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Behavioral Intervention Normalizes Stress-related Hormone in High-Risk Kids

Family Intervention that Improves Behavior, Social Skills Also Improves Cortisol Patterns

Science Update

A family-based behavioral intervention that helps prevent social and behavior problems in high-risk preschoolers also may help normalize their cortisol levels when they anticipate stressful situations, results of a new NIMH study suggest.  Cortisol is a hormone that regulates response to stress.  Imbalances in stress regulation are thought to contribute to the development of some mental disorders, such as anxiety disorders and depression.

Results of the study were published in the October issue of Archives of General Psychiatry by NIMH investigators Laurie Miller Brotman, PhD, and Daniel S. Pine, MD, and colleagues.

Studies show that children who are developing normally and are at low risk of developing antisocial behavior and conduct problems have a boost in cortisol when facing stress.  However, some studies have shown that the boost in cortisol does not occur in children at high risk of developing these problems.

The preschoolers in this study were told they would be playing with an unfamiliar group of children later, a stressful situation for this age group.  Children were identified as high risk for psychopathology if they had been exposed to a combination of several risk factors; for example, parenting practices that promote behavior problems, siblings in trouble with the law, mothers with mental disorders, and poverty.

About half of the 92 high-risk children and their families were offered almost six months of a weekly intervention shown by previous research to improve parenting practices and children’s social skills.  The other half of the group did not receive the intervention.

When anticipating the play session, high-risk children who had gone through the intervention had cortisol boosts similar to those in low-risk children.  But children who had not gone through the intervention lacked this normal increase in cortisol.

“This anticipatory increase in cortisol may have developed in us as a signal that stress is warranted – that something in our environment is important and we need to pay attention to it,” Pine said.  “Children who don’t show this pattern may be less biologically equipped to adapt to stressful situations. That a family-based intervention was found to alter this important neurobiological system provides a window on the dynamic interaction of environment, behavior, and brain to shape the course of adaptive development in children.”


Brotman LM, Gouley KK, Chesir-Teran D, Kamboukos D, Huang KY, Fratto C, Pine DS.  Effects of a psychosocial family-based preventive intervention on cortisol response to a social challenge in preschoolers at high risk for psychopathology.  Archives of General Psychiatry, October 2007.