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Abstract
The aim of the present study was to investigate the role of cortisol circadian rhythm regulation in the effect of infant neglect severity on internalizing and externalizing problem behaviors at school entry. 165 children investigated by Child Protective Services were followed longitudinally. Caregivers and CPS caseworkers reported severity of neglect at Time 1 (child age 0-12 months), and caregivers reported internalizing and externalizing problem behaviors and collected saliva samples at Time 2 (age 5-6 years). Severity of neglect significantly predicted both internalizing and externalizing behaviors, and these pathways were significantly moderated by patterns of diurnal cortisol secretion. Only children with low diurnal cortisol change evidenced significant associations between neglect severity at time 1 and internalizing and externalizing behaviors at time 2. Results suggest that children neglected as infants with subsequent dysregulation of the stress response system may be particularly vulnerable to problem externalizing and internalizing behaviors at early school age.