{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:53:59Z","timestamp":1790733239081,"version":"4.1.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Child Psychol Psychiatry"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>This paper explores how an adoptive family\u2019s feelings of blame and embarrassment shifted after receiving an accurate diagnosis for their 9-year-old child. Narratives of attachment and trauma had been used previously to explain the child\u2019s rumination and regurgitation symptoms and excessive appetite from an early age. The paper outlines the assessment that ruled the previous explanation out and gave a diagnosis of Tourette syndrome, a neurodevelopmental disorder with an evidence-based pathway of care. It also examines the theory behind this revised formulation, integrating both environmental influences, biological predispositions and their interaction. The discussion explores the negative implications of neglecting biological factors in the mental health assessments of adopted children and interpreting their presentations through the lens of past trauma and attachment disruptions only, as lack of early identification and therefore, intervention can lead to serious long-term consequences. Conducting complex assessments require multidisciplinary specialist services with professionals trained in making differential diagnoses in adopted children, that include the consideration of neurodevelopmental and mental health problems. Such services should also offer consultation and provide training to other professionals working within the children\u2019s complex systems.<\/jats:p>","DOI":"10.1177\/13591045251394425","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T17:52:42Z","timestamp":1762537962000},"page":"816-824","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["\u201cThe Cost of Diagnostic Oversight: Rumination Misattributed to Attachment in a Child With Tourette Syndrome. How an Adopted Child Stopped Feeling Embarrassed and His Parents Blamed after a Specialist Assessment that Led to Psychoeducation and Evidence-Based Interventions\u201d"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3887-6289","authenticated-orcid":false,"given":"Carmen","family":"Pinto","sequence":"first","affiliation":[{"name":"South London & Maudsley NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"e_1_3_5_2_1","volume-title":"Patterns of attachment: A psychological study of the strange situation","author":"Ainsworth M. D. S.","year":"1978","unstructured":"Ainsworth M. D. S., Blehar M. C., Waters E., Wall S. (1978). Patterns of attachment: A psychological study of the strange situation: Lawrence Erlbaum Associates."},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0308575919856175"},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2206.2005.00380.x"},{"key":"e_1_3_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-8721.2007.00525.x"},{"key":"e_1_3_5_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077559505283699"},{"key":"e_1_3_5_7_1","volume-title":"A home for me? A comparative review of the value of different forms of permanence for children \u2013 Adoption, SGOs and fostering","author":"Clifford D.","year":"2022","unstructured":"Clifford D. (2022) \u2018A home for me? A comparative review of the value of different forms of permanence for children \u2013 Adoption, SGOs and fostering\u2019. Sonnet Impact. https:\/\/cvaa.org.uk\/wp-content\/uploads\/2022\/12\/CVAA-The-value-of-adoption-report-final-Nov-22.pdf"},{"key":"e_1_3_5_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/13591045221135993"},{"key":"e_1_3_5_9_1","doi-asserted-by":"publisher","DOI":"10.1352\/1944-7558-129.2.116"},{"key":"e_1_3_5_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/nutrit\/nuaa121"},{"key":"e_1_3_5_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/9780191976643.001.0001"},{"key":"e_1_3_5_12_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-devpsych-120621-043414"},{"key":"e_1_3_5_13_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.106.025023"},{"key":"e_1_3_5_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-015-2680-6"},{"key":"e_1_3_5_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-021-01198-w"},{"key":"e_1_3_5_16_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.130.3373.421"},{"key":"e_1_3_5_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077559504264304"},{"key":"e_1_3_5_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13679-024-00601-z"},{"key":"e_1_3_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2134(02)00341-1"},{"key":"e_1_3_5_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2206.2012.00825.x"},{"key":"e_1_3_5_21_1","unstructured":"NICE. (2018 update). Attention deficit hyperactivity disorder: diagnosis and management. NICE guideline [NG87]. https:\/\/www.nice.org.uk\/guidance\/ng87"},{"key":"e_1_3_5_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0308575919856173"},{"key":"e_1_3_5_23_1","unstructured":"Poore J. Simmonds J. (2024). Assessment of adopters: A literature review. CoramBAAF. https:\/\/adoptionengland.co.uk\/sites\/default\/files\/2024-03\/Literature_review_-_Assessment_of_Adopters.pdf"},{"key":"e_1_3_5_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0b013e32835f19c3"},{"key":"e_1_3_5_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.2006.01688.x"},{"key":"e_1_3_5_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2009.09.012"},{"key":"e_1_3_5_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-8624.2009.01390.x"},{"key":"e_1_3_5_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12507"},{"key":"e_1_3_5_29_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.2003.034"},{"key":"e_1_3_5_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2021.111423"},{"key":"e_1_3_5_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/03085759251345493"},{"key":"e_1_3_5_32_1","unstructured":"World Health Organization. (2019). The ICD-11 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. World Health Organization. https:\/\/icd.who.int\/"},{"key":"e_1_3_5_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/camh.12357"}],"container-title":["Clinical Child Psychology and Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13591045251394425","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13591045251394425","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13591045251394425","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T05:42:13Z","timestamp":1784353333000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13591045251394425"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,7]]},"references-count":32,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/13591045251394425"],"URL":"https:\/\/doi.org\/10.1177\/13591045251394425","relation":{},"ISSN":["1359-1045","1461-7021"],"issn-type":[{"value":"1359-1045","type":"print"},{"value":"1461-7021","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,7]]}}}