Development and Psychopathology

Regular Articles

Intervening to enhance cortisol regulation among children at risk for neglect: Results of a randomized clinical trial

Kristin Bernarda1 c1, Mary Doziera2, Johanna Bicka3 and M. Kathleen Gordona2

a1 Stony Brook University

a2 University of Delaware

a3 Boston Children's Hospital


The hypothalamus–pituitary–adrenal axis is particularly sensitive to conditions of maltreatment. In particular, neglected children have shown a flatter slope with lower wake-up values relative to nonneglected children. An intervention, the Attachment and Biobehavioral Catch-Up (ABC), was developed to enhance biological and behavioral regulation in young children at risk for neglect. The effectiveness of the intervention was assessed in a randomized clinical trial for children with involvement with Child Protective Services. Following the intervention, children receiving the ABC intervention (n = 49) showed more typical cortisol production, with higher wake-up cortisol values and a steeper diurnal slope, than children receiving the control intervention (n = 51). These results suggest that the ABC intervention is effective in enhancing biological regulation.


c1 Address correspondence and reprint requests to: Kristin Bernard, Psychology Department, Stony Brook University, Stony Brook, NY 11794; E-mail:


  The project described was supported by Award Numbers R01MH052135, R01MH074374, and R01MH084135 from the National Institute of Mental Health (to M.D.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health.