A Double Hit? COVID-19, Cortisol, and Psychopathology Symptoms for Previously Institutionalized Adolescents and Young Adults Following Pubertal Recalibration

• In Event: Pubertal Recalibration in PI Youth: Associations with Physiology, Mental Health, Behavior, and Inflammation

Abstract

Youth who experienced institutional care in infancy tend to show blunted cortisol reactivity post-adoption (Koss et al., 2016). However, our research group demonstrated that previously institutionalized (PI) youth display increasing cortisol stress reactivity as they develop through puberty, becoming more similar to NA youth over time (Gunnar et al., 2019). Importantly, we found this recalibration was associated with increasing, not decreasing, internalizing symptoms and observed anxiety (Perry et al., in press; Perry et al., in prep). Further, the impact of the COVID-19 pandemic during or soon after the pubertal period may represent a “second hit” for PI youth that may further exacerbate increases in cortisol and psychopathology (Brown et al., preprint). The present study sought to examine a) whether recalibration-related increases in internalizing symptoms for PI youth persist into late adolescence/early adulthood, b) whether the psychosocial impact of COVID-19 is associated with differences in HPA activity and internalizing symptoms, and c) whether the impact of COVID-19 is larger for PI compared to NA youth.

Data collection for the current study is ongoing. However, to date, 203 of the original 308 participants completed an online follow-up to the original longitudinal study mentioned above. Youth in the current study were approximately 12-21 years old (M = 15.8). PI youth participants (n = 96, 47%) experienced institutional care in infancy/toddlerhood before being adopted into well-resourced families in a Midwestern region of the United States. These youth had spent at least 50% of their pre-adoptive life in an institution and were adopted before 60 months of age. The remaining youth (n = 107, 53%) were born and raised in their families of origin in the United States (non-adopted, NA). Youth and their parents submitted an online version of the MacArthur Health and Behavior Questionnaire (HBQ; Essex et al., 2002) and a COVID-19 impact questionnaire. Youth also submitted the Child Depression Inventory (CDI), as well as the State-Trait Anxiety Inventory (STAI; (Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983), and mailed a hair sample cut near the scalp at the occipital ridge (Ouellet-Morin et al., 2016) to obtain a measure of overall cortisol production during the pandemic.

Final results are forthcoming. Hair cortisol has not yet been assayed but will be completed prior to presentation (N=120). Preliminary findings suggest that PI youth continue to show greater internalizing symptoms. PI youth who showed increases in cortisol reactivity across the 3 sessions in the previously described study (recalibrators) had significantly higher internalizing symptoms (M=.63, SD =.30) at this follow-up time point than PI youth who did not show increases in cortisol reactivity (non-recalibrators; M = .50, SD =.25); t(79)=2.14, p = .035. Hypotheses regarding the impact of COVID-19 will be assessed using multiple linear regression, with a COVID-19 impact composite predicting mental health variables and social functioning. Preliminary correlations suggest greater COVID-19 hardship is associated with decreased mental health. Once data are cleaned and processed, we will test whether COVID-19 is associated with mental health differently for PI and NA youth using a moderation analysis.

Authors

• Carrie E DePasquale, Pennsylvania State University, University Park
  Non-Presenting Author

• Nicole Perry, University of Texas at Austin
  Non-Presenting Author

• Bonny Donzella, University of Minnesota - Twin Cities
  Presenting Author

• Teresa Grunklee, University of Minnesota - Twin Cities
  Non-Presenting Author

• Abby Cavananaugh, University of Minnesota
  Non-Presenting Author

• Megan R. Gunnar, University of Minnesota - Twin Cities
  Non-Presenting Author