Cortisol Production Patterns in Young Children Living With Birth Parents vs Children Placed in Foster Care Following Involvement of Child Protective Services

Bernard, Kristin MA
Butzin-Dozier, Zachary
Rittenhouse, Joseph
Dozier, Mary PhD

Author Affiliations: Department of Psychology, University of Delaware, Newark.

Correspondence: Kristin Bernard, MA, Department of Psychology, University of Delaware, 108 Wolf Hall, Newark, DE 19716 ([email protected]).

Accepted for Publication: January 21, 2010.

Author Contributions:Study concept and design: Bernard and Dozier. Acquisition of data: Bernard, Butzin-Dozier, and Rittenhouse. Analysis and interpretation of data: Bernard, Butzin-Dozier, Rittenhouse, and Dozier. Drafting of the manuscript: Bernard, Butzin-Dozier, Rittenhouse, and Dozier. Critical revision of the manuscript for important intellectual content: Bernard and Dozier. Statistical analysis: Bernard. Obtained funding: Dozier. Study supervision: Dozier.

Financial Disclosure: None reported.

Funding/Support: This work was supported by grants R01MH052135, R01MH074347, and R01MH084135 from the National Institute of Mental Health (Dr Dozier).

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health.

Archives of Pediatrics & Adolescent Medicine 164(5):p 438-443, May 2010.

Objective

To examine differences in waking to bedtime cortisol production between children who remained with birth parents vs children placed in foster care following involvement of Child Protective Services (CPS).

Design

Between-subject comparison of cortisol patterns among 2 groups of children.

Setting

Children referred from the child welfare system.

Participants

Three hundred thirty-nine children aged 2.9 to 31.4 months who were living with birth parents (n = 155) or placed in foster care (n = 184) following CPS involvement as well as 96 unmatched children from low-risk environments.

Main Exposures

Involvement by CPS and foster care.

Main Outcome Measure

Salivary cortisol samples obtained at waking and bedtime for children on 2 days.

Results

Child Protective Services–involved children who continued to live with birth parents and CPS-involved children placed in foster care differed in cortisol production, with children living with their birth parents showing flatter slopes in waking to bedtime values.

Conclusions

Continuing to live with birth parents following involvement of CPS is associated with greater perturbation to the diurnal pattern of cortisol production than living with foster parents. Foster care may have a regulating influence on children's cortisol among children who have experienced maltreatment.