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Offspring of these siblings (born 1965-2020) were also followed to assess intergenerational spillover effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The variable of interest was adoption into non-biological families. Outcomes included psychiatric diagnoses, long term unemployment, receipt of social welfare, highest attained education (and upper secondary education ineligibility for generation 3), criminal convictions, and, among men, non-cognitive skills and general intelligence assessed at military conscription.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Adopted individuals (n=1535) showed a lower risk of psychiatric disorders (29.8%\n                      <jats:italic>v<\/jats:italic>\n                      36.1% among non\u2011adopted siblings), criminal convictions (26.1%\n                      <jats:italic>v<\/jats:italic>\n                      34.0%), and receiving social welfare (37.8%\n                      <jats:italic>v<\/jats:italic>\n                      48.5%). They also showed higher mean intelligence scores (4.5\n                      <jats:italic>v<\/jats:italic>\n                      3.8) and non-cognitive skills scores (4.8\n                      <jats:italic>v<\/jats:italic>\n                      3.9) and were more likely to have attended university (26.0%\n                      <jats:italic>v<\/jats:italic>\n                      15.2%). The offspring of adopted individuals (n=2750), in turn, also displayed modestly higher psychosocial functioning than their cousins (eg, 29.6%\n                      <jats:italic>v<\/jats:italic>\n                      32.3% with psychiatric disorders), although the associations were weaker and less precisely estimated. This pattern of associations was similar in the maternal half sibling sample.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early adoption into a family with favourable home environment conditions was associated with moderate, enduring benefits across psychiatric, social, and cognitive outcomes, extending into the next generation. These results highlight the potential for environmental improvements during childhood to mitigate intergenerational disadvantage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmj-2025-087844","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T09:49:25Z","timestamp":1776937765000},"page":"e087844","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Home environment conditions during childhood and psychosocial outcomes across three generations in Sweden: population based adoption-discordant sibling comparison study"],"prefix":"10.1136","volume":"393","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1373-4050","authenticated-orcid":false,"given":"Zhenxin","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengping","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"},{"name":"Beijing International Center for Mathematical Research, Peking University, Beijing, China"},{"name":"Chongqing Taiji Industry, Sinopharm, Chonginq, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabell","family":"Brikell","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf","family":"Kuja-Halkola","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian M","family":"D\u2019Onofrio","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Larsson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"},{"name":"School of Medical Sciences, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Lichtenstein","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Pettersson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"2026042221000730000_393.apr22_9.e087844.1","doi-asserted-by":"publisher","DOI":"10.1037\/0002-9432.75.1.3"},{"key":"2026042221000730000_393.apr22_9.e087844.2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-3426"},{"key":"2026042221000730000_393.apr22_9.e087844.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2020.101933"},{"key":"2026042221000730000_393.apr22_9.e087844.4","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.20230353"},{"key":"2026042221000730000_393.apr22_9.e087844.5","doi-asserted-by":"publisher","DOI":"10.1257\/aer.115.5.1369"},{"key":"2026042221000730000_393.apr22_9.e087844.6","doi-asserted-by":"publisher","DOI":"10.1257\/jep.27.2.109"},{"key":"2026042221000730000_393.apr22_9.e087844.7","doi-asserted-by":"crossref","unstructured":"Duncan G Kalil A Mogstad M Rege M . 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