Under conditions of suboptimal parental care, children with specific temperamental features have been shown to be especially vulnerable to the effects of stress. Most studies of temperamentally vulnerable children have been conducted using parental questionnaires, which are unfortunately not completely objective. An alternative approach, the use of objective methods for assessing temperament in childhood, can and should be used to study the impact of poor parenting quality on children's stress levels, an important factor in child development. Although studies using such objective methods exist, they are quite rare. A PubMed search identified twelve articles reviewed here. Existing data indicate that, in general, higher basal cortisol and cortisol stress response are associated with "reactive" temperament: shyness, fearfulness, behavioral inhibition, and negative affectivity. Furthermore, child temperament interacts with the quality of parental care to predict cortisol levels in early childhood. Accordingly, in the context of inadequate parental care, temperamentally vulnerable children with "reactive" temperaments are particularly at risk for negative effects of stress. Studies of stress-by-parental-care-interactions are essential for preventing long-term mental problems and problems with physical health that could occur in temperamentally vulnerable children who receive suboptimal parental care.
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