To date, there is little evidence that “hypocortisolism” patterns continue once young children are removed from ELS conditions. Indeed, there is evidence that with time in more supportive care environments, not only is the typical pattern of diurnal HPA activity observed, but there is some evidence of elevated basal cortisol levels. This has been shown in several studies of children who spent the early portions of their lives in the depriving conditions of institutions (i.e. post-institutionalized children) prior to being adopted into supportive, well-providing homes (Wismer Fries et al., 2005; Gunnar et al., 2001; Kertes et al., 2008). Elevated levels of basal cortisol several years post-removal from ELS conditions may be particularly likely for children who experience severe stunting in linear growth consistent with psychosocial low stature (e.g. deprivation dwarfism; Kertes et al., 2008; Gunnar et al., 2009). Stunting of physical growth due to early neglect may reflect chronic elevations in CRH and GCs and their impact on the growth axis (Albanese et al., 1994). In sum, severe deprivation of early nurturance may up-regulate HPA activity even though the initial signature of chronic early deprivation or neglect may reveal itself in patterns of hypocortisolism.
