Links between early baseline cortisol,attachment classification,and problem behaviors: A test of differential susceptibility versus diathesis-stress

The purpose of the current study was to predict concurrent levels of problem behaviors from young children’s baseline cortisol and attachment classification, a proxy for the quality of caregiving experienced. In a sample of 58 children living at or below the federal poverty threshold, children’s baseline cortisol levels, attachment classification, and problem behaviors were assessed at 17 months of age. We hypothesized that an interaction between baseline cortisol and attachment classification would predict problem behaviors above and beyond any main effects of baseline cortisol and attachment. However, based on limited prior research, we did not predict whether or not this interaction would be more consistent with diathesis-stress or differential susceptibility models. Consistent with diathesis-stress theory, the results indicated no significant differences in problem behavior levels among children with high baseline cortisol. In contrast, children with low baseline cortisol had the highest level of problem behaviors in the context of a disorganized attachment relationship. However, in the context of a secure attachment relationship, children with low baseline cortisol looked no different, with respect to problem behavior levels, then children with high cortisol levels. These findings have substantive implications for the socioemotional development of children reared in poverty.     

Stress, Cortisol, and Externalizing Behavior in Adolescent Males: An Examination in the Context of Multisystemic Therapy

Stress and hypothalamic-pituitary-adrenal (HPA) axis dysregulation have been associated with externalizing behavior in adolescence, but few studies have examined these factors in a treatment context. This study investigated the relationship between stress, cortisol, and externalizing behavior among 120 adolescent males (mean age?=?15) receiving Multisystemic Therapy (MST). To examine the differential relationship of cortisol with various types of stressors, self-report measures assessed lifetime stress, current episodic stress, and daily hassles. Morning and afternoon cortisol samples were collected to examine whether the relationship between stress and treatment outcome depended on the youth's biological stress levels. Regression analyses indicated that awakening cortisol levels moderated the relationship between daily hassles and externalizing behaviors at post-treatment. More specifically, higher levels of daily hassles predicted worse outcomes only among adolescents with high levels of morning cortisol. In addition, lifetime stressors and afternoon measures of cortisol interacted to predict changes in caretaker reports of externalizing problems and youth arrests following treatment; lifetime stressors were positively associated with externalizing behavior when adolescents had low levels of afternoon cortisol. Implications for theory and future directions for evidence-based treatment are discussed.     

Fearful Inhibition,Inhibitory Control,and Maternal Negative Behaviors During Toddlerhood Predict Internalizing Problems at Age 6

Many, but not all, young children with high levels of fearful inhibition will develop internalizing problems. Individual studies have examined either child regulatory or environmental factors that might influence the level of risk. We focused on the interaction of regulation and environment by assessing how early fearful inhibition at age 2, along with inhibitory control and maternal negative behaviors at age 3, interactively predicted internalizing problems at age 6. A total of 218 children (105 boys, 113 girls) and their mothers participated in the study. Results indicated a three-way interaction among fearful inhibition, inhibitory control, and maternal negative behaviors. The correlation between fearful inhibition and internalizing was significant only when children had low inhibitory control and experienced high levels of maternal negative behaviors. Either having high inhibitory control or experiencing low maternal negative behaviors buffered against the adverse effect caused by the absence of the other. These findings highlight the importance of considering associations among both within-child factors and environmental factors in studying children’s socioemotional outcomes.     

Learning to fear a second-order stimulus following vicarious learning

Vicarious fear learning refers to the acquisition of fear via observation of the fearful responses of others. The present study aims to extend current knowledge by exploring whether second-order vicarious fear learning can be demonstrated in children. That is, whether vicariously learnt fear responses for one stimulus can be elicited in a second stimulus associated with that initial stimulus. Results demonstrated that children's (5–11 years) fear responses for marsupials and caterpillars increased when they were seen with fearful faces compared to no faces. Additionally, the results indicated a second-order effect in which fear-related learning occurred for other animals seen together with the fear-paired animal, even though the animals were never observed with fearful faces themselves. Overall, the findings indicate that for children in this age group vicariously learnt fear-related responses for one stimulus can subsequently be observed for a second stimulus without it being experienced in a fear-related vicarious learning event. These findings may help to explain why some individuals do not recall involvement of a traumatic learning episode in the development of their fear of a specific stimulus.     

Situation-Specific Scripts for Threat in Blood Fearful and Nonfearful Individuals

Self-schemata for threatening situations were examined in blood fearful and nonfearful individuals. In the context of 5 scenarios involving blood, injections, hospitals, or injury, participants listed events that they typically experience in these situations or events that occur when they witness another individual in these situations. Blood fearful and nonfearful individuals generally listed sequences of events corresponding to a similar macrostructure. However, blood fearful individuals included more negative emotional and physiological events than nonfearful individuals, and several of their sequences reflected higher levels of fear and lower levels of positive affect. These results suggest that the self-schemata of blood fearful individuals for situations involving harm or threat consist of both normal and maladaptive elements.     

Attentional bias toward fear-related stimuli: an investigation with nonselected children and adults and children with anxiety disorders

Research investigating anxiety-related attentional bias for emotional information in anxious and nonanxious children has been equivocal with regard to whether a bias for fear-related stimuli is unique to anxious children or is common to children in general. Moreover, recent cognitive theories have proposed that an attentional bias for objectively threatening stimuli may be common to all individuals, with this effect enhanced in anxious individuals. The current study investigated whether an attentional bias toward fear-related pictures could be found in nonselected children (n=105) and adults (n=47) and whether a sample of clinically anxious children (n=23) displayed an attentional bias for fear-related pictures over and above that expected for nonselected children. Participants completed a dot-probe task that employed fear-related, neutral, and pleasant pictures. As expected, both adults and children showed a stronger attentional bias toward fear-related pictures than toward pleasant pictures. Consistent with some findings in the childhood domain, the extent of the attentional bias toward fear-related pictures did not differ significantly between anxious children and nonselected children. However, compared with nonselected children, anxious children showed a stronger attentional bias overall toward affective picture stimuli.     

Father contributions to cortisol responses in infancy and toddlerhood

The current study is one of the first prospective examinations of longitudinal associations between observed father caregiving behaviors and child cortisol reactivity and regulation in response to emotional arousal. Observations of father and mother caregiving behaviors and child cortisol levels in response to challenges at 7 months and 24 months of child age were collected. Analyses were based on a subsample of children from the Family Life Project who lived with both their biological mothers and fathers and for whom there was at least partial cortisol data (7 months: n = 717; 24 months: n = 579). At the challenge conducted at 7 months of child age, 49.0% of the sample were girls; racial composition of the sample was 25.8% African American and 74.2% European American. At the challenge conducted at 24 months of child age 49.9% of the sample were girls; racial composition was 24.7% African American and 75.3% European American. We conducted analyses across assessment points simultaneously using mixed linear modeling for repeated measures data to test for differential effects of fathering across infancy and toddlerhood. Concurrent measures of father negativity were positively associated with greater increases in child cortisol levels in response to emotion challenge at 7 months (p = .01) and with higher overall levels of cortisol at 24 months (p < .001). However, there was no evidence that father caregiving during infancy independently predicted later cortisol activity during toddlerhood.     

Perinatal Factors, Parenting Behavior, and Reactive Aggression: Does Cortisol Reactivity Mediate this Developmental Risk Process?

Little is known about the mechanisms of action that link perinatal risk and the development of aggressive behavior. The aim of this study was to examine whether perinatal risk and parenting interacted to specifically predict reactive aggression, as opposed to general aggressive behavior, and to examine cortisol reactivity as a mediator of this developmental risk process. In a community sample of 99 elementary school-aged children, prenatal risk was measured by a count of minor physical anomalies (MPAs), reactive aggression was measured by laboratory observations of aggression in response to provocation, and general aggression was measured by parent report. Cortisol reactivity was not found to mediate the association between MPAs and reactive aggression or general aggression. However, MPAs were found to interact with parenting behaviors to predict reactive aggression and general aggression, as well as cortisol reactivity. Specifically, as the deficits in parenting increased, MPAs became more strongly and positively associated with reactive aggressive and general aggressive outcomes. Similarly, in cases of poor parenting behaviors, MPAs were positively associated with higher cortisol reactivity. Implications for theory and prevention are discussed.     

Emotional contrast and psychological function impact response inhibition to threatening faces

Poor inhibitory control over negative emotional information has been identified as a possible contributor to affective disorders, but the distinct effects of emotional contrast and fearful versus angry faces on response inhibition remain unknown. In the present study, young adults completed an emotional go/no-go task involving happy, neutral, and either fearful or angry faces. Results did not reveal differences in accuracy or speed between angry and fearful face conditions. However, responses were slower and indicated poorer inhibition in blocks where threatening faces were paired with happy, versus neutral, faces. Results may reflect cognitive load of emotional valence contrast, such that higher contrast blocks (containing threatening with happy faces) produced more conflict and required more processing than lower contrast blocks (threatening with neutral faces). Preliminary findings also revealed higher anxiety and depression symptoms corresponded with slower responses and worse accuracy, consistent with patterns of adverse impacts of anxiety and depression on response inhibition to threatening faces, even at subclinical levels of symptomatology.     

Higher cortisol is associated with poorer executive functioning in preschool children: The role of parenting stress,parent coping and quality of daycare

Child executive functions (cognitive flexibility, inhibitory control, working memory) are key to success in school. Cortisol, the primary stress hormone, is known to affect cognition; however, there is limited information about how child cortisol levels, parenting factors and child care context relate to executive functions in young children. The aim of this study was to examine relationships between child cortisol, parenting stress, parent coping, and daycare quality in relation to executive functions in children aged 3–5 years. We hypothesized that (1) poorer executive functioning would be related to higher child cortisol and higher parenting stress, and (2) positive daycare quality and positive parent coping style would buffer the effects of child cortisol and parenting stress on executive functions. A total of 101 children (53 girls, 48 boys, mean age 4.24 years ±0.74) with complete data on all measures were included. Three saliva samples to measure cortisol were collected at the child’s daycare/preschool in one morning. Parents completed the Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P), Parenting Stress Index (PSI), and Ways of Coping Questionnaire (WCQ). The Early Childhood Environment Rating Scale – Revised (ECERS-R) was used to measure the quality of daycare. It was found that children with poorer executive functioning had higher levels of salivary cortisol, and their parents reported higher parenting stress. However, parent coping style and quality of daycare did not modulate these relationships. Identifying ways to promote child executive functioning is an important direction for improving school readiness.     

Cortisol and Children’s Adjustment: The Moderating Role of Sympathetic Nervous System Activity

We examined relations among cortisol, markers of sympathetic nervous system (SNS) activity (including salivary alpha-amylase and skin conductance level), and children's adjustment. We also tested the Bauer et al. (Journal of Developmental and Behavioral Pediatrics, 23(2), 102-113, 2002) hypothesis that interactions between the SNS and cortisol would be associated with internalizing and externalizing problems. Saliva samples were obtained from 8- to 9-year-olds before and after a laboratory assessment battery, and were assayed for cortisol and alpha-amylase (sAA). Basal skin conductance level (SCL) was measured during resting conditions. Parents reported on child adjustment. Interactions between basal SNS and cortisol levels explained moderate amounts of unique variance in children's externalizing and internalizing problems. More specifically, higher basal cortisol levels were positively associated with higher internalizing and externalizing problems among children with higher SNS activity, as compared to children with lower SNS activity. Findings underscore the utility of including information about the coordination between hypothalamic-pituitary-adrenal (HPA) and SNS activity in biosocial models of atypical child development.     

Emotion Regulation via the Autonomic Nervous System in Children with Attention-Deficit/Hyperactivity Disorder (ADHD)

Despite growing interest in conceptualizing ADHD as involving disrupted emotion regulation, few studies have examined the physiological mechanisms related to emotion regulation in children with this disorder. This study examined parasympathetic and sympathetic nervous system reactivity via measures of respiratory sinus arrhythmia (RSA) and cardiac pre-ejection period (PEP) in children with ADHD (n = 32) and typically developing controls (n = 34), using a novel emotion task with four conditions: negative induction, negative suppression, positive induction, and positive suppression of affect. Both groups showed strong task-response effects in RSA. However, typically developing children showed systematic variation in parasympathetic activity (RSA) depending on both emotion valence (more activation for negative emotion, reduced activation for positive emotion) and task demand (more activation for suppression than induction). In contrast, children with ADHD displayed a stable pattern of elevated parasympathetic activity (RSA) across all task conditions compared to baseline. No group differences in sympathetic activity (PEP) were observed. It is concluded ADHD in childhood is associated with abnormal parasympathetic mechanisms involved in emotion regulation.     

Wives' and Husbands' Cortisol Reactivity to Proximal and Distal Dimensions of Couple Conflict

Poor marital quality has been linked repeatedly to spouses' health problems, with alterations to physiological stress response systems, such as the hypothalamic‐pituitary‐adrenocortical (HPA) axis, as one putative mechanism. This study assessed wives' and husbands' HPA axis (i.e., cortisol) reactivity to marital criticism during laboratory‐based conflict discussions, in the context of marital aggression experienced during the previous year. Ninety‐five couples provided one saliva sample prior to—and three samples following—a triadic family conflict discussion involving their teenage child. Marital criticism during the conflict discussion was related to heightened HPA reactivity for husbands only. For wives, an interaction emerged between criticism during the conflict and previous‐year marital aggression: only those wives who had experienced high levels of marital aggression demonstrated a positive association between criticism and cortisol output. Husbands thus appeared to be more physiologically reactive to the in‐the‐moment critical behaviors, whereas wives' responses to proximal conflict were related to previous and perhaps more chronic experiences of marital aggression. These findings shed light on ways in which within‐couple processes during family conflicts involving children contribute to individual physiological functioning, enhancing our understanding of the role of family relationships in physical health outcomes.     

Higher attention bias for fear at 8 months of age is associated with better socioemotional competencies during toddlerhood

BackgroundIn previous studies, an attention bias for signals of fear and threat has been related to socioemotional problems, such as anxiety symptoms, and socioemotional competencies, such as altruistic behaviors in children, adolescents and adults. However, previous studies lack evidence about these relations among infants and toddlers.AimsOur aim was to study the association between the individual variance in attention bias for faces and, specifically, fearful faces during infancy and socioemotional problems and competencies during toddlerhood.Study design and subjectsThe study sample was comprised of 245 children (112 girls). We explored attentional face and fear biases at the age of 8 months using eye tracking and the face-distractor paradigm with neutral, happy and fearful faces and a scrambled-face control stimulus. Socioemotional problems and competencies were reported by parents with the Brief Infant and Toddler Social Emotional Assessment (BITSEA) when children were 24 months old.Outcome measures and resultsA higher attentional fear bias at 8 months of age was related to higher levels of socioemotional competence at 24 months of age (β = .18, p = .008), when infants’ sex and temperamental affectivity, maternal age, education and depressive symptoms were controlled. We found no significant association between attentional face or fear bias and socioemotional problems.ConclusionsWe found that the heightened attention bias for fearful faces was related to positive outcomes in early socioemotional development. Longitudinal study designs are needed to explore the changes in the relation between the attention bias for fear or threat and socioemotional development during early childhood.     

Consistency in physiological stress responses and electromyographic activity during induced stress exposure in women and men

Physiological responses serve the role as objective indicators of stress as well as a link between psychosocial stress and various health outcomes. The aim of the present exposure session was to compare different physiological stress responses (systolic and diastolic blood pressure, heart rate, urinary epinephrine and norepinephrine, salivary cortisol) as well as trapezius muscle activity, measured by surface electromyography, during mental and physical stress in 11 women and ten men. The results show significantly increased activity in all measures but cortisol and significant associations between sympathetic arousal and EMG activity. The association between sympathetic arousal and muscle activity is of importance for understanding the high prevalence of musculoskeletal disorders in mentally stressful but physically light work tasks. Men had higher blood pressure and a more pronounced increase in epinephrine output than women, whereas women had higher heart rate. It was concluded that sympathetic activity is more sensitive to moderately intense stress exposure than pituitary adrenocortical (cortisol) activity and that men respond to performance stress with more epinephrine output than women. Although the correlations between the different indicators of sympathetic arousal were high, together they could still only explain 30–70% of the inter-individual variance. Thus, several parameters are needed in order to obtain a reliable measure of sympathetic activity.     

Consistency in Physiological Stress Responses and Electromyographic Activity during Induced Stress Exposure in Women and Men

Physiological responses serve the role as objective indicators of stress as well as a link between psychosocial stress and various health outcomes. The aim of the present exposure session was to compare different physiological stress responses (systolic and diastolic blood pressure, heart rate, urinary epinephrine and norepinephrine, salivary cortisol) as well as trapezius muscle activity, measured by surface electromyography, during mental and physical stress in 11 women and ten men. The results show significantly increased activity in all measures but cortisol and significant associations between sympathetic arousal and EMG activity. The association between sympathetic arousal and muscle activity is of importance for understanding the high prevalence of musculoskeletal disorders in mentally stressful but physically light work tasks. Men had higher blood pressure and a more pronounced increase in epinephrine output than women, whereas women had higher heart rate. It was concluded that sympathetic activity is more sensitive to moderately intense stress exposure than pituitary adrenocortical (cortisol) activity and that men respond to performance stress with more epinephrine output than women. Although the correlations between the different indicators of sympathetic arousal were high, together they could still only explain 30-70% of the inter-individual variance. Thus, several parameters are needed in order to obtain a reliable measure of sympathetic activity.     

Longitudinal associations among child maltreatment, social functioning, and cortisol regulation

Child maltreatment increases the risk for impaired social functioning and cortisol regulation. However, the longitudinal interplay among these factors is still unclear. This study aimed to shed light on the effect of maltreatment on social functioning and cortisol regulation over time. The sample consisted of 236 children (mean age 7.64 years, SD = 1.36; 125 maltreated children and 111 nonmaltreated children, 128 boys and 108 girls) who attended a week-long summer camp for 2 consecutive years. Saliva was collected during 5 days at 9:00 a.m. and 4:00 p.m. Means of morning and afternoon cortisol levels and cortisol change (difference between morning and afternoon levels, controlled for morning levels) were used to group the children into low-, medium-, and high-cortisol groups. Prosocial, disruptive/aggressive, and withdrawn behaviors were assessed using information from peers and counselors. Maltreated children showed less prosocial and more disruptive/aggressive and withdrawn behavior. Results of structural equation modeling analyses indicated that there were indirect effects of maltreatment on Year 2 morning cortisol via prosocial and disruptive/aggressive behavior: Lower levels of prosocial behavior and higher levels of disruptive/aggressive behavior were related to lower morning cortisol levels 1 year later. Withdrawn behavior was related to higher afternoon cortisol values 1 year later. Results of this study suggest that maltreated children are more likely to experience difficulties in social functioning, which in turn is related to cortisol regulation 1 year later. This altered hypothalamic-pituitary-adrenocortical (HPA) axis functioning may put children at risk for later psychopathology.     

Hormonal sensitivity of preterm versus full-term infants to the effects of maternal depression

Comparisons were made of differences in the hormonal sensitivity of preterm versus full-term infants to maternal depression, as reflected in children's cortisol levels. In Study 1 (N=25), a comparison was made between preterm versus healthy full-term children. In Study 2 (N=80), a comparison was made between preterm infants and full-term infants with mild or moderate medical problems. Preterm infants were found to be highly reactive to maternal depression (as measured by the Beck Depression Inventory). That is, they demonstrated higher cortisol levels when paired with depressed mothers and lower cortisol levels when paired with non-depressed mothers. No equivalent effects were found for children who were full-term, even when they had experienced other medical problems at birth. It was concluded that premature infants are exceptionally sensitive to the "emotional climate" in their home environment. As a result, they may manifest very different hormonal outcomes--with implications for their later development.     

The import of the cortisol rise in child care differs as a function of behavioral inhibition

Children of ages 3 to 4.5 years (N = 107; 45 boys, 62 girls) were studied twice, 6 months apart, to examine whether the cortisol rise in child care at Time 1 (T1) was associated with (a) changes in anxious, vigilant behavior from T1 to Time 2 (T2) and (b) higher internalizing symptoms at T2. Controlling for measures of home environment and child care quality at T1, as well as for cortisol activity at T2, we obtained results indicating that behavioral inhibition moderated the associations between the rise in cortisol at T1 and child outcomes at T2 (i.e., anxious, vigilant behavior and internalizing symptoms). For both outcomes, the rise in cortisol at T1 became more positively predictive at increasing levels of behavioral inhibition. Specifically, at higher levels of behavioral inhibition, children with larger T1 cortisol increases expressed more internalizing symptoms than did children at lower levels of behavioral inhibition; in contrast, for those with low cortisol activity at T1, children with higher levels of inhibition expressed fewer internalizing symptoms than did children at lower levels of inhibition. In addition, children with higher levels of behavioral inhibition and lower cortisol activity at T1 exhibited reductions in anxious, vigilant behavior from T1 to T2, whereas at lower levels of behavioral inhibition, variations in the T1 cortisol rise bore no relation to changes in this behavior. These results suggest that the rise in cortisol at child care may have differential predictive value as a function of behaviorally inhibited temperament.     

Emotionally meaningful targets enhance orienting triggered by a fearful gazing face

Studies investigating the effect of emotional expression on spatial orienting to a gazed-at location have produced mixed results. The present study investigated the role of affective context in the integration of emotion processing and gaze-triggered orienting. In three experiments, a face gazed non-predictively to the left or right, and then its expression became fearful or happy. Participants identified (Experiments 1 and 2) or detected (Experiment 3) a peripheral target presented 225 or 525 ms after the gaze cue onset. In Experiments 1 and 3 the targets were either threatening (a snarling dog) or non-threatening (a smiling baby); in Experiment 2 the targets were neutral. With emotionally valenced targets, the gaze-cuing effect was larger when the face was fearful compared to happy—but only with the longer cue–target interval. With neutral targets, there was no interaction between gaze and expression. Our results indicate that a meaningful context optimises attentional integration of gaze and expression information.