Young children in institutional care experience conditions that are incompatible with their needs for attachment relationships. As a result, early institutionalization is expected to have lasting effects on the regulation of the hypothalamic–pituitary–adrenocortical (HPA) axis. The current study tested whether early institutionalization has persistent consequences for diurnal HPA axis outcomes among 130 children who had been adopted internationally between the ages of 6 and 48 months. Daily cortisol samples were collected from children at two time points: shortly after adoption (average of 5.3 months after adoption) and approximately 3 years later (average of 39.2 months after adoption). Shortly after adoption, children who had experienced a long duration of institutional care had lower morning cortisol levels and more blunted declines in cortisol across the day than children who experienced minimal or no institutional care. Three years later, children who had experienced a long duration of institutionalization continued to exhibit low morning cortisol levels and also exhibited low bedtime cortisol levels. Altogether, these results support the idea that early adversity results in the downregulation of the HPA axis and suggest that the effects of institutionalization on HPA axis functioning may persist several years after children are adopted into highly enriched families.

中文翻译：

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国际收养儿童的早期机构护理与昼夜皮质醇结果之间的持续关联

机构照料中的幼儿经历的条件与他们对依恋关系的需求不相容。因此，早期机构化预计将对下丘脑-垂体-肾上腺皮质 (HPA) 轴的调节产生持久影响。目前的研究测试了 130 名 6 至 48 个月在国际上被收养的儿童，早期机构化是否对每日 HPA 轴结果产生持续影响。在两个时间点从儿童身上收集每日皮质醇样本：收养后不久（收养后平均 5.3 个月）和大约 3 年后（收养后平均 39.2 个月）。收养后不久，经历过长时间机构照料的儿童早上皮质醇水平较低，一天中皮质醇的下降幅度比接受很少或没有机构照料的儿童更慢。三年后，经历过长期机构收容的儿童继续表现出较低的早晨皮质醇水平，也表现出较低的睡前皮质醇水平。总而言之，这些结果支持早期逆境导致 HPA 轴下调的观点，并表明在儿童被收养到高度富裕的家庭后几年，制度化对 HPA 轴功能的影响可能会持续数年。经历过长期收容的儿童继续表现出较低的早晨皮质醇水平，也表现出较低的睡前皮质醇水平。总而言之，这些结果支持早期逆境导致 HPA 轴下调的观点，并表明在儿童被收养到高度富裕的家庭后几年，制度化对 HPA 轴功能的影响可能会持续数年。经历过长期收容的儿童继续表现出较低的早晨皮质醇水平，也表现出较低的睡前皮质醇水平。总而言之，这些结果支持早期逆境导致 HPA 轴下调的观点，并表明在儿童被收养到高度富裕的家庭后几年，制度化对 HPA 轴功能的影响可能会持续数年。