Mitigating HPA axis dysregulation associated with placement changes in foster care

Philip A. Fisher, Mark J. Van Ryzin, Megan R. Gunnar

Research output: Contribution to journalArticlepeer-review

99 Scopus citations


Maltreated foster children often exhibit alterations in diurnal hypothalamic-pituitary-adrenal (HPA) axis activity that are characterized by lower cortisol levels upon waking and smaller declines in morning-to-evening cortisol levels. Previous research has shown that this dysregulated pattern is associated with high caregiver stress levels over the course of foster care placements. In contrast, therapeutic interventions that emphasize consistent and responsive caregiving have been associated with more regulated cortisol rhythms. In this paper, two related issues were explored: whether placement changes (i.e., moving between foster homes or from a foster home to a permanent placement) were associated with more blunted daily cortisol rhythms and whether a caregiver-based intervention exerted a protective effect in this context. Because the intervention program has components specifically designed to prepare foster children for placement changes and to maintain consistent parenting techniques despite them, a prevention effect on HPA axis dysregulation during placement changes was hypothesized. The results of linear mixed modeling analyses showed that placement changes predicted dysregulation in cortisol rhythms in the regular foster care group but not in the intervention foster care group. These findings are discussed in terms of implications for child welfare policy and practice.

Original languageEnglish (US)
Pages (from-to)531-539
Number of pages9
Issue number4
StatePublished - May 2011

Bibliographical note

Funding Information:
Support for this research was provided by the following grants: R01 MH059780 and R21 MH065046 , NIMH, U.S. PHS ; R01 HD045894 , NICHD, U.S. PHS ; R01 DA021424 and P30 DA023920 , NIDA, U.S. PHS . The authors thank the staff and families of the Multidimensional Treatment Foster Care for Preschoolers program, Kristen Greenley for project management, and Matthew Rabel for editorial assistance.


  • Diurnal cortisol
  • Dysregulation
  • Foster care
  • Intervention
  • Preschool


Dive into the research topics of 'Mitigating HPA axis dysregulation associated with placement changes in foster care'. Together they form a unique fingerprint.

Cite this