Effects of a Psychosocial Family-Based Preventive Intervention on Cortisol Response to a Social Challenge in Preschoolers at High Risk for Antisocial Behavior

Brotman, Laurie Miller; Gouley, Kathleen Kiely; Huang, Keng Yen; Kamboukos, Dimitra; Fratto, Carolyn M.; Pine, Daniel S.

doi:10.1001/archpsyc.64.10.1172

Cited by 97 publications

(93 citation statements)

References 44 publications

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“…The first study that met inclusion criteria was published in 1997. 47 The majority of studies were RCTs (n = 13) 44,45,[47][48][49][50][51][52][53][54][55][56][57][58] ; quasi experiments were less common (n = 4). [59][60][61][62] The sample sizes ranged from 12 53 to 1197, 61 with a median of 126 participants.…”

Section: Search Results and Description Of Included Studiesmentioning

confidence: 99%

“…Across the 12 studies that collected diurnal cortisol, [44][45][46][47][50][51][52][57][58][59][60]62 substantial variation existed in how the data were analyzed. Some studies evaluated differences in slope [44][45][46]50,51,58,59,62 ; others examined area under the curve (AUC), 52,57 individual components of diurnal measures separately (eg, AM and PM), 44,47,51,58,60,62 or average cortisol across morning and evening measures.…”

Section: Diurnal Cortisol Assessmentmentioning

confidence: 99%

“…Some studies evaluated differences in slope [44][45][46]50,51,58,59,62 ; others examined area under the curve (AUC), 52,57 individual components of diurnal measures separately (eg, AM and PM), 44,47,51,58,60,62 or average cortisol across morning and evening measures. 58 Some studies used multiple analytic strategies.…”

Section: Diurnal Cortisol Assessmentmentioning

confidence: 99%

“…58 Some studies used multiple analytic strategies. 44,51,58,59,62 Among the 8 studies that examined differences in cortisol slope between intervention and control groups, 3 reported that children in control conditions had blunted morning to evening cortisol decreases relative to children who received interventions. 44,45,62 In contrast, in a small pilot study of a foster care intervention, children in the control group had a steeper cortisol slope on the fifth day of a new school year relative to an intervention group and community controls, primarily due to higher morning cortisol levels.…”

Section: Diurnal Cortisol Assessmentmentioning

confidence: 99%

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Interventions to Improve Cortisol Regulation in Children: A Systematic Review

2014

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Childhood adversity is associated with physiologic dysregulation across multiple biological systems; however, relatively little is known about whether these changes are reversible with intervention. The objective of this review was to examine evidence for the effectiveness of interventions to promote healthy cortisol regulation in children. We selected articles from English-language publications in PubMed and EBSCO databases through 2012. Two independent reviewers assessed articles against eligibility criteria. Eligible studies were randomized controlled or quasi-experimental studies designed to improve relationships, environments, or psychosocial functioning in children and examined cortisol as an outcome. We identified 19 articles. There was substantial heterogeneity across studies with regard to age, selection criteria, intervention design, cortisol assessment, and follow-up duration. Eighteen of the 19 articles reported at least 1 difference in baseline cortisol, diurnal cortisol, or cortisol responsivity between intervention and control participants. Importantly, however, there was remarkable inconsistency with regard to how the interventions influenced cortisol. Therefore, studies that included a low-risk comparison group (n = 8) provided critical insight, and each found some evidence that postintervention cortisol levels in the intervention group approximated the low-risk comparison group and differed from children receiving usual care. In conclusion, existing studies show that cortisol activity can be altered by psychosocial interventions. These findings are promising, not only because they indicate physiologic plasticity that can be leveraged by interventions but also because they suggest it may be possible to repair regulatory systems after childhood adversity, which could inform strategies for reducing health disparities and promoting lasting improvements in health. Pediatrics 2014;133:312-326

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Section: Search Results and Description Of Included Studiesmentioning

confidence: 99%

Section: Diurnal Cortisol Assessmentmentioning

confidence: 99%

Section: Diurnal Cortisol Assessmentmentioning

confidence: 99%

Section: Diurnal Cortisol Assessmentmentioning

confidence: 99%

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Interventions to Improve Cortisol Regulation in Children: A Systematic Review

2014

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“…Although physiological reactivity in humans can be altered in the short term by psychosocial interventions (34,35), including in children exposed to maternal deprivation (36,37), we are unaware of experimental research examining whether random assignment to a caregiving environment alters patterns of physiological reactivity later in development. Finally, although a sensitive period exists during which the environment has particularly strong influences on stress response system development in animals, studies that can rigorously identify such a period in humans are lacking.…”

mentioning

confidence: 99%

Causal effects of the early caregiving environment on development of stress response systems in children

McLaughlin

Sheridan

Tibu³

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

381

330

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Disruptions in stress response system functioning are thought to be a central mechanism by which exposure to adverse early-life environments influences human development. Although early-life adversity results in hyperreactivity of the sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal (HPA) axis in rodents, evidence from human studies is inconsistent. We present results from the Bucharest Early Intervention Project examining whether randomized placement into a family caregiving environment alters development of the autonomic nervous system and HPA axis in children exposed to early-life deprivation associated with institutional rearing. Electrocardiogram, impedance cardiograph, and neuroendocrine data were collected during laboratorybased challenge tasks from children (mean age = 12.9 y) raised in deprived institutional settings in Romania randomized to a highquality foster care intervention (n = 48) or to remain in care as usual (n = 43) and a sample of typically developing Romanian children (n = 47). Children who remained in institutional care exhibited significantly blunted SNS and HPA axis responses to psychosocial stress compared with children randomized to foster care, whose stress responses approximated those of typically developing children. Intervention effects were evident for cortisol and parasympathetic nervous system reactivity only among children placed in foster care before age 24 and 18 months, respectively, providing experimental evidence of a sensitive period in humans during which the environment is particularly likely to alter stress response system development. We provide evidence for a causal link between the early caregiving environment and stress response system reactivity in humans with effects that differ markedly from those observed in rodent models.childhood adversity | early-life stress | HPA axis | autonomic nervous system | stress reactivity D isruptions in stress response system functioning are thought to be a central mechanism by which exposure to adverse early-life environments influences human development. This idea is borne out in rodent models, where the effects of early-life adversity on the development of stress response systems have been well characterized. Exposure to early-life adversityinvolving repeated and prolonged separation of a pup from its mother-results in hyperreactivity of the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis in adolescence and adulthood and elevations in anxiety, fearful behaviors, and hypervigilance (1-4). Stress exposure in mature rodents is associated with immediate, but not lasting, changes in stress response systems (5, 6), suggesting the presence of an early sensitive period when exposure to adverse environments results in long-term changes in physiological stress response system functioning.

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Effects of ParentCorps in Prekindergarten on Child Mental Health and Academic Performance

et al. 2016

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IMPORTANCE Low-income minority children living in urban neighborhoods are at high risk for mental health problems and underachievement. ParentCorps, a family-centered, school-based intervention in prekindergarten, improves parenting and school readiness (ie, self-regulation and preacademic skills) in 2 randomized clinical trials. The longer-term effect on child mental health and academic performance is not known.OBJECTIVE To examine whether ParentCorps delivered as an enhancement to prekindergarten programs in high-poverty urban schools leads to fewer mental health problems and increased academic performance in the early elementary school years. DESIGN, SETTING, AND PARTICIPANTS This is a 3-year follow-up study of a cluster randomized clinical trial of ParentCorps in public schools with prekindergarten programs in New York City. Ten elementary schools serving a primarily low-income, black student population were randomized in 2005, and 4 consecutive cohorts of prekindergarten students were enrolled from September 12, 2005, through December 31, 2008. We report follow-up for the 3 cohorts enrolled after the initial year of implementation. Data analysis was performed from September 1, 2014, to December 31, 2015. INTERVENTIONS ParentCorps included professional development for prekindergarten and kindergarten teachers and a program for parents and prekindergarten students (13 two-hour group sessions delivered after school by teachers and mental health professionals). MAIN OUTCOMES AND MEASURES Annual teacher ratings of mental health problems and academic performance and standardized tests of academic achievement in kindergarten and second grade by testers masked to the intervention or control group randomization. RESULTS A total of 1050 children (4 years old; 518 boys [49.3%] and 532 girls [50.7%]) in 99 prekindergarten classrooms participated in the trial (88.1% of the prekindergarten population), with 792 students enrolled from 2006 to 2008. Most families in the follow-up study (421 [69.6%]) were low income; 680 (85.9%) identified as non-Latino black, 78 (9.8%) as Latino, and 34 (4.3%) as other. Relative to their peers in prekindergarten programs, children in ParentCorps-enhanced prekindergarten programs had lower levels of mental health problems (Cohen d=0.44; 95% CI, 0.08-0.81) and higher teacher-rated academic performance (Cohen d = 0.21; 95% CI, 0.02-0.39) in second grade.CONCLUSIONS AND RELEVANCE Intervention in prekindergarten led to better mental health and academic performance 3 years later. Family-centered early intervention has the potential to prevent problems and reduce disparities for low-income minority children. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01670227

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Effects of a Psychosocial Family-Based Preventive Intervention on Cortisol Response to a Social Challenge in Preschoolers at High Risk for Antisocial Behavior

Cited by 97 publications

References 44 publications

Interventions to Improve Cortisol Regulation in Children: A Systematic Review

Interventions to Improve Cortisol Regulation in Children: A Systematic Review

Causal effects of the early caregiving environment on development of stress response systems in children

Effects of ParentCorps in Prekindergarten on Child Mental Health and Academic Performance

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