Promoting hope: preliminary investigation into a college-level hope curriculum.

OBJECTIVE: Hope is a malleable, cognitive, motivational skill that supports college student outcomes. We evaluated a college-level curriculum that taught hope skills. PARTICIPANTS: Using a voluntary response sampling method, a total of 50 participants were included in the present study with 25 in each the control and intervention group. METHODS: All students completed surveys on hope at the beginning and end of the semester. The intervention group participated in a 10-week curriculum; students in the control group completed their regular introductory course. RESULTS: The intervention group had a significant increase in hope over the semester. Completing the hope course predicted significantly higher end-of- -semester hope, accounting for the beginning-of- semester hope. CONCLUSIONS: Hope can be taught via a classroom setting using a curriculum that requires limited financial and time resources. Improving college student hope has implications for their academic and well-being outcomes.

A multimethod examination of hope and adolescent STEM career expectancies.

INTRODUCTION: Science, technology, engineering, and mathematics (STEM) fields are growing rapidly and understanding adolescent's interest and hope for pursuing a STEM career is essential for additional growth and opportunity collectively and individually. Hope is a cognitive-motivational construct that includes three components: hopeful future expectations (HFEs), intentional self-regulation (ISR), and connection, and is associated with academic achievement and career pursuit; it has not been examined in relation to STEM. This study fills a gap in the literature by taking a multimethod approach to understanding the association between adolescents' hope and STEM career interests. METHODS: Participants were 639 middle- and high-school adolescents in the southwestern United States who quantitatively reported their hope and STEM career interests and provided qualitative descriptions of reasons for wanting to pursue a STEM career. RESULTS: Quantitatively, HFEs significantly and positively predicted STEM career interest. Relations were examined by gender and school level. For middle-school girls, ISR significantly predicted STEM career interest, for middle-school boys and high-school girls, HFEs positively significantly predicted STEM career interest, but results of high-school boys were nonsignificant. Qualitatively, adolescents mentioned reasons aligning with HFEs and ISR as motivations for pursuing a STEM career, as well as prosocial motivations. Additionally, they discussed their interest in a STEM career as a way to pursue other goals such as financial stability. DISCUSSION: Findings highlight the possibility of hope as a malleable motivation for STEM career pursuit. Our findings support the components of hope as a salient associate of early STEM career interest, with adolescents who have high HFEs and ISR being particularly apt to say they would like to pursue a STEM career. Our results support the active development of hope among US adolescents as a catalyst toward personal and global success.

Students' perceptions, educational challenges and hope during the COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic has disrupted the lives of US students both at home and at school. Little is known regarding how adolescents perceive COVID-19 has impacted (both positively and negatively) their academic and social lives and how protective factors, such as hope, may assist with resilience. Importantly, not all pandemic experiences are necessarily negative, and positive perceptions, as well as potential protective factors, are key to understanding the pandemic's role in students' lives. METHOD: Utilizing quantitative and qualitative approaches, the present study descriptively examined 726 6th through 12th grade (51% female, 53% White) students' perceptions of how COVID-19 related to educational and life disruptions, and positive aspects of their lives, within the United States. Analyses additionally explored the role of pre-pandemic hope in improving feelings of school connectedness during the pandemic. RESULTS: Results showed that most students felt that switching to online learning had been difficult and their education had suffered at least moderately, with a sizeable proportion of students feeling less academic motivation compared with last year. When asked to share qualitative answers regarding perceived challenges and positive aspects of life, themes were consistent with quantitative perceptions. Students' pre-pandemic hope positively predicted students' feelings of school connectedness. CONCLUSIONS: Findings paint a complex picture of youth's COVID-19 experiences and have implications for proactive ways to support students as COVID-19 continues to affect daily life and educational structures and practices.

The Role of Parents in Reducing Academic, Health, and Behavioral Problems for Native American, African American, and Latinx Adolescents.

OBJECTIVE: The aim of the study was to determine how parental modeling of thoughtful behavior and the home physical environment may reduce the number of developmental problems exhibited by Native American, African American, and Latinx adolescents. METHOD: Demographic and home environmental data were collected from 54 Native American, 131 African American, and 159 Latinx families living in 4 states as part of a home visit. Parents and adolescents were administered surveys that captured adolescent health, social skills, problem behavior, self-efficacy beliefs, vocabulary attainment, and school grades. Scores from the surveys were combined to construct both an adolescent problems index and a household risk index. For each of the 3 racial/ethnic groups examined, the adolescent problems index was regressed on parental modeling and encouragement of mature behavior, the home physical environment, and the household risk index. RESULTS: Modeling and encouragement of mature behavior was a significant bivariate predictor of overall problems in all 3 groups of adolescents-albeit the overall regression model was nonsignificant for Native Americans. By contrast, the other 2 predictors were nonsignificant in regression models for all 3 groups. CONCLUSION: Native American, African American, and Latinx adolescents often face a multitude of risks, including poverty and discrimination. As a consequence, adolescents from these 3 racial/ethnic groups frequently display problems pertaining to health, competence, and adaptive behavior. The results from this study suggest that adolescents from such demographic groups are less likely to manifest developmental problems if their parents model mature behavior and encourage the adolescent to act in thoughtful ways.

Hope levels across adolescence and the transition to high school: Associations with school stress and achievement.

INTRODUCTION: Feeling hopeful is an important condition for adolescents' health, well-being, and educational success and attainment, yet limited research has examined hope at different ages throughout adolescence. Information regarding hope levels across grade could help educators know when to capitalize on goal-setting behaviors, and when to intervene should hope levels be low. Additionally, hope could help with the middle to high school transition because it presents opportunities and challenges, including school-related stress, as students adjust to new environments and expectations. METHODS: To investigate hope levels across adolescence, inter- and intra-personal analyses examined hope levels across grade-level in two cohorts of southwestern U.S. students (n = 1,018, 6th-10th grade students, 47% female, 55% White/45% non-White, (predominately Latinx)). The study used online self-report surveys to collect data. Next, longitudinal regression analyses across one year investigated relations of school stress and hope, and hope and achievement across the transition to high school. RESULTS: Students in both cohorts reported relatively stable hope levels from 6th to 10th grade, except for large decreases in hope during 8th grade, which recovered during 9th grade. For longitudinal analyses across the high school transition, student stress about school performance primarily influenced 8th graders who had relatively low hope. Eighth grade hope predicted 9th grade academic achievement. CONCLUSION: Findings regarding hope across adolescence show that hope is similar across grade, except for a large decrease in hope that may occur before the transition to high school. Longitudinal analyses showed that school performance stress may contribute to this decrease but may also assist in hope recovery after the transition. Findings support educational practices and policies that target student hope before the high school transition to potentially buffer student stress and promote high school achievement.

The case for the repeatability intra-class correlation as a metric of precision for salivary bioscience data: Justification, assessment, application, and implications.

Best practice standards for measuring analyte levels in saliva recommend that all biospecimens be tested in replicate with mean concentrations used in statistical analyses. This approach prioritizes minimizing laboratory-based measurement error but, in the process, expends considerable resources. We explore the possibility that, due to advances in salivary assay precision, the contribution of laboratory-based measurement error in salivary analyte data is very small relative to more important and meaningful variability in analyte levels across biological replicates (i.e., between different specimens). To evaluate this possibility, we examine the utility of the repeatability intra-class correlation (rICC) as an additional index of salivary analyte data precision. Using randomly selected subsamples (Ns=200 and 60) of salivary analyte data collected as part of a larger epidemiologic study, we compute the rICCs for seven commonly assayed salivary measures in biobehavioral research - cortisol, alpha-amylase, c-reactive protein, interlekin-6, uric acid, secretory immunoglobulin A, and testosterone. We assess the sensitivity of rICC estimates to assay type and the unique distributions of the underlying analyte data. We also use simulations to examine the bias, precision, and coverage probability of rICC estimates calculated for small to large sample sizes. For each analyte, the rICCs revealed that less than 5% of variation in analyte levels was attributable to laboratory-based measurement error. rICC estimates were similar across all analytes despite differences in analyte levels, average intra-assay coefficients of variation, and in the distributional properties of the data. Guidelines for calculating rICC are provided to enable investigators and laboratory staff to apply this metric and more accurately quantify, and communicate, the magnitude of laboratory-based measurement error in their data. By helping investigators scale measurement error relative to more scientifically meaningful variability between biological replicates, the application of the rICC has the potential to influence research strategies and tactics such that resources (e.g., finances, effort, number/volume of biospecimens) are allocated more efficiently and effectively.

Effect of animal assisted interactions on activity and stress response in children in acute care settings.

Objective: Determine the effects of animal assisted interactions (AAI) on activity and stress response in pediatric acute care settings. Design: Randomized treatment control design. Setting: Inpatient pediatric acute care units (PICU, CVICU and Hematology/Oncology). Patients: Eighty pediatric inpatients (49% male) age 2-19 years. Intervention: The AAI experimental group patients interacted with therapy dog teams for 5-10 min and the comparison group patients continued their current activity without an AAI visit. Measurement and results: Salivary cortisol, activity level, and mood were assessed before and after AAI. AAI was associated with a decrease in cortisol levels and increases in mood and activity. Conclusion: AAI benefits children in pediatric acute care units.

A multi-centre international study of salivary hormone oestradiol and progesterone measurements in ART monitoring.

RESEARCH QUESTION: Ovarian stimulation during IVF cycles involves close monitoring of oestradiol, progesterone and ultrasound measurements of follicle growth. In contrast to blood draws, sampling saliva is less invasive. Here, a blind validation is presented of a novel saliva-based oestradiol and progesterone assay carried out in samples collected in independent IVF clinics. DESIGN: Concurrent serum and saliva samples were collected from 324 patients at six large independent IVF laboratories. Saliva samples were frozen and run blinded. A further 18 patients had samples collected more frequently around the time of HCG trigger. Saliva samples were analysed using an immunoassay developed with Salimetrics LLC. RESULTS: In total, 652 pairs of saliva and serum oestradiol were evaluated, with correlation coefficients ranging from 0.68 to 0.91. In the European clinics, a further 237 of saliva and serum progesterone samples were evaluated; however, the correlations were generally poorer, ranging from -0.02 to 0.22. In the patients collected more frequently, five out of 18 patients (27.8%) showed an immediate decrease in oestradiol after trigger. When progesterone samples were assessed after trigger, eight out of 18 (44.4%) showed a continued rise. CONCLUSIONS: Salivary oestradiol hormone testing correlates well to serum-based assessment, whereas progesterone values, around the time of trigger, are not consistent from patient to patient.

Correspondence Between Cytomegalovirus Immunoglobulin-G Levels Measured in Saliva and Serum.

Human cytomegalovirus (HCMV) infects more than 80% of the global population. While mostly asymptomatic, HCMV infection can be serious among the immunocompromised, and it is implicated in chronic disease pathophysiology in adulthood. Large-scale minimally invasive HCMV screening could advance research and public health efforts to monitor infection prevalence and prevent or mitigate downstream risks associated with infection. We examine the utility of measuring HCMV immunoglobulin-G (IgG) levels in saliva as an index of serum levels. Matched serum and saliva samples from healthy adults (N = 98; 44% female; 51% white) were assayed for HCMV IgG, total salivary protein, and salivary markers related to oral inflammation, blood, and tissue integrity. We examine the serum-saliva association for HCMV IgG and assess the influence of participant characteristics and factors specific to the oral compartment (e.g., oral inflammation) on HCMV IgG levels and cross-specimen relations. We found a robust serum-saliva association for HCMV IgG with serum antibody levels accounting for >60% of the variance in salivary levels. This relation remained after adjusting for key demographic and oral immune-related variables. Compared to the serum test, the salivary HCMV IgG test had 51% sensitivity and 97% specificity. With improvements in assay performance and sample optimization, HCMV antibody levels in oral fluids may be a useful proxy for serum levels.

Biobehavioral Dysregulation and its Association with Obesity and Severe Obesity Trajectories from 2 to 15 Years of Age: A Longitudinal Study.

OBJECTIVE: This study aimed to identify obesity trajectories from childhood to adolescence (2-15 years of age) and investigate differences in behavioral, eating, and adrenocortical regulation by trajectory membership. METHODS: A total of 1,077 households from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development were included. Anthropometrics were measured 11 times between ages 15 months and 15 years. Behavioral self-regulation was assessed at ages 3 and 4 years. Disordered eating behaviors and awakening cortisol were assessed at age 15 years. RESULTS: Latent growth curve modeling identified four BMI trajectories: two nonoverweight trajectories based on average BMI at the 40th and 70th percentiles and overweight/obesity and severe obesity trajectories. Youth in the severe obesity trajectory exhibited lower behavioral self-regulation in early childhood and lower awakening cortisol at age 15 years compared with youth in the nonoverweight trajectories. Youth in the overweight/obesity and severe obesity trajectories showed higher levels of disordered eating behaviors at age 15 years. CONCLUSIONS: Obesity trajectories were associated with biobehavioral markers of dysregulation in early childhood and adolescence. Dysregulation across biobehavioral domains was particularly apparent among youth who developed severe obesity. Further work is needed to better understand resilience factors that distinguish youth who develop obesity and severe obesity from those who do not.

Salivary total Immunoglobulin G as a surrogate marker of oral immune activity in salivary bioscience research.

The integration of salivary biomeasures in biobehavioral, psychophysiological, and clinical research has greatly expanded our ability to study the biopsychosocial processes underlying health. Much of this research, however, has failed to adequately assess and adjust for the impact of oral immune activity on salivary biomeasure concentrations and associations with serum levels. Aiming to improve the validity and reliability of salivary biomeasure data, we examine salivary total Immunoglobulin G (IgG) as a potential surrogate marker of oral inflammation and immune activity. During a single study visit in Baltimore, Maryland, healthy young adult participants provided matched blood and saliva samples (N=99; age 18-37 years, 42% female) and completed an oral health questionnaire. Biospecimens were assayed for total IgG and immune markers related to inflammation (cytokines), blood in saliva (transferrin), and tissue remodeling (matrix metalloproteinase-8). Total IgG (µg/mL) concentrations were higher in serum than saliva. Salivary total IgG was associated with some self-reported oral health measures, and strongly positively associated with all salivary immune markers. Controlling for salivary total IgG may be a feasible, affordable approach to adjusting salivary biomeasure findings for the influence of the oral immune environment when it is not possible or practical to obtain clinical oral health data.

Improving infants' stress-induced cortisol regulation through attachment-based intervention: A randomized controlled trial.

Attachment-based parenting interventions have shown positive effects on early cortisol regulation, a key biomarker. Evaluations to date have focused on diurnal cortisol production in high-risk infants. It is important to understand whether attachment-based intervention may also improve stress-induced cortisol production in typically developing infants. This randomized controlled trial tested an enhanced model of U.S. Early Head Start (EHS) services that combined home-based EHS with a brief, attachment-based parenting intervention, Attachment and Biobehavioral Catch-up (ABC). The trial included 153 low-income mothers and their infants (M age 12.4 months [SD = 4.1]). Control participants received home-based EHS plus 10 weekly books. Intent-to-treat analyses using multilevel models revealed a significant indirect intervention effect on infants' rates of cortisol change in response to a series of mild stressors. The intervention increased maternal sensitivity, which in turn improved cortisol regulation, particularly infants' rates of cortisol recovery. The findings illustrate the efficacy of EHS plus ABC for supporting infants' stress-induced cortisol regulation and implicate sensitive maternal behavior as the underlying driver of the intervention effect. Findings are discussed in terms of the preventative value of attachment-based parenting interventions that improve both parenting and infants' physiological regulation.

Parents' and teachers' academic influences, behavioral engagement, and first- and fifth-grade achievement.

Parents and teachers-primary socializers across elementary grades-offer potentially differential support mechanisms for children's healthy functioning across developmental periods. Utilizing child, parent, teacher, and observational data from the National Institute of Child Health and Human Department Study of Early Child Care and Youth Development (n = 1,031), we employed a longitudinal path model to examine indirect associations between parents' and teachers' academic influences (i.e., direct parental involvement, the student-teacher relationship, instructional support) and achievement (reading and math) through behavioral engagement at 1st and 5th grades. Results indicated indirect associations linking direct parental involvement (positively, 1st grade only), student-teacher conflict (negatively, both grades), and instructional support (positively, both grades) to achievement via behavioral engagement, after accounting for the co-occurrence of parents' and teachers' academic influences and other child characteristics. School psychologists may opt for interventions focusing on parents' and teachers' academic influence to indirectly effect achievement by promoting elementary school behavioral engagement. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Stress physiology and memory for emotional information: Moderation by individual differences in pubertal hormones.

In contrast to a large body of work concerning the effects of physiological stress reactivity on children's socioemotional functioning, far less attention has been devoted to understanding the effects of such reactivity on cognitive, including mnemonic, functioning. How well children learn and remember information under stress has implications for a range of educational, clinical, and legal outcomes. We evaluated 8-14 year olds' (N = 94, 50 female) memory for negative, neutral, and positive images. Youth had seen the images a week previously as a part of a laboratory stress task. At encoding and retrieval, and in between, youth provided saliva samples that were later assayed for cortisol, salivary α amylase (sAA), testosterone, and dehydroepiandrosterone (DHEA). Overall, higher cortisol reactivity to the lab task predicted enhanced memory for emotional but not neutral images. However, cortisol further interacted with pubertal hormones (testosterone and DHEA) to predict memory. Among girls with lower pubertal hormone levels, greater cortisol reactivity was associated with enhanced memory for negative information, whereas among boys with higher pubertal hormone levels, cortisol reactivity was associated with enhanced memory for positive information. sAA, was unrelated to memory. Overall, our findings reveal that individual differences in hormone levels associated with pubertal development have implications for our understanding of how stress-responsive biological systems directly and interactively influence cognitive outcomes. (PsycINFO Database Record

The effect of a service dog on salivary cortisol awakening response in a military population with posttraumatic stress disorder (PTSD).

Recent studies suggest a therapeutic effect of psychiatric service dogs for military veterans with posttraumatic stress disorder (PTSD), but are limited by self-report biases. The current study assessed the effect of PTSD service dogs on the salivary cortisol awakening response (CAR) and arousal-related functioning in a population of military veterans with PTSD. Participants included 73 post-9/11 military veterans with PTSD including 45 with a service dog and 28 on the waitlist to receive one. Saliva samples were collected on two consecutive weekday mornings at awakening and 30 min later to quantify the cortisol awakening response (CAR) and its area under the curve (AUCi) in addition to standardized survey measures of anxiety, anger, sleep quality and disturbance, and alcohol abuse. There was a significant main effect of having a service dog on both the CAR and the AUCi, with individuals with a service dog exhibiting a higher CAR and AUCi compared to those on the waitlist. Results also revealed that those with a service dog reported significantly lower anxiety, anger, and sleep disturbance as well as less alcohol abuse compared to those on the waitlist, with medium to large effect sizes. Although those with a service dog reported significantly less PTSD symptom severity, CAR was not significantly associated with PTSD symptoms within or across group. In conclusion, results indicate that the placement of a PTSD service dog may have a significant positive influence on both physiological and psychosocial indicators of wellbeing in military veterans with PTSD. Although clinical significance cannot be confirmed, a higher CAR/AUCi among those with a service dog may indicate better health and wellbeing in this population. Future within-subject, longitudinal research will be necessary to determine potential clinical significance and impact of individual differences.

The validity, stability, and utility of measuring uric acid in saliva.

AIM: Serum uric acid (UA) is associated with many health conditions, including kidney, cardiovascular, and metabolic disorders. We examined the validity and stability of salivary UA as a noninvasive measure of serum UA. MATERIALS & METHODS: Using serum and salivary UA data from healthy adults (n = 99), we examined the UA serum-saliva correlation, and UA associations with adiponectin and C-reactive protein. Using longitudinal data from young adults (n = 182), we examined salivary UA stability. RESULTS: We found robust positive serum-saliva correlations for UA. UA and adiponectin were inversely related in serum and saliva. Salivary UA was relatively stable; 62-66% of variance could be attributed to a latent trait-like component. CONCLUSION: Salivary UA may be an important biomarker indexing health and disease risk.

First grade classroom-level adversity: Associations with teaching practices, academic skills, and executive functioning.

Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development and a model-building approach, the authors examined direct and indirect associations between first-grade (G1) classroom-level adversity (CLA), G1 teaching practices, and student (N = 1,073; M = 6.64 years; 49% girls; 82% White) academic skills and executive functioning in G1 and third grades (G3). Teachers reported the prevalence of adversity among their students (e.g., poor home/family life, poor academic/social readiness). Observers rated G1 teaching practices: teachers' classroom management, controlling instruction, and amount of academic instruction (classroom observation system). Children completed literacy and math assessments at 54 months, G1, and G3 (Woodcock Johnson Letter-Word Identification and Applied Problems), and executive functioning at G1 and G3 (Tower of Hanoi). Direct associations emerged between CLA and controlling instruction (positive), classroom management, and academic instruction (both negative). In addition, CLA was related to G1 literacy (but not math) directly and indirectly via classroom management (negatively) and controlling instruction (positively). The addition of G3 outcomes revealed a negative direct longitudinal association between CLA and G3 executive functioning, and indirect associations with G3 literacy and math through G1 teaching practices and literacy. Results support the notion that collective student characteristics influence student outcomes in part through teaching practices and suggest that teachers and students may benefit from the diffusion of high-adversity classroom compositions when possible. Moreover, in high-adversity classrooms teachers and students may benefit from supports targeting classroom management and foundational student competencies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Long-Term Effects of Prematurity, Cumulative Medical Risk, and Proximal and Distal Social Forces on Individual Differences in Diurnal Cortisol at Young Adulthood.

This study examined the effects of prematurity, cumulative medical risk, and proximal and distal social forces on individual differences in the activity of the hypothalamic-pituitary-adrenal (HPA) axis in young adulthood. A prospective sample of 149 infants born healthy preterm (PT; n = 22), sick PT ( n = 93, medical illness, neurological illness, small for gestational age), and full term ( n = 34) was recruited from a Level III neonatal intensive care unit in southern New England between 1985 and 1989 and followed to age 23 years. Cumulative medical risk was indexed across seven assessment waves (spanning 17 years) using medical and neurological health status at birth, toddlerhood (ages 18 and 30 months), childhood (ages 4 and 8 years), and adolescence (ages 12 and 17 years). Distal risk included socioeconomic status (SES) at birth. Proximal social factors were indexed from assessments of the home environment and measures of child vulnerability and maternal self-esteem, involvement, and control style from birth, 4 years, 8 years, and 12 years. At age 23 years, five saliva samples were collected upon awakening, 45 min after waking, 4 hr after waking, 8 hr after waking, and bedtime (later assayed for cortisol). Results reveal effects of cumulative medical risk on the diurnal pattern of HPA axis activity, with moderating effects of SES and proximal social factors. Findings are discussed in terms of implications for contemporary theories related to developmental sensitivity and susceptibility to context and the developmental origins of health and disease theory.

Kindergarten School Engagement: Linking Early Temperament and Academic Achievement at the Transition to School.

RESEARCH FINDINGS: Although children's temperament contributes to their academic success, little is known regarding the mechanisms through which temperament is associated withacademic achievement during the transition to elementary school. One such mechanism may be school engagement, but findings are inconsistent and limited. Across two waves of data at the transition to school, we examined the role of kindergarten emotional and behavioral engagement as links between preschool temperament (positive emotionality, anger, andeffortful control), and kindergartenacademic achievement, among a predominantlyMexican/Mexican-Americansample of 241children drawn from Head Start classrooms. Significant direct effects indicated that preschool anger was negatively,and positive emotionality and effortful control werepositively,associated withkindergarten behavioralengagement.Only preschool anger was significantly associatedwithkindergarten emotional engagement. In turn, kindergarten behavioral, but not emotional, engagement was directly, positively associated withkindergartenacademic achievement. All three preschool temperament measures were indirectly related to kindergarten achievement via kindergarten behavioral engagement, and anger was indirectly related to kindergarten achievement via emotional engagement. PRACTICE OR POLIC: Findings highlight the importance of understanding the role of engagement as a mechanismthat can foster children'sacademic achievement at a key developmental transition.

Prematurity and perinatal adversity effects hypothalamic-pituitary-adrenal axis reactivity to social evaluative threat in adulthood.

This study examined the long-term effects of prematurity and perinatal adversity on individual differences in stress-related reactivity and regulation of the HPA axis. A prospective sample of 155 infants born preterm and healthy (n = 20), medical illness (n = 48), neurological illness (n = 26), and small for gestational age (n = 24) and full-term (n = 37) were recruited between 1985 and 1989. At age 23 years, multiple saliva samples were collected before and after participation in the Trier Social Stress Test and later assayed for cortisol. Results reveal that at age 23 years, infants born premature with neurological complications showed higher cortisol reactivity to social evaluative threat compared to either their full-term, small for gestation age, medically ill, or healthy preterm peers. Findings are discussed in terms of implications for contemporary theories that propose effects of early adversity on biological sensitivities and susceptibilities, which translate experience into developmental outcomes related to poor health and risk for disease.