Neglected children’s acute hypothalamic–pituitary–adrenal axis (HPA axis) reactivity in response to a laboratory visit was contrasted with that of a comparison group. The authors examined initial salivary cortisol response upon entering the laboratory and its trajectory following a set of tasks designed to elicit negative self-evaluation in 64 children (30 with a history of neglect and 34 demographically matched comparison children). Neglected, but not comparison, children showed higher initial cortisol responses. The cortisol response of both groups showed a decline from the sample taken at lab entry, with neglected children’s cortisol exhibiting steeper decline. The groups, however, did not differ in their mean cortisol levels at 20 and 35 min post-task. The results are interpreted in terms of the meaning of initial responses as a "baseline" and as evidence for neglected children’s heightened HPA-axis reactivity as either a reflection of differences in home levels or the consequence of stress/anxiety associated with arrival at the laboratory.

Physically neglected youth are at increased risk of mental health problems, but there are few interventions that have demonstrated efficacy in reducing mental health symptoms for this vulnerable population. The Fostering Healthy Futures (FHF) program, which consists of mentoring and skills groups, was developed for preadolescent youth in foster care. In a published randomized controlled trial with 156 youth, FHF demonstrated positive impacts on mental health functioning. The current study sought to determine whether FHF might be particularly effective in ameliorating the impact of neglectful family environments. Because it was not possible to isolate a neglected-only subgroup, as most children with physical neglect histories had experienced other types of maltreatment, we tested the hypothesis that intervention effects would be stronger among children with more severe physical neglect. Findings did not support this hypothesis, however, as severity of physical neglect did not significantly moderate the impact of the intervention on psychosocial outcomes.

Given the high prevalence of child neglect among maltreatment subtypes, and its association with exposure to additional environmental adversity, understanding the processes that potentiate child neglect and link neglect to subsequent child externalizing psychopathology may shed light on key targets for preventive intervention. Among 170 urban low-income children (ages 4–9) and their mothers, this 5-year prospective study examined the effects of early neglect severity and maternal substance abuse, as well as neighborhood crime, on children’s later externalizing behavior problems. Severity of child neglect (up to age 6 years) mediated the relation between maternal drug dependence diagnosis (MDDD), determined at children’s age of 4 years, and children’s externalizing behavior problems at age 9. Rates of neighborhood crime mediated the link between presence of child neglect and children’s externalizing behavior problems. The roles of MDDD, child neglect, and community violence in the development of child psychopathology are discussed in terms of their implications for intervention.

Scant research has examined how children of different races or ethnic backgrounds manifest consequences of neglect. We examined multiple domains of functioning (academic/intellectual, social/behavioral, and psychiatric), three theories (racial invariance, double jeopardy, and resilience), and potential confounding variables. Children with documented cases of neglect (ages 0–11) and matched controls without such histories were followed up and interviewed in adulthood (N = 1,039). The sample was 47.3% female, 62.4% White, 34.3% Black, and 3.4% Hispanic. Black and White neglected children showed negative consequences for IQ, reading ability, and occupational status compared to controls. Compared to same race and ethnic group controls, neglected White children showed extensive mental health consequences, Black children showed more anxiety and dysthymia, and Hispanic children showed increased risk for alcohol problems. Black and White neglected children differed in risk for violence compared to same race controls: Neglected Black children were arrested for violence two times more often than Black controls, whereas neglected White children were more likely than White controls to report engaging in violence. Findings provide some support for each theory (racial invariance, double jeopardy, and resilience). Understanding the factors that account for similarities and differences in consequences requires further investigation. Implications for research and policy are discussed.