A pilot study of stress system activation in children enrolled in a targeted prevention program: Implications for personalization

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Empirically validated interventions addressing childhood psychological problems are now readily available, but success likely depends in part on accurately identifying which children will benefit from which intervention. This pilot study examined the stress activation and response system, first as a way to differentiate high versus low-risk children, and second to explore indicators of the stress system associated with favorable intervention response. Method. Participants (N = 43, 58% male) were school-aged children who qualified for inclusion in the Early Risers “Skills for Success” Prevention Program based on their elevated levels of aggressive and/or socially withdrawn behavior and a normally developing comparison group. Compared to the normally developing group, children who were participants in the intervention exhibited a more blunted cortisol response to the stress paradigm. However, for the children in the intervention group, elevated cortisol levels at the start of the stress paradigm were concurrently associated with internalizing problems and predictive of improvement in internalizing problems over time. These findings provide preliminary evidence that hypothalamic pituitary adrenal (HPA) axis biological variables may be helpful tools for identifying children who would benefit from intervention and personalizing interventions.

Original languageEnglish (US)
Article number361
JournalInternational journal of molecular sciences
Issue number2
StatePublished - Feb 2018

Bibliographical note

Funding Information:
Acknowledgments: We are indebted to the families who volunteered their time to participate in this study. We also thank Sarah Coleman who was the project manager, Sheri Tesch who conducted the ER intervention, and the research assistants who donated their time. Early Risers Going-to-Scale Prevention Trial funded by National Institute of Drug Abuse (DA016067; PI August) and Cortisol and the Effects of an Intensive School-Based Prevention Program funded by the Minnesota Medical Foundation (PI Klimes-Dougan).


  • Children
  • Cortisol
  • HPA axis
  • Intervention
  • Personalization
  • Prevention

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