Stress, Cortisol, and Externalizing Behavior in Adolescent Males: An Examination in the Context of Multisystemic Therapy Open Access

Schechter, Julia Corwin (2010)

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Abstract


Abstract
Stress, Cortisol, and Externalizing Behavior in Adolescent Males: An Examination in the
Context of Multisystemic Therapy
By Julia C. Schechter
Aggression and delinquency are associated with an array of emotional, behavioral, and
health problems (Loeber, Burke, Lahey, Winters, & Zera, 2000). Additionally, a
multitude of variables are thought to lead to the development of externalizing disorders in
adolescent males. The purpose of the current study was to investigate the relationship
among stress, cortisol, and externalizing behaviors in males, specifically in a treatment
context. In an effort to examine potential differential effects of stressor types, measures
of stress were delineated into lifetime, current episodic, and daily hassles sub-categories.
This study examined data from a sample of 120 adolescent males (mean age = 15 years)
referred to Multisystemic Therapy (MST) for externalizing problems. Partial correlations
were used to examine concurrent relationships among self-reported stress, morning
cortisol, and externalizing problems (parent reports of aggression and delinquency) at
time of referral. Analyses did not yield significant relationships between stress or cortisol
and externalizing behavior prior to treatment. Regression analyses were used to measure
whether cortisol or stress predicted treatment outcome for youths with externalizing
behavior problems. Results indicated that compared to youth who had experienced fewer
hassles, youth that had experienced more daily hassles had higher levels of externalizing
behavior after treatment. This relationship was moderated by cortisol levels at
awakening, such that youth with more daily hassles and high levels of cortisol had the
worst outcome at post treatment. This interaction remained significant after controlling
for post treatment internalizing disorders. Implications and future directions for treatment
are discussed.


Stress, Cortisol, and Externalizing Behavior in Adolescent Males: An Examination in the
Context of Multisystemic Therapy
Julia Corwin Schechter
B.S., Cornell University, 2007
Advisor: Patricia Brennan, Ph.D.
A thesis submitted to the Faculty of the
James T. Laney School of Graduate Studies of Emory University
in partial fulfillment of the requirements for the degree of
Master of Arts in Psychology
2010

Table of Contents


Table of Contents
Introduction ........................................................................................................................ .1
Types of Stress .......................................................................................................... 4
Stress Exposure and Cortisol .................................................................................... 6
Cortisol and Externalizing Problems ......................................................................... 8
Internalizing Disorders ............................................................................................ 11
Treatment Outcome .................................................................................................. 12
Cortisol as a Moderator of the Relationship Between Stress and Externalizing
Behavior .................................................................................................................... 14
Multisystemic Therapy (MST) ................................................................................... 15
The Present Study.............................................................................................................. 16
Hypotheses.................................................................................................................. 16
Method........................................................................................................................ 17
Measures ..................................................................................................................... 18
Results ......................................................................................................................... 21
Discussion ......................................................................................................................... 25
Potential Limitations and Future Directions ..................................................................... 33
References ......................................................................................................................... 36
Table 1: Descriptive Statistics........................................................................................... 50
Table 2: Pearson Product Moment Inter-correlations Between Cortisol and Stress
Measures…………………………………………………………………………………51
Table 3: Pearson Product Moment Inter-correlations Between Cortisol, Stress Measures,
and Externalizing Behaviors ............................................................................................. 52
Table 4: Moderator Analyses ............................................................................................ 53
Table 5: Zero-order Correlations not Controlling for Ethnicity........................................ 54



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