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Effects of an attachment-based intervention on the cortisol production of infants and toddlers in foster care

  • Mary Dozier (a1), Elizabeth Peloso (a1), Erin Lewis (a1), Jean-Philippe Laurenceau (a1) and Seymour Levine (a2)...


Studies with nonhuman primates and rodents, as well as with human children, have suggested that early separations from caregivers are often associated with changes in the functioning of the hypothalamus–pituitary–adrenal (HPA) axis. On the basis of these findings, we designed a relational intervention that was intended to normalize HPA functioning among children in foster care. This paper presents findings from a randomized clinical trial that assessed the effectiveness of a relational intervention (Attachment and Biobehavioral Catch-up [ABC]) with regard to HPA functioning. The ABC intervention was intended to enhance children's ability to regulate physiology and behavior. The control intervention (Developmental Education for Families) was intended to enhance children's cognitive skills. A comparison group of children who had never been in foster care was also included. Children's cortisol production was assessed upon arrival at the lab, and 15 and 30 min following the Strange Situation. Random effects analyses of variance were performed to assess differences in initial values and change between children in the two intervention groups. Children in the ABC intervention and comparison group children showed lower initial values of cortisol than children in the treatment control group, considering arrival at lab as initial values (p < .05). Groups did not differ significantly in change over time. These results suggest that the ABC intervention is effective in helping children regulate biology in ways more characteristic of children who have not experienced early adversity.


Corresponding author

Address correspondence and reprint requests to: Mary Dozier, Department of Psychology, 114 Wolf Hall, University of Delaware, Newark, DE 19716; E-mail:


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Support for this research was provided by NIMH R01 52135 and NIMH K02 74374 to the first author, and by NIMH Network Grant 65046 (Gunnar and Fisher, co-Principal Investigators). We acknowledge the support of the Philadelphia Department of Human Services and Delaware Division of Family Services and the caseworkers, foster families, and children at both agencies.



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