Children's Diurnal Cortisol Research Articles

Diurnal Cortisol Change Moderates the Associations Between Bedtime Parenting Sensitivity and Young Children's Executive Functioning and Emotion Regulation

Abstract: The present study examined children's diurnal cortisol as a moderator of the association between parenting sensitivity at bedtime and young children's executive functioning and emotion regulation. Fifty-one children ( M age = 4.47 years) and their families participated. Parenting sensitivity was assessed from video recordings of child bedtime. Average child morning and evening cortisol levels were measured from saliva across 3 days. A greater decline in cortisol from morning to evening reflected healthy diurnal patterning. Children's executive functioning was measured objectively, and parents reported on children's emotion regulation. Regression analyses showed that lower parenting sensitivity at bedtime was associated with lower executive functioning and more labile and less adaptive emotion regulation only for children who showed less cortisol decline from morning to evening, suggesting that adaptive cortisol patterning may be protective in the context of low parenting sensitivity. The findings identify children at greatest risk and inform interventions targeting children's developmental outcomes.

Maternal stress and mental health before pregnancy and offspring diurnal cortisol in early childhood.

The current study investigates whether prepregnancy maternal posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, and stress predict children's cortisol diurnal slopes and cortisol awakening responses (CARs) adjusting for relevant variables. Mothers were enrolled after delivering a baby and followed through their subsequent pregnancy with 5 years of longitudinal data on their subsequent child. This prospective design allowed assessment of PTSD symptoms, depressive symptoms, and perceived stress prior to pregnancy. Children provided three saliva samples per day on three consecutive days at two timepoints in early childhood (M age=3.7 years, SD=0.38; M age=5.04 years, SD=0.43). Mothers' PTSD symptoms prior to pregnancy were significantly associated with flatter child diurnal cortisol slopes at 4 and 5 years, but not with child CAR. Findings at the age of 4 years, but not 5 years, remained statistically significant after adjustment for maternal socioeconomic status, race/ethnicity, child age, and other covariates. In contrast, maternal prepregnancy depressive symptoms and perceived stress did not significantly predict cortisol slopes or CAR. Results suggest that maternal prepregnancy PTSD symptoms may contribute to variation in early childhood physiology. This study extends earlier work demonstrating risk of adverse outcomes among children whose mothers experienced trauma but associations cannot be disentangled from effects of prenatal mental health of mothers on children's early childhood.

Children's diurnal cortisol output and temperament in two different childcare settings at 2 and 3.5 years of age.

Prior research suggests that child temperament may play an important role in early childhood stress regulation. We compared children's diurnal cortisol and the association between cortisol and temperament in two different childcare settings. Cortisol was measured from saliva samples over 2 days in children (N=84) attending out-of-home childcare and in children (N=27), who were cared for at home at the age of 3.5 years. There was no difference between the childcare groups in total diurnal cortisol. However, of the individual measurements, afternoon cortisol levels were higher in the out-of-home childcare group during their childcare day when compared with their home day. Child temperament was not associated with total diurnal cortisol. Comparison with our prior measurements showed that the association between temperamental surgency/extroversion and total diurnal cortisol diminished along with the child age from 2 to 3.5 years in both childcare settings. This may indicate that more extroverted children are physiologically more reactive to environmental stimuli when they are younger, but this association does not appear as the children develop. Our results further suggest that the afternoon hours in the out-of-home childcare may be demanding and accelerate the hypothalamus-pituitary-adrenal axis activation in young children independent of their age.

Cortisol in early childhood moderates the association between family routines and observed affective balance in children from low-income backgrounds.

The study of emotion regulation often addresses control of negative emotion. Researchers have proposed that affective balance is an indicator of emotion regulation that incorporates the role of positive emotion in the context of negative emotional experiences. Environmental and individual factors, such as family processes and biological stress regulation, are known to shape emotion regulation. The present study investigated whether child diurnal cortisol, an indicator of biological stress regulation, moderated the association between family routines and observed affective balance. Children (N=222; M age=4.70 years, SD=0.60) from low-income households provided saliva samples to measure diurnal cortisol and completed a behavioral task designed to elicit negative emotions. Affective balance was defined as the difference score between the proportion of positive and negative emotional expressions displayed during the task. A higher affective balance score indicated greater positive compared with negative emotional displays. Simple slope analyses indicated that for children with a low morning cortisol intercept, more frequent family routines were associated with more affective balance. This pattern was not observed in children with average or high morning cortisol. Positive family routines may play an important role in shaping affective balance among children with disrupted cortisol levels from low-income backgrounds.

Indicators of deprivation predict diurnal cortisol regulation during infancy.

Dysregulation of diurnal cortisol rhythms is often seen among children exposed to early adversity and has been associated with a variety of negative physical and mental health outcomes. The present study examined whether two indicators of deprivation, sociodemographic burden and observed parental insensitivity, were associated with child diurnal cortisol rhythms among a diverse community sample of 250 infants ages 5 to 22 months (M = 12.68 months, 47.2% male). The sample was diverse in terms of socioeconomic status as assessed by household income (M = $59,163, SD = $57,775, range = $0-230,000) and infant race/ethnicity (41.6% African American, 19.2% White, 17.2% multiracial, 14.0% Hispanic/Latin, 2.8% Caribbean, 2.8% other, 1.2% American Indian/Alaska Native, and 1.2% Asian). Sociodemographic burden indicators were assessed through questionnaires completed by the parent. Parental sensitivity was assessed through observations of parents' interactions with their infants during a play interaction task. Cortisol was assayed from infant saliva samples collected at waking and bedtime across 3 days. Structural equation modeling revealed that higher sociodemographic burden, but not parental insensitivity, was associated with blunted diurnal cortisol slopes. Neither sociodemographic burden nor parental insensitivity were associated with the cortisol awakening response. These findings suggest that sociodemographic burden may be an important early predictor of diurnal cortisol slope dysregulation, highlighting the importance of interventions providing support to individuals who experience sociodemographic burden and promoting reduction of these early stressors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Foster parent responsiveness and young children's diurnal cortisol production.

Foster children are at risk for dysregulated hypothalamic pituitary adrenal (HPA) axis functioning, conferring risk for negative health outcomes. Responsive parenting may support young children's HPA axis regulation; however, few studies have examined the association between responsive parenting and cortisol production among children in foster care. In a sample of 97 foster parent-child dyads, we examined whether variation in foster parent responsiveness was linked to children's waking and bedtime levels of cortisol. Children's saliva samples were collected at wake-up and bedtime for three consecutive days. Foster parent responsiveness, as indicated by parent sensitivity, intrusiveness, and positive regard, was assessed during video-recorded semistructured play interactions between foster parents and children. Foster parent responsiveness significantly predicted children's waking cortisol levels (β=0.26, p=.023). Follow-up analyses revealed that foster parent sensitivity uniquely predicted waking cortisol (β=0.46, p=.006), over and above other dimensions of parenting, such that children with more sensitive foster parents had higher waking cortisol than children with less sensitive foster parents. The association between foster parent sensitivity and the waking-to-bedtime slope of cortisol across the day was nonsignificant. Findings suggest that sensitive caregiving may support foster children's healthy HPA axis functioning.

Child diurnal cortisol differs based on profiles of maternal emotion socialization in high risk, low income, and racially diverse families.

Young children's physiological and emotional regulation depend on supportive caregiving, especially in the context of stress and adversity. Experiences of child maltreatment become biologically embedded by shaping stress physiology. Maternal emotion socialization may have an important influence on children's limbic-hypothalamic-pituitary-adrenal (LHPA) functioning. Grounded in theories of caregiver emotion socialization, a person-centered latent profile analysis was utilized to identify profiles of maternal emotion socialization among a high risk, low income, and racially diverse group of 248 mothers and their young children (Mage =4.39years, SD=1.10). The majority of the mothers (n=165) had a history of involvement with the Department of Child Services for substantiated cases of child maltreatment. A latent profile analysis was conducted revealing three emotion socialization profiles: disengaged, engaged, and engaged+supportive. Emotion socialization profile differences in children's diurnal cortisol levels and slope (using area under the curve with respect to ground and increase, respectively) were examined. Children's diurnal cortisol levels were higher, and slopes were flatter, when mothers used more disengaged emotion socialization strategies. Mothers who neglected their children were more likely to fit the disengaged profile than the engaged profile. Implications for the socialization of regulation in children exposed to adversity are discussed.

Longitudinal effects of maltreatment, intimate partner violence, and Reminiscing and Emotion Training on children's diurnal cortisol regulation.

Dysregulation in children's physiological stress systems is a key process linking early adversity to poor health and psychopathology. Thus, interventions that improve children's stress physiology may help prevent deleterious health outcomes. Reminiscing and Emotion Training (RET) is a brief relational intervention designed to improve maternal caregiving support by enhancing maltreating mothers' capacity to reminisce with their young children. This study evaluated associations between maltreatment, intimate partner violence, and the RET intervention with changes in children's diurnal cortisol regulation across the 1 year following the intervention, and the extent to which improvements in maternal elaborative reminiscing differed between intervention groups and mediated change in children's physiological functioning. Participants were 237 children (aged 36 to 86 months) and their mothers. Results indicated that the RET intervention was associated with significant positive change in elaborative reminiscing, which was sustained over time. Mothers' elaboration immediately after the intervention served as a mediator of RET's effects on improvements in children's diurnal cortisol regulation (steeper diurnal slopes) from baseline to 1 year following intervention. This suggests RET is effective in facilitating physiological regulation among maltreated children.

Attachment and stress regulation in socioeconomically disadvantaged children: Can public childcare compensate?

Children growing up in families experiencing socioeconomic disadvantage (SED) are at greater risk for deficits in attachment and stress regulation as compared to peers in families with more socioeconomic resources. The present study hypothesized that care providers in out‐of‐home care might help these children to compensate. We therefore investigated 60 children (n = 30 from SED, n = 30 matched counterparts from middle class) and assessed children's Attachment Q‐Sort (AQS) toward the mother and the primary care provider in childcare centers. Moreover, children's diurnal cortisol rhythm was measured based on 12 saliva samples taken across three days a week.The disadvantaged children showed lower AQS scores with their mothers than their care providers. Compared to their counterparts, disadvantaged children also displayed heightened cortisol release and flatter cortisol profiles reflecting overall high hypothalamic‐pituitary‐adrenocortical activities and lower capacities to regulate stress. Most notably however, multilevel path modeling linked higher care provider AQS scores to decreasing cortisol release throughout the week.

Intimate partner violence indirectly dysregulates child diurnal adrenocortical functioning through positive parenting.

Data were drawn from an ongoing study of preschoolers (N=221). Mothers self-reported experiences of intimate partner violence (IPV) and parenting practices, and collected three saliva samples (waking, midday, and bedtime) on themselves and their child on 2 consecutive days. Saliva samples were later assayed for cortisol. Bootstrapped mediation analyses revealed IPV to indirectly impact child diurnal cortisol through positive parenting. Specifically, greater exposure to IPV was associated with reduced positive parenting and subsequently heightened child waking cortisol levels. IPV did not indirectly impact child diurnal cortisol via autonomy supporting parenting or maternal diurnal cortisol. These findings suggest a possible pathway by which mother's experience of IPV indirectly influences child physiological regulation via maternal positive parenting.

Intimate partner violence indirectly dysregulates child diurnal adrenocortical functioning through positive parenting.

Data were drawn from an ongoing study of preschoolers (N = 221). Mothers self-reported experiences of intimate partner violence (IPV) and parenting practices, and collected three saliva samples (waking, midday, and bedtime) on themselves and their child on two consecutive days. Saliva samples were later assayed for cortisol. Bootstrapped mediation analyses revealed IPV to indirectly impact child diurnal cortisol through positive parenting. Specifically, greater exposure to IPV was associated with reduced positive parenting and subsequently heightened child waking cortisol levels. IPV did not indirectly impact child diurnal cortisol via autonomy supporting parenting or maternal diurnal cortisol. These findings suggest a possible pathway by which mother's experience of IPV indirectly influences child physiological regulation via maternal positive parenting.

A meta-analytic review of parenting interventions in foster care and adoption.

Foster and adoptive parents often face challenges while taking care of children who, due to their adverse early life experiences, are at risk of developing insecure attachment relationships, behavior problems, and stress dysregulation. Several intervention programs have been developed to help foster and adoptive parents to overcome these challenges. In the current study, a series of eight meta-analyses were performed to examine the effectiveness of these intervention programs on four parent outcomes (sensitive parenting, k = 11, N = 684; dysfunctional discipline, k = 4, N = 239; parenting knowledge and attitudes, k = 7, N = 535; parenting stress, k = 18, N = 1,306), three child outcomes (attachment security, k = 6, N = 395; behavior problems, k = 33, N = 2,661; diurnal cortisol levels, k = 3, N = 261), and placement disruption (k = 7, N = 1,100). Results show positive effects for the four parent outcomes and child behavior problems, but not for attachment security, child diurnal cortisol levels, or placement disruption. Indirect effects on child outcomes may be delayed, and therefore long-term follow-up studies are needed to examine the effects of parenting interventions on children.

Child Maltreatment and Mother-Child Transmission of Stress Physiology.

In the current study, we examined the attunement and transmission of mother-child diurnal cortisol among maltreating (N = 165) and nonmaltreating (N = 83) mothers and their preschool-aged children. Over half of the families had a substantiated child maltreatment case with the mother as the perpetrator. Mothers collected three saliva samples (waking, midday, and bedtime) on themselves and their child on two consecutive days, which were later assayed for cortisol. This design allows for the examination of concurrent attunement, as well as cross-lagged transmission, across the day. Results from actor-partner interdependence models revealed significant differences in mother-child cortisol attunement and transmission between the maltreating and nonmaltreating groups. Specifically, only maltreating mothers transmitted cortisol to their children and were attuned at first waking; only nonmaltreating dyads were attuned at midday. Implications of these results for sociocultural models of stress physiology and for our understanding of how child maltreatment affects diurnal cortisol regulation are discussed.

Cognitive control moderates parenting stress effects on children's diurnal cortisol.

This study investigated associations between parenting stress in parents and self-reported stress in children with children's diurnal cortisol secretion and whether these associations are moderated by known stress-regulating capacities, namely child cognitive control. Salivary cortisol concentrations were assessed from awakening to evening on two weekend days from 53 6-to-7-year-old children. Children completed a cognitive control task and a self-report stress questionnaire with an experimenter, while parents completed a parenting stress inventory. Hierarchical, linear mixed effects models revealed that higher parenting stress was associated with overall reduced cortisol secretion in children, and this effect was moderated by cognitive control. Specifically, parenting stress was associated with reduced diurnal cortisol levels in children with lower cognitive control ability and not in children with higher cognitive control ability. There were no effects of self-reported stress in children on their cortisol secretion, presumably because 6-to-7-year-old children cannot yet self-report on stress experiences. Our results suggest that higher cognitive control skills may buffer the effects of parenting stress in parents on their children’s stress regulation in middle childhood. This could indicate that training cognitive control skills in early life could be a target to prevent stress-related disorders.

Children's Transition to School: Relationships Between Preschool Attendance, Cortisol Patterns, and Effortful Control

Aims: To determine whether distinct trends can exist in children's diurnal cortisol slopes as they transition to school, and the extent to which these trends relate to preschool attendance and/or exerted effortful control. Method: A secondary analysis of the anonymised data gathered for the UK Transition to School Study was carried out. 105 children were studied over a 12-month period during transition to school at mean age 55 months. Children's diurnal cortisol slopes were measured as the difference between average salivary cortisol concentrations (SCC) sampled at waking and early evening over two days at each of three measurement time points: 4 months before, 2 weeks after, and 6 months after school entry. Children's effortful control was measured at 2 weeks after school entry using the parent-administered Child Behavior Questionnaire. Parental questionnaires recorded the duration children spent in preschool (months; days per week; hours per week), and four background characteristics: child gender, parental cohabitation, responding parent's age, and responding parent's level of education. Findings: Latent class growth analysis suggested two distinct trends in diurnal cortisol slopes during children's transition to school: 39% of children demonstrated flatter diurnal cortisol slopes. These children were likely to have spent fewer hours per week in preschool, and were likely to exert less effortful control 2 weeks after transitioning to school. These associations underscore the importance of continuity in children's daily routines as they transition to school. Implications are discussed concerning school readiness and the effectiveness of early interventions.

Children's diurnal cortisol responses to negative events at school and home

This study examined the within-and between-person associations between daily negative events – peer problems, academic problems and interparental conflict – and diurnal cortisol in school-age children. Salivary cortisol levels were assessed four times per day (at wakeup, 30min later, just before dinner and at bedtime) on eight days in 47 youths ages 8–13 years old (60% female; M age=11.28, SD=1.50). The relative contributions of within- and between-person variances in each stressor were estimated in models predicting same-day diurnal cortisol slope, same-day bedtime cortisol, and next morning wakeup cortisol. Children who reported more peer problems on average showed flatter slopes of cortisol decline from wakeup to bedtime. However, children secreted more cortisol at wakeup following days when they had reported more peer or academic problems than usual. Interparental conflict was not significantly associated with diurnal cortisol. Findings from this study extend our understanding of short-term cortisol responses to naturally occurring problems in daily life, and help to differentiate these daily processes from the cumulative effects of chronic stress.

Effects of interpersonal violence-related post-traumatic stress disorder (PTSD) on mother and child diurnal cortisol rhythm and cortisol reactivity to a laboratory stressor involving separation

Women who have experienced interpersonal violence (IPV) are at a higher risk to develop posttraumatic stress disorder (PTSD), with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and impaired social behavior. Previously, we had reported impaired maternal sensitivity and increased difficulty in identifying emotions (i.e. alexithymia) among IPV-PTSD mothers. One of the aims of the present study was to examine maternal IPV-PTSD salivary cortisol levels diurnally and reactive to their child's distress in relation to maternal alexithymia. Given that mother-child interaction during infancy and early childhood has important long-term consequences on the stress response system, toddlers' cortisol levels were assessed during the day and in response to a laboratory stressor. Mothers collected their own and their 12–48month-old toddlers' salivary samples at home three times: 30min after waking up, between 2–3pm and at bedtime. Moreover, mother-child dyads participated in a 120-min laboratory session, consisting of 3 phases: baseline, stress situation (involving mother-child separation and exposure to novelty) and a 60-min regulation phase. Compared to non-PTSD controls, IPV-PTSD mothers — but not their toddlers, had lower morning cortisol and higher bedtime cortisol levels. As expected, IPV-PTSD mothers and their children showed blunted cortisol reactivity to the laboratory stressor. Maternal cortisol levels were negatively correlated to difficulty in identifying emotions. Our data highlights PTSD-IPV-related alterations in the HPA system and its relevance to maternal behavior. Toddlers of IPV-PTSD mothers also showed an altered pattern of cortisol reactivity to stress that potentially may predispose them to later psychological disorders.

Mother-child adrenocortical synchrony; Moderation by dyadic relational behavior

Mother-child adrenocortical synchrony, the coupling of cortisol (CT) secretion in mother and child, has been associated with shared parent-child experiences and maladaptive familial contexts. Yet, few studies tested adrenocortical synchrony in diurnal CT patterns. Guided by the bio-behavioral synchrony model, we examined whether mother-child relational behavior and maternal psychopathology may moderate the degree of concordance between mother and child's diurnal CT. Ninety-seven mothers and their six-year old children participated in two groups; mothers diagnosed with major depression disorder (N=28) and non-depressed controls (N=69). Mother-child interactions were observed and coded for dyadic reciprocity and dyadic tension and diurnal cortisol was collected from mother and child over two consecutive weekend days. Concordance between maternal and child's diurnal CT was found, significant above and beyond time of measurement. Maternal depression, while associated with attenuated child diurnal CT variability, was unrelated to adrenocortical synchrony. Higher child diurnal CT production predicted a stronger linkage between maternal and child's diurnal CT, suggesting that greater child physiological stress is associated with increased susceptibility to the influences of maternal stress physiology. Mother-child reciprocity was related to lower adrenocortical synchrony. Findings suggest that higher adrenocortical synchrony is associated with greater physiological stress and less adaptive dyadic relational patterns. Results raise the possibility that diurnal adrenocortical synchrony taps a unique aspect of HPA-axis functioning whose role in the cross-generational transfer of stress physiology requires further research.

Everyday Support to Aging Parents: Links to Middle-Aged Children’s Diurnal Cortisol and Daily Mood

Middle-aged adults are often called upon to support aging parents. However, providing support to an aging parent with health problems and disability may be a stressful experience. This study asked whether giving everyday support to parents in the context of health problems and disability has implications for middle-aged children's diurnal cortisol and daily mood. During four consecutive days, 148 middle-aged adults (mean age = 55) reported the support they gave to their parents and provided saliva 4 times a day (wake, 30 min post-wake, lunchtime, and bedtime). Multilevel models estimated within-person differences in positive affect (PA) and negative affect (NA), cortisol awakening response and area under the curve with respect to ground (AUC-G) as a function of giving same-day and previous-day support. We examined whether these associations are exacerbated when a parent has health problems or activities of daily living (ADL) needs. Middle-aged children had significantly higher next-day AUC-G on days after they gave support to parents with ADL needs. When participants gave support to parents with ADL needs, they had significantly greater same-day PA and lower next-day NA. Giving support to parents with health problems was associated with significantly higher next-day NA. Giving support to parents is an ambiguous experience with implications for biological stress and daily mood. A biopsychosocial approach reveals under what conditions giving support to parents may become detrimental to health and well-being; this knowledge is essential for the development and implementation of interventions.

Children's diurnal cortisol activity during the first year of school

ABSTRACTThe present study examined 4- to 5-year-old British children's diurnal cortisol activity during their first year of school. The children's cortisol was measured before enrollment (baseline), upon enrollment, and both 3 and 6 months after enrollment. On each day, cortisol was sampled four times, providing information about the diurnal amount of cortisol secreted (AUCG). Mixed-effect models were constructed to examine the way children's cortisol fluctuated over the course of the school year. Physiological activity was greater 3 months after enrollment, suggesting that some children reacted more to the challenge of school later than they did initially. Implications and suggestions for transitional practices and future research are discussed.