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Attachment security buffers the HPA axis of toddlers growing up in poverty or near poverty: Assessment during pediatric well-child exams with inoculations.
Psychoneuroendocrinology. 2018 09; 95:120-127.P

Abstract

Poverty is associated with poor physical and emotional development. Activation of the hypothalamic-pituitary-adrenocortical (HPA) axis is argued to be one of the pathways through which poverty acts on these outcomes. While studies of school-aged children have found some evidence for this, there is little evidence for this hypothesis early in development. This may be, in part, because for very young children, the security of their attachment relationships with parents moderates the impact of poverty on HPA axis functioning. The current study investigated the relations between family income as a percentage of the federal poverty limit (FPL), salivary cortisol and attachment (Attachment Q-sort) during well-child checkups with inoculations in 177 toddlers between 12- and 22-months of age. Approximately half of the toddlers were in families living below 150% FPL, with 47% of these classified as securely attached, compared to 72% of toddlers in families living above 150% FPL. Cortisol levels increased in response to the inoculation and this did not differ by poverty or attachment security. Overall, however, beginning at clinic arrival toddlers in families living below 150% FPL who had an insecure attachment had significantly higher cortisol compared to toddlers living in poverty or near poverty with secure attachments. This finding held when we removed toddlers with high levels of negative life events in their families and primary caregivers who exceeded the screening cutoff for depressive symptoms. Thus, attachment was a significant moderator of the association between poverty and HPA axis activity, with significant implications for screening and referral of caregiving dyads at risk.

Authors+Show Affiliations

University of Nebraska-Lincoln, Lincoln, Nebraska, United States.University of Minnesota, Minneapolis, Minnesota, United States.University of Minnesota, Minneapolis, Minnesota, United States.Children's Hospitals and Clinics of Minnesota, United States.University of Minnesota, Minneapolis, Minnesota, United States. Electronic address: Gunnar@umn.edu.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29852405

Citation

Johnson, Anna B., et al. "Attachment Security Buffers the HPA Axis of Toddlers Growing Up in Poverty or Near Poverty: Assessment During Pediatric Well-child Exams With Inoculations." Psychoneuroendocrinology, vol. 95, 2018, pp. 120-127.
Johnson AB, Mliner SB, Depasquale CE, et al. Attachment security buffers the HPA axis of toddlers growing up in poverty or near poverty: Assessment during pediatric well-child exams with inoculations. Psychoneuroendocrinology. 2018;95:120-127.
Johnson, A. B., Mliner, S. B., Depasquale, C. E., Troy, M., & Gunnar, M. R. (2018). Attachment security buffers the HPA axis of toddlers growing up in poverty or near poverty: Assessment during pediatric well-child exams with inoculations. Psychoneuroendocrinology, 95, 120-127. https://doi.org/10.1016/j.psyneuen.2018.05.030
Johnson AB, et al. Attachment Security Buffers the HPA Axis of Toddlers Growing Up in Poverty or Near Poverty: Assessment During Pediatric Well-child Exams With Inoculations. Psychoneuroendocrinology. 2018;95:120-127. PubMed PMID: 29852405.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Attachment security buffers the HPA axis of toddlers growing up in poverty or near poverty: Assessment during pediatric well-child exams with inoculations. AU - Johnson,Anna B, AU - Mliner,Shanna B, AU - Depasquale,Carrie E, AU - Troy,Michael, AU - Gunnar,Megan R, Y1 - 2018/05/22/ PY - 2018/01/27/received PY - 2018/04/18/revised PY - 2018/05/21/accepted PY - 2018/6/1/pubmed PY - 2019/4/11/medline PY - 2018/6/1/entrez KW - Attachment KW - Cortisol KW - Infant KW - Inoculation KW - Poverty KW - Stress SP - 120 EP - 127 JF - Psychoneuroendocrinology JO - Psychoneuroendocrinology VL - 95 N2 - Poverty is associated with poor physical and emotional development. Activation of the hypothalamic-pituitary-adrenocortical (HPA) axis is argued to be one of the pathways through which poverty acts on these outcomes. While studies of school-aged children have found some evidence for this, there is little evidence for this hypothesis early in development. This may be, in part, because for very young children, the security of their attachment relationships with parents moderates the impact of poverty on HPA axis functioning. The current study investigated the relations between family income as a percentage of the federal poverty limit (FPL), salivary cortisol and attachment (Attachment Q-sort) during well-child checkups with inoculations in 177 toddlers between 12- and 22-months of age. Approximately half of the toddlers were in families living below 150% FPL, with 47% of these classified as securely attached, compared to 72% of toddlers in families living above 150% FPL. Cortisol levels increased in response to the inoculation and this did not differ by poverty or attachment security. Overall, however, beginning at clinic arrival toddlers in families living below 150% FPL who had an insecure attachment had significantly higher cortisol compared to toddlers living in poverty or near poverty with secure attachments. This finding held when we removed toddlers with high levels of negative life events in their families and primary caregivers who exceeded the screening cutoff for depressive symptoms. Thus, attachment was a significant moderator of the association between poverty and HPA axis activity, with significant implications for screening and referral of caregiving dyads at risk. SN - 1873-3360 UR - https://www.unboundmedicine.com/medline/citation/29852405/Attachment_security_buffers_the_HPA_axis_of_toddlers_growing_up_in_poverty_or_near_poverty:_Assessment_during_pediatric_well_child_exams_with_inoculations_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0306-4530(18)30073-8 DB - PRIME DP - Unbound Medicine ER -