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The persistent associations between early institutional care and diurnal cortisol outcomes among children adopted
Jennifer Isenhour1, K Lee Raby1, Mary Dozier2
1Department of Psychology, University of Utah, Salt Lake City, UT, USA.
Insights
Early institutionalization negatively impacts the hypothalamic-pituitary-adrenoadrenal (HPA) axis, leading to lasting effects on cortisol regulation even years after adoption into supportive families.
Area of Science:
- Developmental Psychology
- Neuroendocrinology
- Child Psychiatry
Background:
- Institutional care disrupts critical attachment needs in young children.
- Early adversity, such as institutionalization, is linked to long-term dysregulation of the hypothalamic-pituitary-adrenocortical (HPA) axis.
Purpose of the Study:
- To investigate the persistent effects of early institutionalization on diurnal HPA axis functioning in internationally adopted children.
- To examine how the duration of institutional care influences cortisol levels and patterns post-adoption.
Main Methods:
- Longitudinal study of 130 internationally adopted children (aged 6-48 months at adoption).
- Collection of daily salivary cortisol samples at two time points: shortly after adoption and approximately 3 years later.
- Comparison of HPA axis outcomes between children with varying durations of institutional care.
Main Results:
- Children with longer institutionalization showed lower morning cortisol and blunted diurnal cortisol decline shortly after adoption.
- These children continued to exhibit low morning and bedtime cortisol levels 3 years post-adoption.
- Findings suggest a downregulation of the HPA axis due to early institutional adversity.
Conclusions:
- Early institutionalization has persistent negative consequences on HPA axis regulation.
- The effects of institutionalization on cortisol patterns can endure for several years, even after adoption into nurturing environments.
- This research highlights the profound and lasting impact of early life adversity on neuroendocrine development.
Abstract:
Young children in institutional care experience conditions that are incompatible with their needs for attachment relationships. As a result, early institutionalization is expected to have lasting effects on the regulation of the hypothalamic-pituitary-adrenocortical (HPA) axis. The current study tested whether early institutionalization has persistent consequences for diurnal HPA axis outcomes among 130 children who had been adopted internationally between the ages of 6 and 48 months. Daily cortisol samples were collected from children at two time points: shortly after adoption (average of 5.3 months after adoption) and approximately 3 years later (average of 39.2 months after adoption). Shortly after adoption, children who had experienced a long duration of institutional care had lower morning cortisol levels and more blunted declines in cortisol across the day than children who experienced minimal or no institutional care. Three years later, children who had experienced a long duration of institutionalization continued to exhibit low morning cortisol levels and also exhibited low bedtime cortisol levels. Altogether, these results support the idea that early adversity results in the downregulation of the HPA axis and suggest that the effects of institutionalization on HPA axis functioning may persist several years after children are adopted into highly enriched families.
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