Intervening to enhance cortisol regulation among children at risk for neglect: Results of a randomized clinical trial

Dev Psychopathol. 2015 Aug;27(3):829-41. doi: 10.1017/S095457941400073X. Epub 2014 Aug 26.


The hypothalamus-pituitary-adrenal axis is particularly sensitive to conditions of maltreatment. In particular, neglected children have shown a flatter slope with lower wake-up values relative to nonneglected children. An intervention, the Attachment and Biobehavioral Catch-Up (ABC), was developed to enhance biological and behavioral regulation in young children at risk for neglect. The effectiveness of the intervention was assessed in a randomized clinical trial for children with involvement with Child Protective Services. Following the intervention, children receiving the ABC intervention (n = 49) showed more typical cortisol production, with higher wake-up cortisol values and a steeper diurnal slope, than children receiving the control intervention (n = 51). These results suggest that the ABC intervention is effective in enhancing biological regulation.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Child Abuse*
  • Child Protective Services
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrocortisone / metabolism*
  • Hypothalamo-Hypophyseal System / metabolism
  • Infant
  • Male
  • Middle Aged
  • Parenting / psychology*
  • Pituitary-Adrenal System / metabolism
  • Psychotherapy / methods*
  • Treatment Outcome
  • Young Adult


  • Hydrocortisone