Moderate versus severe early life stress: Associations with stress reactivity and regulation in 10-12-year-old children

Megan R. Gunnar, Kristin Frenn, Sandi S. Wewerka, Mark J. Van Ryzin

Research output: Contribution to journalArticlepeer-review

286 Scopus citations


Early life stress (ELS) is expected to increase reactivity of the hypothalamic-pituitary-adrenocortical (HPA) axis; however, several recent studies have shown diminished cortisol reactivity among adults and children with ELS exposure. The goal of this study was to examine cortisol activity in 10-12-year-old internationally adopted children to determine if moderate and severe ELS have different impacts on the HPA axis. Salivary cortisol and two measures of autonomic activity were collected in response to the Trier Social Stress Test for Children (TSST-C). Three groups reflecting moderate, severe, and little ELS were studied: early adopted children who came predominantly from foster care overseas (early adopted/foster care (EA/FC), n = 44), later adopted children cared for predominantly in orphanages overseas (late adopted/post-institutionalized (LA/PI), n = 42) and non-adopted (NA) children reared continuously by their middle- to upper-income parents in the United States (n = 38). Diminished cortisol activity was noted for the EA/FC group (moderate ELS), while the LA/PI group (severe ELS) did not differ from the NA group. Overall, few children showed cortisol elevations to the TSST-C in any group. The presence/absence of severe growth delay at adoption proved to be a critical predictive factor in cortisol activity. Regardless of growth delay, however, LA/PI children exhibited higher sympathetic tone than did NA children. These results suggest that moderate ELS is associated with diminished cortisol activity; however, marked individual differences in cortisol activity among the LA/PI children suggest that child factors modify the impact of severe ELS. Lack of effects of severe ELS even for growth delayed children may reflect the restorative effects of adoption or the generally low responsiveness of this age group to the TSST-C.

Original languageEnglish (US)
Pages (from-to)62-75
Number of pages14
Issue number1
StatePublished - Jan 2009

Bibliographical note

Funding Information:
This research was supported by the National Institute of Mental Health through a research grant, MH068857 and Senior Research Scientist Award, MH066208, to the first author and by grant M01-RR00400 from the National Institutes of Health to the University of Minnesota’s General Clinical Research Center. The funding source had no influence, beyond the initial review and award of the grant, into the design, analysis, or decision to submit this manuscript.


  • Cortisol
  • Early life stress
  • Group-based trajectory modeling
  • Growth curve modeling
  • Internationally adopted children
  • Linear mixed modeling


Dive into the research topics of 'Moderate versus severe early life stress: Associations with stress reactivity and regulation in 10-12-year-old children'. Together they form a unique fingerprint.

Cite this