Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T15:52:47.389Z Has data issue: false hasContentIssue false
  • English
  • Français

Intervention effects on foster parent stress: Associations with child cortisol levels

Published online by Cambridge University Press:  07 July 2008

Philip A. Fisher  and
Mike Stoolmiller
Philip A. Fisher*
Affiliation:
Oregon Social Learning Center and Center for Research to Practice
Mike Stoolmiller
Affiliation:
University of Oregon
*
Address correspondence and reprint requests to: Philip A. Fisher, Oregon Social Learning Center, 10 Shelton Mc Murphey Boulevard, Eugene, OR 97401; E-mail: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Foster children exhibit high rates of atypical neuroendocrine functioning compared to children in the general population. In particular, alterations in the daytime diurnal activity of the hypothalamic–pituitary–adrenal (HPA) axis have been observed in foster children, often characterized by blunted salivary cortisol levels (i.e., low morning levels that remain low throughout the day). There is emerging evidence that therapeutic interventions for foster children can affect this pattern of HPA axis activity, but the specific intervention components responsible for change have not been fully explicated. Within a randomized trial to evaluate a therapeutic intervention for foster preschoolers (n = 57 intervention condition; n = 60 comparison condition; n = 60 community comparison condition), the present study examined whether diurnal cortisol activity was associated with caregiver self-reported stress in response to child problem behavior. Results showed immediate reductions in caregiver stress that were sustained through 12 months postbaseline in the intervention condition. In contrast, caregivers in the regular foster care condition showed higher rates of stress across time and increased stress sensitivity to child problem behaviors. In addition, among caregivers in regular foster care, higher self-reported stress was associated with lower morning cortisol levels and more blunted diurnal cortisol activity. These results provide evidence that interventions can simultaneously impact caregiver stress and buffer children from the negative impacts of caregiver stress on HPA axis regulation.

Type
Research Article
Information
Development and Psychopathology , Volume 20 , Issue 3 , Summer 2008 , pp. 1003 - 1021
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Support for this research was provided by the following grants: NIMH MH059780, NICHD HD045894, and NIDA DA021424 and DA017592. We thank Matthew Rabel for editorial assistance and Kristen Greenley and the staff and families of the Multidimensional Treatment Foster Care for Preschoolers project for their ongoing dedication and participation.

References

Becker, W. C., Madsen, C. H., Arnold, C. R., & Thomas, D. R. (1967). The contingent use of teacher attention and praise in reducing classroom behavior problems. Journal of Special Education, 1, 287–307.CrossRefGoogle Scholar
Bower, G. H. (1981). Mood and memory. American Psychologist, 36, 129–148.CrossRefGoogle ScholarPubMed
Bruce, J., Kroupina, M., Parker, S., & Gunnar, M. (2000, July). The relationships between cortisol patterns, growth retardation, and developmental delays in postinstitutionalized children. Paper presented at the International Conference on Infant StudiesBrighton, UK.Google Scholar
Bruce, J., Fisher, P. A., Pears, K. C., & Levine, S. (2007). Morning cortisol levels in preschool-aged foster children: Differential effects of maltreatment type. Manuscript submitted for publication.Google Scholar
Carlson, M., & Earls, F. (1997). Psychological and neuroendocrinological sequelae of early social deprivation in institutionalized children in Romania. Annals of Neuroscience Abstracts, 218, 12.Google Scholar
Chamberlain, P., Moreland, S., & Reid, K. (1992). Enhanced services and stipends for foster parents: Effects on retention rates and outcomes for children. Child Welfare, 5, 387–401.Google Scholar
Chamberlain, P., Price, J. M., Reid, J. B., Landsverk, J., Fisher, P. A., & Stoolmiller, M. (2006). Who disrupts from placement in foster and kinship care? Child Abuse and Neglect, 30, 409–424.CrossRefGoogle ScholarPubMed
Chamberlain, P., & Reid, J. B. (1987). Parent observation and report of child symptoms. Behavioral Assessment, 9, 97–109.Google Scholar
Chamberlain, P., & Reid, J. B. (1991). Using a specialized foster care community treatment model for children and adolescents leaving the state mental hospital. Journal of Community Psychology, 19, 266–276.3.0.CO;2-5>CrossRefGoogle Scholar
Cicchetti, D., & Hinshaw, S.P. (2002). Prevention and intervention science: Contributions to developmental theory [Editorial]. Development and Psychopathology, 14, 667–671.CrossRefGoogle ScholarPubMed
Cicchetti, D., & Rogosch, F. A. (1999). Psychopathology as risk for adolescent substance use disorders: A developmental psychopathology perspective. Journal of Clinical Child Psychology, 28, 355–365.CrossRefGoogle ScholarPubMed
Danforth, J. S., Harvey, E., Ulaszek, W. R., & McKee, T. E. (2006). The outcome of group parent training for families of children with attention-deficit hyperactivity disorder and defiant/aggressive behavior. Journal of Behavior Therapy and Experimental Psychiatry, 37, 188–205.CrossRefGoogle ScholarPubMed
de Kloet, E. R. (1991). Brain corticosteroid receptor balance and homeostatic control. Frontiers in Neuroendocrinology, 12, 95–164.Google Scholar
Dozier, M., Albus, K., Fisher, P. A., & Sepulveda, S. (2002). Interventions for foster parents: Implications for developmental theory. Development and Psychopathology, 14, 843–860.CrossRefGoogle ScholarPubMed
Dozier, M., & Lindhiem, O. (2006). This is my child: Differences among foster parents in commitment to their young children. Child Maltreatment, 11, 338–345.CrossRefGoogle ScholarPubMed
Fisher, P. A., Burraston, B., & Pears, K. C. (2005). The Early Intervention Foster Care Program: Permanent placement outcomes from a randomized trial. Child Maltreatment, 10, 61–71.CrossRefGoogle ScholarPubMed
Fisher, P. A., & Chamberlain, P. (2000). Multidimensional Treatment Foster Care: A program for intensive parent training, family support, and skill building. Journal of Emotional and Behavioral Disorders, 8, 155–164.CrossRefGoogle Scholar
Fisher, P. A., Ellis, B. H., & Chamberlain, P. (1999). Early Intervention Foster Care: A model for preventing risk in young children who have been maltreated. Children's Services: Social Policy, Research, and Practice, 2, 159–182.CrossRefGoogle Scholar
Fisher, P. A., Gunnar, M. R., Dozier, M., Bruce, J., & Pears, K. C. (2006). Effects of a therapeutic intervention for foster children on behavior problems, caregiver attachment, and stress regulatory neural systems. Annals of the New York Academy of Sciences, 1094, 215–225.CrossRefGoogle ScholarPubMed
Fisher, P. A., & Kim, H. K. (2007). Intervention effects on foster preschoolers' attachment-related behaviors from a randomized trial. Prevention Science, 8, 161–170.CrossRefGoogle ScholarPubMed
Fisher, P. A., Stoolmiller, M., Gunnar, M. R., & Burraston, B. (2007). Effects of a therapeutic intervention for foster preschoolers on diurnal cortisol activity. Psychoneuroendocrinology, 32, 892–905.CrossRefGoogle ScholarPubMed
Forgatch, M. S., & Toobert, D. J. (1979). A cost-effective parent training program for use with normal preschool children. Journal of Pediatric Psychology, 4, 129–145.CrossRefGoogle Scholar
Friese, E., Hesse, J., Hellhammer, J., & Hellhammer, D. (2005). A new view on hypocortisolism. Psychoneuroendocrinology, 30, 1010–1016.CrossRefGoogle Scholar
Gaab, J., Blättler, N., Menzi, T., Pabst, B., Stoyer, S., & Ehlert, U. (2003). Randomized controlled evaluation of the effects of cognitive–behavioral stress management on cortisol responses to acute stress in healthy subjects. Psychoneuroendocrinology, 28, 767–779.CrossRefGoogle ScholarPubMed
Gaab, J., Sonderegger, L., Scherrer, S., & Ehlert, U. (2006). Psychoneuroendocrine effects of cognitive–behavioral stress management in a naturalistic setting—A randomized controlled trial. Psychoneuroendocrinology, 31, 428–438.CrossRefGoogle Scholar
George, S., van Oudenhoven, N., & Wazir, R. (2001, July). Stakeholders in foster care: An international comparative study. Paper presented at the Meeting of the International Federation of Foster Care OrganizationsVeldhoven, The Netherlands.Google Scholar
Gunnar, M., & Donzella, B. (2002). Social regulation of the cortisol levels in early human development. Psychoneuroendocrinology, 27, 199–220.CrossRefGoogle ScholarPubMed
Gunnar, M. R., Fisher, P. A., & The Early Experience, Stress, and Prevention Science Network. (2006). Bringing basic research on early experience and stress neurobiology to bear on preventive intervention research on neglected and maltreated children. Development and Psychopathology, 18, 651–677.CrossRefGoogle ScholarPubMed
Gunnar, M. R., Morison, S. J., Chisholm, K., & Schuder, M. (2001). Salivary cortisol levels in children adopted from Romanian orphanages. Development and Psychopathology, 13, 611–627.CrossRefGoogle ScholarPubMed
Gunnar, M. R., & Vazquez, D. M. (2001). Low cortisol and a flattening of expected daytime rhythm: Potential indices of risk in human development. Development and Psychopathology, 13, 515–737.CrossRefGoogle Scholar
Halme, N., Tarkka, M.-T., Nummi, T., & Åstedt-Kurki, P. (2006). The effect of parenting stress on fathers' availability and engagement. Child Care in Practice, 12, 13–26.CrossRefGoogle Scholar
Hammerfald, K., Eberle, C., Grau, M., Kinsperger, A., Zimmermann, A., Ehlert, U., et al. (2005). Persistent effects of cognitive-behavioral stress management on cortisol responses to acute stress in healthy subjects—A randomized controlled trial. Psychoneuroendocrinology, 31, 333–339.CrossRefGoogle ScholarPubMed
Herman, J. P., & Cullinan, W. E. (1997). Neurocircuitry of stress: Central control of the hypothalamo–pituitary–adrenocortical axis. Trends in Neurosciences, 20, 78–84.CrossRefGoogle ScholarPubMed
Insightful Corporation. (2001). S-PLUS 6 for Windows user's guide. Seattle, WA: Author.Google Scholar
Keller, T. E., Spieker, S. J., & Gilchrist, L. (2005). Patterns of risk and trajectories of preschool problem behaviors: A person-oriented analysis of attachment in context. Development and Psychopathology, 17, 249–384.CrossRefGoogle ScholarPubMed
Kertes, D. A., Gunnar, M., & Madsen, N. J. (2007). Early deprivation and home basal cortisol levels: A study of internationally-adopted children. Manuscript submitted for publication.Google Scholar
Klee, L., Kronstadt, D., & Zlotnick, C. (1997). Foster care's youngest: A preliminary report. American Journal of Orthopsychiatry, 67, 290–299.CrossRefGoogle ScholarPubMed
Landsverk, J. A., Garland, A. F., & Leslie, L. K. (2002). Mental health services for children reported to child protective services. In Meyers, J. & Briere, J. (Eds.), APSAC handbook on child maltreatment (2nd ed.). Thousand Oaks, CA: Sage.Google Scholar
Levine, S. (2005). Developmental determinants of sensitivity and resistance to stress. Psychoneuroendocrinology, 30, 939–946.CrossRefGoogle ScholarPubMed
Malik, N. M., Boris, N. W., Heller, S. S., Harden, B. J., Squires, J., Chazan-Cohen, R., et al. (2007). Risk for maternal depression and child aggression in Early Head Start families: A test of ecological models. Infant Mental Health Journal, 28, 171–191.CrossRefGoogle ScholarPubMed
McClowry, S., Snow, D. L., & Tamis-LeMonda, C. S. (2005). An evaluation of the effects of “INSIGHTS” on the behavior of inner city primary school children. Journal of Primary Prevention, 26, 567–584.CrossRefGoogle ScholarPubMed
Meaney, M., & Szyf, M. (2005). Environmental programming of stress responses through DNA methylation: Life at the interface between a dynamic environment and a fixed genome. Dialogues in Clinical Neuroscience, 7, 103–123.CrossRefGoogle Scholar
Meltzer, L. J., & Mindell, J. A. (2007). Relationship between child sleep disturbances and maternal sleep, mood, and parenting stress: A pilot study. Journal of Family Psychology, 21, 67–73.CrossRefGoogle ScholarPubMed
Mommersteeg, P. M. C., Keijsers, G. P. J., Heijnen, C. J., Verbraak, M. J. P. M., & van Doornen, L. J. P. (2006). Cortisol deviations in people with burnout before and after psychotherapy: A pilot study. Health Psychology, 25, 243–248.CrossRefGoogle ScholarPubMed
O'Connor, T. G., Ben-Shlomo, Y., Heron, J., Golding, J., Adams, D., & Glover, V. (2005). Prenatal anxiety predicts individual differences in cortisol in pre-adolescent children. Biological Psychiatry, 58, 211–217.CrossRefGoogle ScholarPubMed
Owen, A. E., Thompson, M. P., & Kaslow, N. J. (2006). The mediating role of parenting stress in the relation between intimate partner violence and child adjustment. Journal of Family Psychology, 20, 505–513.CrossRefGoogle ScholarPubMed
Patterson, G. R. (1976). The aggressive child: Victim and architect of a coercive system. In Mash, E. J., Hamerlynck, L. A., & Handy, L. C. (Eds.), Behavior modification and families. I. Theory and research. II. Applications and developments (pp. 265–316). New York: Brunner/Mazel.Google Scholar
Patterson, G. R. (1982). Coercive family process. Eugene, OR: Castalia.Google Scholar
Pinheiro, J. C., & Bates, D. M. (2000). Mixed-effects models in S and S-PLUS (Statistics and Computing). New York: Springer.CrossRefGoogle Scholar
R Development Core Team. (2005). R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing.Google Scholar
Rosenfeld, P., Suchecki, D., & Levine, S. (1992). Multifactorial regulation of the hypothalamic–pituitary–adrenal axis during development. Neuroscience and Biobehavioral Reviews, 16, 553–568.CrossRefGoogle ScholarPubMed
Sameroff, A. J. (1975). Early influences on development: Fact or fancy? Merrill–Palmer Quarterly, 21, 267–294.Google Scholar
Sameroff, A. J., & Chandler, M. J. (1975). Reproductive risk and the continuum of caretaking casualty. In Horowitz, F. D. (Ed.), Child development research (Vol. 4, pp. 187–244). Chicago: University of Chicago Press.Google Scholar
Sapolsky, R. M., & Meaney, M. J. (1986). Maturation of the adrenocortical stress response: Neuroendocrine control mechanisms and the stress hyporesponsive period. Brain Research Reviews, 11, 65–76.CrossRefGoogle Scholar
Schafer, J. L., & Graham, J. W. (2002). Missing data: Our view of the state of the art. Psychological Methods, 7, 147–177.CrossRefGoogle ScholarPubMed
Schwartz, E. P., Granger, D. A., Susman, E. J., Gunnar, M. R., & Laird, B. (1998). Assessing salivary cortisol in studies of child development. Child Development, 69, 1503–1513.CrossRefGoogle ScholarPubMed
Secco, M. L., Askin, D., Yu, C. T., Garinger, J., Mulaire-Cloutier, C., Scharf, L., et al. (2006). Factors affecting parenting stress among biologically vulnerable toddlers. Issues in Comprehensive Pediatric Nursing, 29, 131–156.CrossRefGoogle Scholar
Sharry, J., Guerin, S., Griffin, C., & Drumm, M. (2005). An evaluation of the Parents Plus Early Years Programme: A video-based early intervention for parents of pre-school children with behavioural and developmental difficulties. Clinical Child Psychology and Psychiatry, 10, 319–336.CrossRefGoogle Scholar
Smotherman, W. P., & Bell, R. W. (1980). Maternal mediation of early experience. In Bell, R. W. & Smotherman, W. P. (Eds.), Maternal influences and early behavior (pp. 201–210). New York: Spectrum.CrossRefGoogle Scholar
Soliday, E., McCluskey-Fawcett, K., & Meck, N. (1994). Foster mothers' stress, coping, and social support in parenting drug-exposed and other at-risk toddlers. Children's Health Care, 23, 15–32.CrossRefGoogle Scholar
Stone, A. A., Broderick, J. E., Kaell, A. T., DelesPaul, P. A., & Porter, L. E. (2000). Does the peak-end phenomenon observed in laboratory pain studies apply to real-world pain in rheumatoid arthritics? Journal of Pain, 1, 212–217.CrossRefGoogle ScholarPubMed
Tu, M. T., Grunau, R. E., Petrie-Thomas, J., Haley, D. W., Weinberg, J., & Whitfield, M. F. (2007). Maternal stress and behavior modulate relationships between neonatal stress, attention, and basal cortisol at 8 months in preterm infants. Developmental Psychobiology, 49I, 150–164.CrossRefGoogle Scholar
Turner, A. M., & Greenough, W. T. (1985). Differential rearing effects on rat visual cortex synapses. I. synaptic and neuronal density and synapses per neuron. Brain Research, 329, 195–203.CrossRefGoogle ScholarPubMed
US Department of Health and Human Services, Administration on Children, Youth and Families. (2005). Child maltreatment 2003. Washington, DC: US Government Printing Office.Google Scholar
Weinrott, M., Bauske, B., & Patterson, G. R. (1979). Systematic replication of a social learning approach to parent training. In Bates, S. L., Sjoden, P. O., & Dockens, W. S. III (Eds.), Trends in behavior therapy (pp. 331–351). New York: Academic Press.Google Scholar