Coping and empowerment preventive intervention buffers early adolescent neuroendocrine-related risk for internalizing problems.

There is an absence of mechanism-driven interventions equipped to reduce the large mental health disparities that exist for preadolescent youth living in poverty. Building a Strong Identity and Coping Skills (BaSICS) is a preventive intervention designed to target multiple aspects of poverty-related stress adaptation, including altered neuroendocrine function. The purpose of the current study was to examine whether pre-post shifts in preadolescent hypothalamic-pituitary-adrenal (HPA) activation could longitudinally predict internalizing outcomes and to determine whether BaSICS could buffer such HPA-related risk for psychopathology. Low-income youth (n = 112) ages 11-12 years were randomized to the 16-session intervention or assessment-only control (53% intervention; 54% female; 40% Hispanic, 63% Black, 20% White). Youth completed questionnaires and the Trier Social Stress Test, and provided cortisol via saliva at six timepoints during the 90-minute assessment. Adjusting for pre-intervention Cortisol Area Under the Curve-Ground (CAUCg) scores and internalizing problems, post-intervention CAUCg and intervention main and interactive effects were modeled as predictors of internalizing outcomes across post-intervention, 6-month, and 12-month follow-up assessments using multilevel regression methods. A significant post-intervention CAUCg by intervention interaction emerged (B=1.198, SE=0.433, p = .006). For control youth, baseline-adjusted decreases in cortisol output were associated with increases in internalizing problems that remained stably elevated across follow-up assessments. For BaSICS youth, however, internalizing problems decreased and remained stably low following program delivery, irrespective of post-intervention increases or decreases in cortisol output. Findings illustrate how BaSICS may buffer against HPA-related risk for internalizing psychopathology and provide support for interventions targeting biological mechanisms of risk for low-income preadolescents.

HPA-SAM co-activation among racially diverse, economically disadvantaged early adolescents: Secondary analysis with a preliminary test of a multisystem, person-centered approach.

Investigating the co-activation of hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenomedullary (SAM) responses to acute stress can provide insight into how risk might become biologically embedded during early adolescence and improve understanding of what distinguishes physiological dysregulation from normative/expected physiological responses to stress. Evidence has thus far been mixed as to whether symmetric or asymmetric co-activation patterns are associated with higher exposure to chronic stress and poorer mental health outcomes during adolescence. This study expands on a prior multisystem, person-centered analysis of lower-risk, racially homogenous youth by focusing on HPA-SAM co-activation patterns in a higher-risk, racially diverse sample of early adolescents from low-income families (N = 119, Mage=11.79 years, 55.5% female, 52.7% mono-racial Black). The present study was conducted by performing secondary analysis of data from the baseline assessment of an intervention efficacy trial. Participants and caregivers completed questionnaires; youth also completed the Trier Social Stress Test-Modified (TSST-M) and provided six saliva samples. Multitrajectory modeling (MTM) of salivary cortisol and alpha-amylase levels identified four HPA-SAM co-activation profiles. In accordance with the asymmetric-risk model, youth exhibiting Low HPA-High SAM (n = 46) and High HPA-Low SAM (n = 28) profiles experienced more stressful life events, posttraumatic stress, and emotional and behavioral problems relative to Low HPA-Low SAM (n = 30) and High HPA-High SAM (n = 15) youth. Findings highlight potential differences in biological embedding of risk during early adolescence based on individuals' exposure to chronic stress and illustrate the utility of multisystem and person-centered approaches in understanding how risk might get "underneath the skin" across systems.

Targeting the Proximal Mechanisms of Stress Adaptation in Early Adolescence to Prevent Mental Health Problems in Youth in Poverty.

OBJECTIVE: This study used a randomized clinical trial design to evaluate the success with which The Building a Strong Identity and Coping Skills intervention (BaSICS) engaged the proximal mechanisms of poverty-related stress's impact on the psychosocial functioning and mental health of young adolescents living in high poverty contexts. METHOD: 129 youth from very low-income families were randomized to receive the 32-hour group-based intervention or no-treatment control - 16 of these families withdrew before the intervention groups began. The remaining 113 youth aged 11-12 (53% assigned to intervention; 54% female; 40% Hispanic, 63% Black, 20% White) participated in the study, which included four assessment waves: pretest, posttest, 6-month follow-up and 12-month follow-up assessments. Primary control, secondary control, and disengagement coping were assessed via a combination of parent and youth reports as well as via interviews and questionnaires. Hypothalamic-pituitary-adrenal axis (HPA) reactivity was assessed via salivary cortisol responses occurring during a lab-based stress induction (Trier Social Stress Test). RESULTS: Multilevel regression models with repeated measures nested within subjects revealed that in comparison to controls, intervention youth had sustained significant increases in their knowledge about primary control coping (e.g., problem solving, emotion modulation), knowledge and utilization of secondary control (e.g., cognitive restructuring) coping, as well as decreased reliance on disengagement coping. These were accompanied by decreased cortisol reactivity in intervention versus control youth. CONCLUSIONS: These findings support that BaSICS engages several proximal mechanisms of poverty-related stress' impact on early adolescent mental health - coping skills and HPA reactivity - during the neurodevelopmentally plastic pubertal period.

A multiple levels of analysis examination of the performance goal model of depression vulnerability in preadolescent children.

If performance goals (i.e., motivation to prove ability) increase children's vulnerability to depression (Dykman, 1998), why are they overlooked in the psychopathology literature? Evidence has relied on self-report or observational methods and has yet to articulate how this vulnerability unfolds across levels of analysis implicated in stress-depression linkages; for example, hypothalamic-pituitaryadrenal axis (HPA), sympathetic nervous system (SNS). Utilizing a multiple-levels-of-analysis approach (Cicchetti, 2010), this experimental study tested Dykman's goal orientation model of depression vulnerability in a community sample of preadolescents (N = 121, Mage = 10.60 years, Range = 9.08-12.00 years, 51.6% male). Self-reports of performance goals, attachment security, and subjective experience of internalizing difficulties were obtained in addition to objective behavioral (i.e., task persistence) and physiologic arousal (i.e., salivary cortisol, skin conductance level) responses to the Trier Social Stress Test (TSST) and two randomly assigned coping conditions: avoidance, distraction. Children with performance goals reported greater internalizing difficulties and exhibited more dysregulated TSST physiologic responses (i.e., HPA hyperreactivity, SNS protracted recovery), yet unexpectedly displayed greater TSST task persistence and more efficient physiologic recovery during avoidance relative to distraction. These associations were stronger and nonsignificant in the context of insecure and secure attachment, respectively. Findings illustrate a complex matrix of in-the-moment, integrative psychobiological relationships linking performance goals to depression vulnerability.

Within-person patterns of psychobiological stress response correspondence: links to preadolescent internalizing problems and coping behaviors.

Though correspondence across the affective experience and physiologic arousal levels of the stress response is thought to support efficacious coping and buffer against internalizing problems, little evidence has demonstrated such correspondence. Using a community sample of preadolescents (N=151, Mage=10.33 years, Minage=8.92, Maxage=12.00, 51.7% male), this person-centered study examined internalizing problem and coping-linked variability in psychobiological stress response correspondence. Preadolescents were exposed to the Trier Social Stress Test and self-reported negative affect (NA) and salivary cortisol (SC) levels were assessed. Multitrajectory modeling revealed four subgroups. Relative to In-Touch (i.e., Moderate NA-Moderate SC; n=65), Unmindful (i.e., Moderate NA-Low SC; n=49) were more likely to present with parent-reported but not self-reported internalizing problems; Vigilant (i.e., High NA-Low SC; n=13) were more likely to present with self- and parent-reported internalizing problems, less likely to use engagement coping, and more likely to use wishful thinking (e.g., "I wish problems would just go away."); Denial (i.e., Low NA-High SC; n=24) self-reported similarly low internalizing problems, but were also more likely to report reliance on denial (e.g., "I pretend problems don't exist."). Findings illustrate meaningful heterogeneity in preadolescent psychobiological correspondence with implications for multimodal assessment and outcome monitoring in coping-based preventative interventions.

Individual Differences in Adolescent Coping: Comparing a Community Sample and a Low-SES Sample to Understand Coping in Context.

Coping that is adaptive in low-stress environments can be ineffective or detrimental in the context of poverty. Identifying coping profiles among adolescents facing varying levels of stress can increase understanding of when and for whom coping may be most adaptive. The present study applied latent profile analysis (LPA) to identify coping profiles in two distinct samples of adolescents: a community sample of youth aged 11-16 years (N = 374, Mage = 13.14, 53% girls), and a low-SES sample of youth aged 12-18 years (N = 304, Mage = 14.56, 55% girls). The ten coping subscales of the Responses to Stress Questionnaire were included as indicators in the LPAs (problem solving, emotion regulation, emotion expression, acceptance, positive thinking, cognitive restructuring, distraction, denial, wishful thinking, and avoidance). Five profiles were identified in the community sample: Inactive, Low Engagement, Cognitive, Engaged, and Active Copers. All but the Low Engagement Copers profile were also identified in the low-SES sample, suggesting that adolescents employ similar coping strategies across contexts, but fewer low-SES adolescents engage in lower levels of coping. Profiles differed by gender and symptoms of internalizing psychopathology. Inactive copers in both samples were more likely to be male. Engaged Copers reported the lowest symptom levels whereas Active Copers reported higher symptoms. Cognitive Copers reported higher levels of anxious and depressive symptoms in the low-SES sample only, suggesting that this pattern of coping may be protective only in less stressful contexts. Elucidating within-person coping patterns is a promising avenue for targeting interventions to those most likely to benefit.

The protective roles of ethnic identity, social support, and coping on depression in low-income parents: A test of the adaptation to poverty-related stress model.

OBJECTIVE: This study tested the Adaptation to Poverty-Related Stress (APRS) model's proposed relationships between poverty-related stress (PRS), ethnic identity affirmation (EI), social support, engagement coping, and depression in a racial/ethnically diverse sample of low-income parents. METHOD: Path analysis was used to test the APRS model in a sample of 602 parents living at or below 200% of the federal poverty line (50% male, mean age = 32.55 years, SD = 8.78, 34.8% White). Multigroup path analysis tested moderation by gender and race/ethnicity. RESULTS: Path analysis revealed that PRS was indirectly associated with higher depressive symptoms through less social support and less use of engagement coping operating in parallel and sequentially in a three-path mediated sequence. Conversely, EI was indirectly associated with lower depressive symptoms through greater social support and greater use of engagement coping operating in parallel and sequentially. However, PRS remained a direct predictor of higher depressive symptoms. Moderation by gender and race/ethnicity was not found. CONCLUSION: Overall, the findings provide empirical support for the APRS model. This study suggests that clinical and preventive interventions targeting depression in low-income parents could benefit from focusing on improving low-income parent's use of engagement coping and perceived social support. Ethnic identity is a promising target as it to protects against PRS' negative impact on coping and social support. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Reducing the Biological and Psychological Toxicity of Poverty-related Stress: Initial Efficacy of the BaSICS Intervention for Early Adolescents.

This proof-of-concept study tests the initial efficacy of the Building a Strong Identity and Coping Skills (BaSICS) intervention, a selective prevention of internalizing problems program for early adolescents exposed to high levels of poverty-related stress. Eighty-four early adolescents (Mage  = 11.36 years) residing in very low-income neighborhoods were randomized to receive the 16-session intervention (n = 44) or to an assessment-only control condition (n = 40). BaSICS teaches coping skills, social identity development, and collective social action to empower youth with the ability to connect with members of their communities and cope with poverty-related stress in positive and collaborative ways. Pretest-posttest analyses showed that intervention adolescents acquired problem-solving and cognitive-restructuring skills and reduced their reliance on avoidant coping. In addition, HPA reactivity was significantly reduced in the intervention youth, but not controls. Finally, intervention youth's internalizing and somatic symptoms as reported by both youth and their parents, showed significant reductions over time, whereas control youth had no such changes. Results provide strong support for this approach to strength-building and symptom reduction in a population of early adolescents exposed to poverty-related stress.

Co-activation of SAM and HPA responses to acute stress: A review of the literature and test of differential associations with preadolescents' internalizing and externalizing.

Understanding co-activation patterns of the hypothalamic-pituitary-adrenal axis (HPA) and sympathetic adrenal medullary (SAM) during early adolescence may illuminate risk for development of internalizing and externalizing problems. The present study advances empirical work on the topic by examining SAM-HPA co-activation during both the reactivity and recovery phases of the stress response following acute stress exposure. Fourth and fifth grade boys and girls (N = 149) provided cortisol and alpha-amylase via saliva at seven times throughout a 95-min assessment in which they were administered the modified Trier Social Stress Test. Parents reported on adolescents' life stress, pubertal development, medication use, and externalizing problems. Adolescents reported their own internalizing symptoms. Multiple linear regressions tested both direct and interactive effects of SAM and HPA reactivity and recovery on internalizing and externalizing problems. Results from these analyses showed that whereas SAM and HPA reactivity interacted to predict internalizing symptoms, it was their interaction during the recovery phase that predicted externalizing. Concurrent high SAM and HPA reactivity scores predicted high levels of internalizing and concurrently low SAM and HPA recovery scores predicted high levels of externalizing. Implications of the findings for further study and clinical application are discussed.

Extending the toxic stress model into adolescence: Profiles of cortisol reactivity.

The toxic stress model posits that extended activation of stress response systems in the absence of a supportive relationship with an adult may over time lead to physiological alterations to these same systems, and ultimately to poorer physical and mental health outcomes. However, empirical tests of model hypotheses in adolescence, a critical period of development, are lacking. This study expands the toxic stress model to include more developmentally-appropriate risk and protective factors for adolescents experiencing overwhelming and uncontrollable stressors. Data were collected for a study of early adolescents from urban low-income households (N = 101; 10-12 years old; 59% female). Participants and a caregiver completed questionnaires; youths completed the modified Trier Social Stress Task alone and provided six saliva samples. Using latent profile analysis, three profiles of cortisol reactivity were identified in early adolescents exposed to chronic environmental stress: Elevated and Reactive (11%), Moderate and Non-Reactive (26%), and Blunted and Non-Reactive (63%). In accordance with the toxic stress model, exposure to more community violence and less family support were associated with blunted cortisol reactivity, and Reactive profile membership was associated with fewer trauma symptoms. Overall, the findings provide empirical support for the extension of the toxic stress model in early adolescence through the application of developmentally-sensitive measures and provide implications for future interventions.

Impact of psychophysiological stress-response systems on psychological development: Moving beyond the single biomarker approach.

This Special Section showcases cutting-edge, theory-driven research, which elucidates how multiple physiologic stress-response systems and neural networks that support social behavior operate together to affect psychological processes across from infancy to adolescence. The 8 papers included in the Special Section represent cutting-edge efforts to understand how multiple physiological systems jointly influence behavior. They raise new questions, highlight issues that remain unresolved, and suggest additional directions for research. It is our hope that they will stimulate theory building and new, integrative studies that will advance knowledge about the coordinated effects of neural, endocrine, and autonomic systems on social, emotional, and cognitive development. (PsycINFO Database Record

Future Directions in Research and Intervention with Youths in Poverty.

This article aims to integrate theory and empirical findings about understanding and fostering the process of resilience and adaptation in children and families who live in poverty. In this article, we draw from multiple, somewhat distinct, scholarly streams to identify sources of protection, integrating across the literatures on stress and coping, psychophysiology, cultural identity development, and empowerment theory. Because living in poverty cuts across other dimensions of social differentiation and structural inequality, intersectionality theory frames our discussion of how to leverage poverty-affected youths' diverse experiences. We present a framework to guide intervention and research on resiliency promotion, describe the Building a Strong Identity and Coping Skills intervention stemming from the framework, and suggest possible avenues and next steps for both interventions and research.

Financial stress response profiles and psychosocial functioning in low-income parents.

Parenting in the context of poverty is accompanied by heightened stress and heightened stakes. How parents respond to poverty-related stress has important implications for family functioning, but research investigating individual differences in low-income mothers' and fathers' responses to financial stress and their associations with parents' concurrent psychosocial adaptation is lacking. A better understanding of differences in stress responses among low-income parents is required to develop and tailor prevention programs that meet these families' needs. This study applies latent profile analysis (LPA) to identify and describe profiles of financial stress responses (problem solving, emotion regulation, emotion expression, cognitive restructuring, positive thinking, acceptance, distraction, denial, avoidance, wishful thinking, rumination, intrusive thoughts, emotional arousal, physiologic arousal, impulsive action, emotional numbing, cognitive interference, escape, and inaction) and examines associations between profile membership and psychosocial functioning in low-income parents. Five profiles were identified that were distinguished by self-reported voluntary and involuntary financial stress responses: active (32% of sample), low (11%), high (11%), negative cognitive (NC; 17%), and average (29%) responders. Notable differences emerged on measures of life stress, economic hardship, psychopathology, and social support, with individuals in the NC responders profile reporting the most difficulty and members of the active responders profile reporting the greatest adaptation. These findings offer a more nuanced understanding of how mothers and fathers respond to chronic poverty-related stress and have valuable implications for intervention efforts to promote adaptive stress responses and psychosocial functioning in low-income families. (PsycINFO Database Record

Unlocking the Black Box: A Multilevel Analysis of Preadolescent Children's Coping.

This random assignment experimental study examined the intersection of children's coping and physiologic stress reactivity and recovery patterns in a sample of preadolescent boys and girls. A sample of 82 fourth-grade and fifth-grade (Mage = 10.59 years old) child-parent dyads participated in the present study. Children participated in the Trier Social Stress Test and were randomly assigned to one of two post-Trier Social Stress Test experimental coping conditions-behavioral distraction or cognitive avoidance. Children's characteristic ways of coping were examined as moderators of the effect of experimental coping condition on cortisol reactivity and recovery patterns. Multilevel modeling analyses indicated that children's characteristic coping and experimental coping condition interacted to predict differential cortisol recovery patterns. Children who characteristically engaged in primary control engagement coping strategies were able to more quickly down-regulate salivary cortisol when primed to distract themselves than when primed to avoid, and vice versa. The opposite pattern was true for characteristic disengagement coping in the context of coping condition, suggesting that regulatory fit between children's characteristic ways of coping and cues from their coping environment may lead to more and less adaptive physiologic recovery profiles. This study provides some of the first evidence that coping "gets under the skin" and that children's characteristic ways of coping may constrain or enhance a child's ability to make use of environmental coping resources.

Temperament, coping, and involuntary stress responses in preadolescent children: the moderating role of achievement goal orientation.

BACKGROUND AND OBJECTIVES: Developmental theorists posit that temperament contributes to preadolescent's stress response styles. Findings from empirical studies, however, have yielded mixed results, thus indicating a need to consider moderators of this relation. Utilizing an analytic framework guided by resiliency theory [Zimmerman, M. A. (2013). Resiliency theory: A strengths-based approach to research and practice for adolescent health. Health Education & Behavior, 40, 381-383], this study examined achievement goal orientation as a moderator of the relation between temperament and stress response styles. METHODS: 96 preadolescent-parent dyads (Mage = 10.30 years, range = 9-12 years) participated in the study. Preadolescents reported on their achievement goal orientation, coping and involuntary stress responses (ISRs) styles and a parent reported on children's temperament. RESULTS: Multiple regressions revealed that effortful control positively predicted preadolescent's predominant use of engagement coping and negatively predicted predominance of ISRs, but only for children with a predominant mastery goal orientation. For preadolescents with a predominant performance goal orientation, effortful control negatively predicted the predominant use of engagement coping and positively predicted predominance of ISRs. Negative affectivity and its interaction with goal orientation did not predict coping or ISR styles. CONCLUSIONS: Findings suggest that a predominant mastery goal orientation may function as a promotive factor by enhancing the contribution of effortful control to engagement coping styles and buffering against unmanaged reactivity.

Person-centered examination of salivary cortisol and alpha-amylase responses to psychosocial stress: Links to preadolescent behavioral functioning and coping.

This study adopted a person-centered approach to identify preadolescent salivary cortisol (sC) and alpha-amylase (sAA) co-activation response patterns and examine links to behavioral functioning and coping. Children (N = 151, 51.7% male) were exposed to the Trier Social Stress Test (TSST) and one of two randomly-assigned, post-TSST coping conditions: distraction or avoidance. Multi-trajectory modeling yielded four child subgroups. Child internalizing and externalizing positively predicted High sC-High sAA relative to Low sC-Low sAA and Low sC-High sAA relative to High sC-Low sAA subgroup membership, respectively. Low sC-Low sAA children demonstrated more efficient sC recovery when primed with distraction and more protracted sC recovery when primed with avoidance. For High sC-High sAA, internalizing children, the opposite was true. Findings illustrate adjustment-linked variability in preadolescent sC-sAA co-activation response patterns that further articulates for whom effortful coping works to effectively manage stressor-induced neuroendocrine activation.

If the coping fits, use it: Preadolescent recent stress exposure differentially predicts post-TSST salivary cortisol recovery.

This study examined recent stress exposure and effortful coping effects on salivary cortisol (sC) response patterns in preadolescent boys and girls (N = 121, Mage = 10.60 years). Children were exposed to the Trier Social Stress Test (TSST) and one of two randomly assigned, post-TSST coping conditions: distraction and avoidance. Piecewise growth multilevel modeling did not link children's recent stressful life events or hair cortisol (hC) levels to sC reactivity, though each interacted with coping condition to predict sC recovery patterns. Children with elevated life stressor and hC levels demonstrated protracted sC recovery when primed with distraction, yet more efficient sC recovery when primed with avoidance. Findings challenge assumptions about universally "good" and "bad" coping by highlighting contexts where each succeed and fail in helping children manage acute stress physiology.

Development of Maladaptive Coping: A Functional Adaptation to Chronic, Uncontrollable Stress.

Health disparities are rooted in childhood and stem from adverse early environments that damage physiologic stress-response systems. Developmental psychobiological models of the effects of chronic stress account for both the negative effects of a stress-response system calibrated to a dangerous and unpredictable environment from a health perspective, and the positive effects of such an adaptively calibrated stress response from a functional perspective. Our research suggests that contexts that produce functionally adapted physiologic responses to stress also encourage a functionally adapted coping response-coping that can result in maladjustment in physical and mental health, but enables children to grow and develop within those contexts. In this article, I highlight the value of reframing maladaptive coping as functional adaptation to understand more completely the development of children's coping in different contexts, and the value of such a conceptual shift for coping-based theory, research, and intervention.

A longitudinal examination of the Adaptation to Poverty-Related Stress Model: predicting child and adolescent adjustment over time.

This study tests key tenets of the Adaptation to Poverty-related Stress Model. This model (Wadsworth, Raviv, Santiago, & Etter, 2011 ) builds on Conger and Elder's family stress model by proposing that primary control coping and secondary control coping can help reduce the negative effects of economic strain on parental behaviors central to the family stress model, namely, parental depressive symptoms and parent-child interactions, which together can decrease child internalizing and externalizing problems. Two hundred seventy-five co-parenting couples with children between the ages of 1 and 18 participated in an evaluation of a brief family strengthening intervention, aimed at preventing economic strain's negative cascade of influence on parents, and ultimately their children. The longitudinal path model, analyzed at the couple dyad level with mothers and fathers nested within couple, showed very good fit, and was not moderated by child gender or ethnicity. Analyses revealed direct positive effects of primary control coping and secondary control coping on mothers' and fathers' depressive symptoms. Decreased economic strain predicted more positive father-child interactions, whereas increased secondary control coping predicted less negative mother-child interactions. Positive parent-child interactions, along with decreased parent depression and economic strain, predicted child internalizing and externalizing over the course of 18 months. Multiple-group models analyzed separately by parent gender revealed, however, that child age moderated father effects. Findings provide support for the adaptation to poverty-related stress model and suggest that prevention and clinical interventions for families affected by poverty-related stress may be strengthened by including modules that address economic strain and efficacious strategies for coping with strain.

Children's vagal regulatory capacity predicts attenuated sympathetic stress reactivity in a socially supportive context: evidence for a protective effect of the vagal system.

Social support and vagal regulatory capacity (VRC), an index of flexible vagal responses during various types of stress, are linked to attenuated stress responding and positive health outcomes. Guided by the polyvagal perspective, we tested whether children's VRC is associated with attenuated sympathetic nervous system (SNS) stress reactivity in socially supportive conditions. Sixty-one 4- to 5-year-old children living in poverty underwent two standardized laboratory stress induction procedures. Cardiac vagal reactivity (respiratory sinus arrhythmia) to a first set of stressors (social, cognitive, physical, and emotional) indexed VRC. During a second set of stressors, participants were randomly assigned to a supportive or nonsupportive social context, and cardiac sympathetic reactivity (preejection period) was assessed. We hypothesized VRC would predict lower SNS stress reactivity, but only in the socially supportive context. Children with high VRC showed attenuated SNS stress reactivity in the socially supportive context compared to children with high VRC in the nonsupportive context and children with low VRC in either context. Individual differences in VRC predict attenuated SNS stress reactivity in socially supportive conditions. Understanding how social support and VRC jointly mitigate SNS stress reactivity may further efforts to prevent negative health outcomes. Implications for biological sensitivity to context and differential susceptibility theories are discussed.