Effects of a psychosocial family-based preventive intervention on cortisol response to a social challenge in preschoolers at high risk for antisocial behavior

Context: Salivary cortisol levels during social challenge relate to adaptive functioning in children and adults. Low cortisol levels have been related to conduct problems and antisocial behavior. Although studies in rodents implicate early- life social experience in cortisol regulation, no studies with humans have examined the effects of an experimentally manipulated early- life social experience on cortisol regulation. Objective: To examine the effects of experimental manipulations of social experience on cortisol response to a social challenge in preschoolers at risk for antisocial behavior. Design: Randomized controlled trial. Setting: Department of Child and Adolescent Psychiatry, New York University School of Medicine. Participants: Ninety- two preschool- age siblings of youths adjudicated for delinquent acts. Intervention: Family- based intervention included 22 weekly group sessions for parents and preschoolers and 10 biweekly home visits conducted during a 6- to 8- month period. Main Outcome Measures: Salivary cortisol levels before and after a social challenge ( entry into an unfamiliar peer group). Results: Relative to controls, children in the intervention condition had increased cortisol levels in anticipation of the peer social challenge. Increases were relative to both preintervention cortisol levels during the challenge and cortisol levels in the home, which were not altered by the intervention. Conclusions: A family- based preventive intervention for children at high risk for antisocial behavior alters stress response in anticipation of a peer social challenge. The experimentally induced change in cortisol levels parallels patterns found in normally developing, low- risk children.