Institutional rearing in infancy and early childhood followed by adoption into well-resourced homes provides information on the long-term sequelae of adverse care limited to the earliest years of life. The current article synthesizes research on cortisol stress reactivity and emotional functioning among previously institutionalized youth from early childhood through young adulthood. It examines potential mechanisms through which alterations in cortisol reactivity following early institutional care may contribute to behavioral and mental-health outcomes. Evidence is summarized showing that blunted cortisol reactivity is linked to emotional difficulties in previously institutionalized children during early and middle childhood, followed by recent findings that pubertal increases in cortisol reactivity toward more typical levels are paradoxically associated with heightened internalizing symptoms. The article concludes by outlining directions for future research to clarify the mechanisms connecting cortisol stress reactivity with psychological adjustment, with the goal of advancing understanding of emotional development following early adverse rearing.
Nicole B. Perry (Wed,) studied this question.