Child anxiety symptoms related to longitudinal cortisol trajectories and acute stress responses: evidence of developmental stress sensitization.

Cross-sectional research suggests that individuals at risk for internalizing disorders show differential activation levels and/or dynamics of stress-sensitive physiological systems, possibly reflecting a process of stress sensitization. However, there is little longitudinal research to clarify how the development of these systems over time relates to activation during acute stress, and how aspects of such activation map onto internalizing symptoms. We investigated children's (n = 107) diurnal hypothalamic-pituitary-adrenal activity via salivary cortisol (morning and evening levels) across 29 assessments spanning 6+ years, and related longitudinal patterns to acute stress responses at the end of this period (age 9-10). Associations with child psychiatric symptoms at age 10 were also examined to determine internalizing risk profiles. Increasing morning cortisol levels across assessments predicted less of a cortisol decline following interpersonal stress at age 9, and higher cortisol levels during performance stress at age 10. These same profiles of high and/or sustained cortisol elevation during psychosocial stress were associated with child anxiety symptoms. Results suggest developmental sensitization to stress-reflected in rising morning cortisol and eventual hyperactivation during acute stress exposure-may distinguish children at risk for internalizing disorders.

HPA stability for children in foster care: mental health implications and moderation by early intervention.

Research on stress-sensitive biological systems has typically focused on activation at one time, yet recent theories emphasize dynamic, context-specific adaptation. This study tested hypothesized calibration of one such system by examining both mean levels and longitudinal stability of daily cortisol--reflecting hypothalamic-pituitary-adrenal axis activation--in children exposed to high-risk versus lower-risk caregiving contexts. Context-specific effects of longitudinal cortisol profiles were addressed via relations with child psychiatric symptoms. Children from regular foster care, foster children participating in a family-based intervention, and community comparison children (n = 96 total) collected saliva samples for cortisol assay at 29 timepoints across 6+ years. High-risk (regular foster care) children showed lower and more variable cortisol levels than their lower-risk (treatment foster care, community comparison) counterparts. For the high-risk children only, higher and more stable cortisol related to elevated anxiety symptoms. Implications for contextual calibration of stress systems and family intervention mechanisms are discussed.

Research into Theory into Practice: An Overview of Family Based Interventions for Child Antisocial Behavior Developed at the Oregon Social Learning Center

Although many psychotherapeutic approaches exist for treating troubled children and their families, not all have been evaluated to be effective through research. Moreover, among those that have been determined to be "evidence-based", few have followed as coherent and rigorous a path of rigorous scientific investigation as the interventions that have been developed at the Oregon Social Learning Center. As such, these interventions serve as a model of "research to theory to practice" that may not only be employed to support families with children in need of treatment, but may also guide other programs of treatment development. This is the story of how this work has unfolded over the past four decades (AU)

Aunque existen muchos acercamientos terapéuticos para el tratamiento de los niños que han sufrido problemas y sus familias, ninguno de ellos ha sido validado en las investigaciones. Además, entre aquellos que han sido usados para generar evidencias, pocos han seguido el camino tan coherente y riguroso de investigación científica como las intervenciones que han sido desarrolladas en el Oregon Social Learning Center. Como tal, estas intervenciones sirven como un modelo "de investigación que va de la teoría a la práctica" y que no sólo puede ser empleado para apoyar familias con niños en la necesidad de tratamiento, sino que también puede servir para dirigir el desarrollo de otros programas de tratamiento. Esto es la historia de como se ha ido desarrollando este proyecto a lo largo de las cuatro últimas décadas (AU)

Multidimensional treatment foster care: an alternative to residential treatment for high risk children and adolescents / Tratamiento multidimensional de acogimiento familiar: una alternativa al tratamiento residencial para niños, niñas y adolescentes en alto-riesgo

This paper describes the Multidimensional Treatment Foster Care program (MTFC), an evidence based approach for providing psychotherapeutic treatment for very troubled children and adolescents that is an alternative to residential care. Versions of the MTFC program have been developed and validated for young children with a history of maltreatment as well as for older children and adolescents who are involved with the youth justice system. In the paper we describe the development of the MTFC program and its foundations in the social learning model that originated at the Oregon Social Learning Center in the 1960's and 70's. We present information about program elements. We then review the research that has been conducted on MTFC (AU)

Este programa describe el programa "Tratamiento Multidimensional de Acogimiento Familiar" (MTFC), una práctica basada en la evidencia que proporciona tratamiento a niños, niñas y adolescentes muy problemáticos y que constituye una alternativa al acogimiento residencial. Se han desarrollado y validado diferentes versiones del programa MTFC para niños y niñas con historia de maltrato infantil así como para niños y niñas más mayores y adolescentes involucrados en el sistema de justicia juvenil. En el artículo se describe el desarrollo del programa MTFC y sus bases teóricas, que se inspiran en el modelo de aprendizaje social que se originó en el Oregon Social Learning Center en las décadas de los años 1960 y 1970. Se presenta información de los principales elementos del programa y se revisa la investigación más importante que se ha llevado a cabo con el MTFC (AU)

Research into Theory into Practice: An Overview of Family Based Interventions for Child Antisocial Behavior Developed at the Oregon Social Learning Center.

Although many psychotherapeutic approaches exist for treating troubled children and their families, not all have been evaluated to be effective through research. Moreover, among those that have been determined to be "evidence-based," few have followed as coherent and rigorous a path of rigorous scientific investigation as the interventions that have been developed at the Oregon Social Learning Center. As such, these interventions serve as a model of "research to theory to practice" that may not only be employed to support families with children in need of treatment, but may also guide other programs of treatment development. This is the story of how this work has unfolded over the past four decades.

Multidimensional Treatment Foster Care: An Alternative to Residential Treatment for High Risk Children and Adolescents.

This paper describes the Multidimensional Treatment Foster Care program (MTFC), an evidence based approach for providing psychotherapeutic treatment for very troubled children and adolescents that is an alternative to residential care. Versions of the MTFC program have been developed and validated for young children with a history of maltreatment as well as for older children and adolescents who are involved with the youth justice system. In the paper we describe the development of the MTFC program and its foundations in the social learning model that originated at the Oregon Social Learning Center in the 1960's and 70's. We present information about program elements. We then review the research that has been conducted on MTFC.