Paper
Use of neurobiological measures in research involving foster children
- issue: Issue 4 / 2009
- authors: Philip A. Fisher
- keywords: foster children
- views: 6034
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abstract
The landscape of prevention science has changed as neurobiological measures have become more readily available in recent years. Advances in neuroimaging have facilitated investigations of structural and functional elements of specific brain systems associated with increased risk for poor outcomes (Rao 2006). Similarly, the development of techniques for assaying biomarkers of brain activity in saliva (whereas blood, urine, or cerebrospinal fluid samples were required previously) have made it considerably easier to examine a variety of neuroendocrine hormones implicated in psychopathology (Gunnar and Vasquez 2001).
Although the current interest to include neurobiological measures in prevention has been noted in a number of prior discussions (Fishbein 2000, Fishbein et al. 2004, Fishbein et al. 2006, Fisher et al. 2006, Gunnar et al. 2006, Riggs et al. 2006), whether such measures will ultimately advance the field remains uncertain. In particular, it is not yet clear what information these measures provide over and above psychosocial variables or what implications such information could have for social policy. If neurobiological measures are ultimately to achieve a lasting presence in prevention research, the rationale for their use in assessment protocols must be justified, and there must be clear evidence of the potential benefits of these investigations.
We argue that there are four primary areas in which neurobiological measures may contribute to research involving high risk populations such as foster children. First, they may help to explicate underlying mechanisms of risk for poor outcomes. Rather than supplanting psychosocial models, such methods may augment these models to explain a greater proportion of the outcome variance. For example, risk for adolescent drug abuse among low-income children appears to be particularly high for children who show deficits in inhibitory control and other aspects of executive functioning associated with activity of the medial prefrontal cortex (Dishion and Connell 2006, Gardner, Dishion, and Posner 2006).
Second, neurobiological measures may facilitate an understanding about how specific events or classes of experience predispose individuals to more positive or negative outcomes. Certain events may affect experience-dependent neural systems that develop all or in part during the postnatal period. For example, severe early neglect appears to be associated with alterations in a number of stress regulatory neural systems, which may increase risk for future anxiety and affective disorders (see Fisher et al. 2006).
Third, neurobiological measures may help to identify developmental epochs during which interventions are likely to have the greatest or least impact. Infancy and toddlerhood have been cited frequently as optimal times for intervention because of the plasticity of many neural systems during these developmental periods (Schonkoff and Phillips 2000). More recently, it has been suggested that the transition to adolescence is another ideal time for intervention because the neural reorganization and restructuring during this period may signal another period of great plasticity (Dahl 2004).
Fourth, neurobiological measures may serve as important indicators of the potential for change resulting from preventive interventions (Fisher et al. 2006). In some circumstances, neurobiological systems may exhibit great plasticity in the context of interventions; in other circumstances, there may be constraints on such plasticity.
Neurobiological outcomes may be treated as main effects; however, they may also be conceptualized as intermediate variables (i.e. greater change in neural systems may be associated with the potential for more fundamental change in the individual). As with all randomized control trials, studies that include neurobiological measures may prove most useful when they facilitate investigations of the underlying conceptual models specifying the associations between psychosocial and neurobiological variables.
For nearly a decade, we have included neurobiological measures including hypothalamic-pituitary-adrenal (HPA) axis activity and prefrontal cortex functioning in randomized control trials of preventive interventions involving children in foster care (Fisher et al. 2000). These studies have helped to inform and provide support for an emerging conceptual model specifying the associations between early adversity, the child's experiences in the foster home environment, and subsequent outcomes (Fisher et al. 2006). Moreover, they provide evidence of the plasticity of foster children's stress regulatory neural systems in the context of preventive inverventions (Fisher et al. 2007, Fisher and Stoolmiller in press).
References
Dahl, R.E. (2004) 'Adolescent brain development: A period of vulnerabilities and opportunities' in R.E. Dahl and L.P. Spear (eds) Adolescent brain development: Vulnerabilities and opportunities (pp. 1-22). New York: New York Academy of Sciences.
Dishion, T.J., and Connell, A. (2006) 'Adolescents' resilience as a self-regulatory process: Promising themes for linking intervention with developmental science' in B. M. Lester, A. Masten, and B. McEwen (eds), Resilience in children (pp. 125-138). Boston: New York Academy of Sciences.
Fishbein, D. (2000) 'The importance of neurobiological research to the prevention of psychopathology.' Prevention Science 1, 89-106.
Fishbein, D., Herman-Stahl, M., Eldreth, D., Paschall, M.J., Hyde, C., Hubal, R., et al. (2006) 'Mediators of the stress-substance-use relationship in urban male adolescents.' Prevention Science 7, 113-126.
Fisher, P.A., Burraston, B., and Pears, K. (2005) The Early Intervention Foster Care Program: Permanent placement outcomes from a randomized trial. Child Maltreatment 10, 61-71.
Fisher, P.A., and Chamberlain, P. (2000) Multidimensional Treatment Foster Care: A program for intensive parent training, family support, and skill building. Journal of Emotional and Behavioral Disorders, 8, 155-164.
Fisher, P.A., Ellis, B.H., and Chamberlain, P. (1999) Early intervention foster care: A model for preventing risk in young children who have been maltreated. Children's Services: Social Policy, Research, and Practice, 2, 159-182.
Fisher, P.A., Gunnar, M.R., Chamberlain, P., and Reid, J.B. (2000) 'Preventive intervention for maltreated preschoolers: Impact on children's behavior, neuroendocrine activity, and foster parent functioning.' Journal of the American Academy of Child and Adolescent Psychiatry 39, 1356-1364.
Fisher, P.A., Gunnar, M.R., Dozier, M., Bruce, J., and Pears, K.C. (2006) 'Effects of a therapeutic intervention for foster children on behavior problems, caregiver attachment, and stress regulatory neural systems.' Annals of the New York Academy of Sciences 1094, 215-225.
Fisher, P.A., and Kim, H. K. (2007) 'Intervention effects on foster preschoolers' attachment-related behaviors from a randomized trial.' Prevention Science 8, 161-170.
Fisher, P.A., Stoolmiller, M., Gunnar, M.R., and Burraston, B. (in press) 'Effects of a therapeutic intervention for foster preschoolers on diurnal cortisol activity.' Psychoneuroendocrinology.
Gardner, T.W., Dishion, T.J., and Posner, M.I. (2006) 'Attention and adolescent tobacco use: A potential self-regulatory dynamic underlying nicotine addiction.' Addictive Behaviors 31, 531-536.
Gunnar, M.R., and Vazquez, D.M. (2001) 'Low cortisol and a flattening of expected daytime rhythm: Potential indices of risk in human development.' Development and Psychopathology 13, 515-737.
Rao, U. (2006). 'Links between depression and substance abuse in adolescents: Neurobiological mechanisms.' American Journal of Preventive Medicine 31 (6S1), 161-S174.
Riggs, N.R., Greenberg, M.T., Kusché, C.A., and Pentz, M.A. (2006) 'The mediational role of neurocognition in the behavioral outcomes of a social-emotional prevention program in elementary school students: Effects of the PATHS curriculum.' Prevention Science 7, 91-102.
Shonkoff, J.P., and Phillips, D. (eds) (2000) From neurons to neighborhoods: The science of early childhood development. Washington, DC: National Academy Press.
Philip Fisher Ph.D., Oregon Social Learning Center, 10 Shelton McMurphy Blvd, Eugene, Or USA 97403
Email: philf@oslc.org