HPA stability for children in foster care: mental health implications and moderation by early intervention

Dev Psychobiol. 2014 Sep;56(6):1406-15. doi: 10.1002/dev.21226. Epub 2014 Jun 2.


Research on stress-sensitive biological systems has typically focused on activation at one time, yet recent theories emphasize dynamic, context-specific adaptation. This study tested hypothesized calibration of one such system by examining both mean levels and longitudinal stability of daily cortisol--reflecting hypothalamic-pituitary-adrenal axis activation--in children exposed to high-risk versus lower-risk caregiving contexts. Context-specific effects of longitudinal cortisol profiles were addressed via relations with child psychiatric symptoms. Children from regular foster care, foster children participating in a family-based intervention, and community comparison children (n = 96 total) collected saliva samples for cortisol assay at 29 timepoints across 6+ years. High-risk (regular foster care) children showed lower and more variable cortisol levels than their lower-risk (treatment foster care, community comparison) counterparts. For the high-risk children only, higher and more stable cortisol related to elevated anxiety symptoms. Implications for contextual calibration of stress systems and family intervention mechanisms are discussed.

Keywords: cortisol; foster care; intervention; longitudinal; stress sensitivity.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Child
  • Child, Preschool
  • Early Diagnosis
  • Female
  • Foster Home Care*
  • Humans
  • Hydrocortisone / analysis
  • Hypothalamo-Hypophyseal System / physiopathology*
  • Longitudinal Studies
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / physiopathology*
  • Mental Health*
  • Models, Theoretical
  • Pituitary-Adrenal System / physiopathology*
  • Predictive Value of Tests
  • Saliva / chemistry


  • Hydrocortisone