicious messages.

"When consumers know about passkeys, they use them," said FIDO Alliance CEO Andrew Shikiar in a press release. 

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"Excitingly, 20% of the world's top 100 websites and services already support passkeys. As the industry accelerates its efforts toward education and making deployment as simple as possible, we urge more brands to work with us to make passkeys available for consumers. The pace of passkey deployment and usage is set to accelerate even more in the next 12 months, and we are eager to help brands and consumers alike make the shift."

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