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"Findings from this study ... demonstrate that the stress response system is highly flexible in the preschool period," study chief Dr Laurie Miller Brotman of New York University School of Medicine told Reuters Health.

Developmental studies show that youth with conduct disorders tend to have atypical responses to stress, she explained. Relative to their well-adjusted peers, they are less likely to respond to socially stressful situations with increased levels of cortisol - the hormone released by the adrenal gland in times of stress.

Stress response flexible in youth
In Brotman's study, preschoolers at high risk for antisocial behaviour (i.e., those with an older delinquent sibling) displayed this atypical stress response style before the intervention. As a group, they did not show the normal spike in cortisol levels in saliva in anticipation of a stressful situation.

However, after going through the family intervention, the preschoolers demonstrated increased cortisol levels in times of social stress - in this case playing with a group of other children they did not know, whereas preschoolers who did not participate in the program showed no changes in cortisol levels and had a cortisol pattern that resembled what has been found in older delinquent youth.

The findings of the study appear in the Archives of General Psychiatry.

"The intervention appears to have resulted in a normalization of the stress response in children at high risk for a multitude of problems," Brotman said. "We are really excited by these findings. They suggest that antisocial behavior isn't hard wired and parents can be part of the solution."

A total of 92 families with a preschooler and adolescent delinquent sibling participated in the study. Nearly half of the parents had not graduated from high school and nearly 60 percent had annual household incomes under $15,000. Most of the parents had suffered with depression and anxiety, in addition to having a teen in trouble with the law.

Lifelong benefits
Families were randomly assigned to the intervention group or had no intervention. The family intervention included 22 group sessions for parents and preschoolers and 10 home visits by mental health professionals over an 8-month period. Parents learned to use non-harsh, consistent and appropriate disciplinary tactics, be less critical, and use positive reinforcement. Preschoolers were taught how to socialise with peers, become more aware of their feelings and emotions and to follow the rules.

The finding of normalisation of cortisol levels in preschoolers who got the intervention, "in combination with a wealth of findings from animal studies, suggest that early family intervention may result in life-long changes in how one reacts to stressful situations, with implications for a range of mental health and health outcomes," Brotman told Reuters Health. - (Reuters Health)

SOURCE: Archives of General Psychiatry, October 2007.

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