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Intervention Effects on Morning and Stimulated Cortisol Responses among Toddlers in Foster Care
Author(s) -
Nelson Elizabeth M.,
Spieker Susan J.
Publication year - 2013
Publication title -
infant mental health journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.693
H-Index - 75
eISSN - 1097-0355
pISSN - 0163-9641
DOI - 10.1002/imhj.21382
Subject(s) - morning , cortisol awakening response , medicine , intervention (counseling) , hydrocortisone , saliva , logistic regression , clinical psychology , demography , psychology , developmental psychology , psychiatry , sociology
Toddlers in child welfare often have a dysregulated stress response. We tested whether toddlers with caregivers randomized to a 10‐week attachment‐based intervention, Promoting First Relationships (PFR; J.F. Kelly, D. Sandoval, T.G. Zuckerman, & K. Buehlman, 2008) would show postintervention change in stimulated salivary cortisol patterns during a research home visit involving a separation–reunion procedure, as compared to a condition including child development and resource advice, but no attachment strategies. At baseline and postintervention, toddlers with a caregiver change within 7 weeks of enrollment ( n = 48, age 10–25 months) provided four saliva samples during a 1½hr research visit, and samples the next morning. The categorical dependent variable was the pattern of cortisol activity during the course of the postintervention research visit: flat, decreasing, or increasing. Multinomial logistic regression was used to test for postintervention group differences in cortisol patterns, controlling for time of day, child's age, morning cortisol level, and baseline cortisol pattern. At baseline and postintervention, 92% of children demonstrated atypically low morning cortisol (<.21 ig/dL); postintervention, flat, decreasing, and increasing patterns were exhibited by 70, 15, and 15% of the sample, respectively. Significantly more children in the PFR condition showed an increasing pattern. This may signal an intervention effect on separation‐based stress response physiology.