Diurnal cortisol after early institutional care—Age matters

Abstract

Several studies have shown that young children who have experienced early caregiving adversity (e.g. previously institutionalization (PI)) exhibit flattened diurnal cortisol slopes; however, less is known about how these patterns might differ between children and adolescents, since the transition between childhood and adolescence is a time of purported plasticity in the hypothalamic-pituitary-adrenal (HPA) axis. PI youth experience a massive improvement in caregiving environment once adopted into families; therefore we anticipated that a developmental increase in HPA axis plasticity during adolescence might additionally allow for an enhanced enrichment effect by the adoptive family. In a cross-sectional sample of 197 youths (PI and Comparison; 4–15 years old) we observed age-related group differences in diurnal slope. First replicating previous findings, PI children exhibited flattened diurnal slope. This group difference, however, was not observed in adolescents. Moderation analyses showed that pubertal development, increased time with family, and early adoption contributed to the steeper diurnal cortisol slope in PI adolescents. These findings add support to existing theories positing that the transition between middle childhood and adolescence may mark an additional sensitive period for diurnal cortisol patterning, allowing PI youth to benefit from the enriched environment provided by adoptive parents during this period of development.

Working memory moderates the association between early institutional care and separation anxiety symptoms in late childhood and adolescence

“…Although the current analyses focused on morning levels only, diurnal salivary cortisol was measured across 2 consecutive (or close to consecutive) days (for analyses of the full diurnal cycle, see Flannery et al, 2017). Parents were asked to collect saliva across four different times of the day (at wake-up, 45 min after wake-up, at 5 p.m., and at 8 p.m.) for 2 days.…”

“…The interassay coefficient for cortisol was below 8% (Kirschbaum & Hellhammer, 2000). Because several studies have shown that PI samples are likely to differ most in morning values of cortisol (e.g., Flannery et al, 2017; Koss, Mliner, Donzella, & Gunnar, 2016), the current study focused on morning values; this was computed by taking the natural log of the mean of the morning collections (wake-up and wake-up+45 min) across the 2 days. No extreme observe values were found within this sample; therefore, all data points were included.…”

“…Of note, diurnal cortisol production often exhibits atypical patterns (i.e., blunted morning cortisol) following institutional care when measured in young children (Gunnar & Quevedo, 2007). However, at older ages this pattern appears to alleviate for some PI youth in the transition to adolescence (Flannery et al, 2017; Quevedo, Johnson, Loman, Lafavor, & Gunnar, 2012). If there is an association between morning cortisol and WM, then individual differences in morning cortisol measured in late childhood and adolescence might be associated with better WM performance and lower separation anxiety.…”

Enhancing diurnal cortisol regulation among young children adopted internationally: A randomized controlled trial of a parenting-based intervention

“…That said, differences between adopted and nonadopted children often remain. A growing number of studies indicate that children or adolescents who have been adopted internationally exhibit atypically low cortisol levels upon wake-up and/or blunted declines in cortisol levels throughout the day (Flannery et al, 2017; Johnson, Bruce, Tarullo, & Gunnar, 2011; Koss et al, 2014; Leneman, Donzella, Desjardins, Miller, & Gunnar, 2018; Quevedo, Johnson, Loman, LaFavor, & Gunnar, 2012; for a review, see Gunnar & Reid, 2019). For at least some individuals adopted internationally, the consequences of the early experiences of adversity for diurnal HPA axis activity persist into adulthood (Kumsta et al, 2017; van der Vegt, van der Ende, Kirschbaum, Verhulst, & Tiemeier, 2009).…”

“…In contrast, young children living in institutional environments often exhibit lower wake-up cortisol levels and flatter diurnal declines than children being raised by their birth parents (Carlson & Earls, 1997; Chernego et al, 2019). These atypical patterns of HPA axis regulation can persist after children are adopted and placed into highly enriched family contexts (Flannery et al, 2017; Koss, Hostinar, Donzella, & Gunnar, 2014), and they can increase the risk for behavioral problems among children adopted internationally (Koss et al, 2014).…”