Cortisol as a Biomarker for Stress During the Assessment and Treatment of Destructive Behavior

Behavior-analytic treatments successfully reduce individuals' destructive behavior (e.g., self-injurious behavior, aggression, property destruction, disruption); however, there is limited research evaluating these treatments' effects on individuals' physiological stress responses, even though stress can have significant negative impacts on quality of life. Research from other fields has demonstrated that salivary cortisol concentration is a valid biomarker for stress, so researchers could potentially use this biomarker to assess the stress of individuals with limited communication repertoires who also engage in destructive behavior. The purpose of this research was to assess changes in salivary cortisol concentrations as a biomarker for stress with two participants to evaluate whether conditions that evoke destructive behavior induce stress relative to conditions that do not evoke destructive behavior. For one participant, salivary cortisol concentrations tended to increase following exposures to stimuli that evoked destructive behavior compared to conditions that did not evoke destructive behavior. The other participant had elevated salivary cortisol concentrations across all conditions. Salivary cortisol may be a useful biomarker for evaluating physiological stress as an outcome measure during research on the assessment and treatment of destructive behavior.