The role of early stressors in child health and mental health outcomes.
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Biomedical subjects
Publications and source records attributed to Mary Dozier.
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Young children in foster care have often experienced inadequate early care and separations from caregivers. Preclinical studies suggest that early inadequate care and separations are associated with long-term changes in regulation of the hypothalamic-pituitary-adrenal (HPA) axis. In this study, the daytime pattern of cortisol production was examined among 55 young children who had been placed into foster care and 104 children who had not. Saliva samples were taken at wake-up, in the afternoon, and bedtime for 2 days. Average salivary cortisol values for each time of day were computed. A group (foster vs. comparison) time (morning, afternoon, night) interaction emerged, reflecting less decline in levels across the day for foster than comparison children. Daytime patterns were categorized as typical, low, or high. Children who had been in foster care had higher incidences of atypical patterns of cortisol production than children who had not. These differences suggest that conditions associated with foster care interfere with children's ability to regulate neuroendocrine functioning.
In this study, the authors examined variables associated with foster mothers' level of commitment to their young foster children, who ranged in age from 5 months to 5 years. Commitment was assessed using a semistructured interview known as the "This Is My Baby" interview (TIMB; Bates & Dozier, 1998). Among 84 foster parent-child dyads, foster mothers who had fostered more children previously showed lower levels of commitment than did foster mothers who had fostered fewer children. Commitment also was associated with child age at placement, with foster parents showing higher levels of commitment to children who were placed at younger ages than to children who were placed at older ages. Commitment predicted the stability of the relationship, with higher levels of commitment associated with a greater likelihood of adoption or long-term placement. These results suggest the importance of designing a child welfare system that will enhance caregivers' ability to commit to the children for whom they provide care.
We examined the effects of using flavored drink crystals as a salivary stimulant on salivary cortisol values. The effects of both amount and method of flavored crystal administration on cortisol values were evaluated using a high sensitivity enzyme immunoassay (EIA) kit to measure cortisol. Repeated saliva sampling, one sample without the drink crystal stimulant, followed immediately by a second sample using the drink crystal stimulant, allowed direct analysis of the effect of the stimulant on cortisol values. Repeated sampling, with the stimulant used when obtaining both the first and second samples, allowed analysis of the repeatability of cortisol measurements using the drink crystals. The results suggest that the use of drink mix crystals as an oral stimulant causes a small increase in measured cortisol values, as well as an increase in the variability of these values. The results also suggest that the effect of drink crystals is sufficiently regular so that it will not distort either within or between subject comparisons as long as there is consistency in use or non-use of the stimulant.
This study investigated the development of attachment relationships in 38 foster infant-caregiver dyads over the first 2 months of placement. We used the Parent Attachment Diary to measure foster infants' daily attachment behaviors, the Adult Attachment Interview to examine foster parents' attachment states of mind, and Ainsworth's Strange Situation to capture attachment classifications. We examined differences in diary scales (secure, avoidant, resistant, and coherence) as they related to age at placement and foster parent attachment, using hierarchical linear modeling and analyses of variance. The results indicated infants with autonomous foster parents and infants placed at younger ages showed higher early and overall levels of secure behavior, less avoidant behavior, and more coherent attachment strategies compared to infants placed with nonautonomous foster parents. Changes in attachment behaviors over time were not predicted by the models; however, there was a significant decrease in the daily coherence of attachment behaviors associated with Strange Situation disorganization. Finally, we found significant concordance between the diary and Strange Situation scales for secure and avoidant behaviors.
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All children who enter foster care have experienced disruptions in their relationships with caregivers, and many have experienced maltreatment. Studying the effects of these adverse early experiences can inform developmental theory. In particular, insight can be provided regarding sensitive periods in the development of attachment and self-regulatory capabilities. The quality of surrogate caregivers varies as a function of both the intervention services provided and foster parent characteristics. Studying the effects of foster parent quality can suggest which aspects of child functioning are more or less canalized at various developmental periods. This paper considers salient developmental issues of infancy, preschool years, middle childhood, and adolescence and examines ways in which these issues may present special difficulties for foster children. Across development, foster care is associated with difficulties regulating behaviors, emotions, and physiology. Thus, conditions associated with foster care placement (e.g., disruptions in care, maltreatment) appear to affect very basic and fundamental regulatory processes. Interventions have been designed that target developmentally specific manifestations of regulatory difficulties. Although the literature regarding evidence-based interventions for foster parents is quite limited, preliminary findings provide some evidence that nurturing, responsive care can serve to partially remediate early deficits. These findings suggest that stable and nonfrightening care is essential for normal development. Nonetheless, even in the case of quite adverse early experience that results in problematic child outcomes, there is some evidence that the development of many systems remains relatively plastic.
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