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The relationship between diurnal cortisol slope and cognitive development among children maltreated as infants

Jane Jiyoun Lee1, Eirini Flouri2

  • 1Child Maltreatment Solutions Network, Social Science Research Institute, Pennsylvania State University, 202 Henderson Building, University Park, PA, 16802.

Children and Youth Services Review
|March 6, 2023
PubMed

Insights

Children's diurnal cortisol slope, reflecting hypothalamic-pituitary-adrenal (HPA) axis functioning, is linked to cognitive development. A steeper cortisol decline in maltreated children was associated with better applied problem-solving and communication skills.

Area of Science:

  • Developmental Psychology
  • Neuroendocrinology
  • Child Welfare Research

Background:

  • The hypothalamic-pituitary-adrenal (HPA) axis plays a crucial role in stress response and development.
  • Limited research exists on HPA axis functioning and cognitive development in vulnerable children, particularly those involved with child protective services.
  • Early life stress and maltreatment can significantly impact HPA axis regulation and long-term cognitive outcomes.

Purpose of the Study:

  • To investigate the association between diurnal cortisol slope and cognitive development in 5- and 6-year-old children with a history of infant maltreatment and child protective services involvement.
  • To explore how HPA axis functioning, as indicated by cortisol patterns, relates to specific cognitive abilities in this vulnerable population.

Main Methods:

  • Utilized data from the National Survey of Child and Adolescent Well-Being (NSCAW) I, including 158 children.
  • Employed multiple regression analyses to examine the relationship between diurnal salivary cortisol slope (morning to evening) and various cognitive outcome measures.
  • Controlled for potential confounding factors in the analyses.

Main Results:

  • A steeper decline in diurnal cortisol was positively associated with higher scores in applied problems and expressive communication.
  • A greater decline in diurnal cortisol was also linked to lower odds of cognitive disability.
  • No significant associations were found between diurnal cortisol slope and letter-word identification, passage comprehension, auditory comprehension, matrices, or vocabulary.

Conclusions:

  • HPA axis dysregulation, suggested by altered diurnal cortisol patterns, may be present in children exposed to early life stress and involved with child protective services.
  • These HPA axis alterations may specifically impact certain cognitive functions, such as applied problem-solving and expressive communication, while others remain unaffected.
  • Findings highlight the complex interplay between early adversity, HPA axis functioning, and cognitive development, with implications for intervention and policy for at-risk children.

Keywords:
NSCAWchild maltreatmentcognitive developmentsalivary cortisoltoxic stress

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