Continuity of psychopathology v. resilience across the transition to adolescence: Role of hair cortisol and sensitive caregiving

Karen Yirmiya, Shai Motsan, Orna Zagoory-Sharon, Anat Schonblum, Lee Koren, Ruth Feldman

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background The transition to adolescence implicates heightened vulnerability alongside increased opportunities for resilience. Contexts of early life stress (ELS) exacerbate risk; still, little research addressed biobehavioral mediators of risk and resilience across the adolescent transition following ELS. Utilizing a unique cohort, we tested biosocial moderators of chronicity in adolescents' internalizing disorders v. resilience. Method Families exposed to chronic war-related trauma, v. controls, were followed. We utilized data from three time-points framing the adolescent transition: late childhood (N = 177, Mage = 9.3 years ± 1.41), early adolescence (N = 111, Mage = 11 0.66 years ± 1.23), and late adolescence (N = 138, Mage = 15.65 years ± 1.31). In late childhood and late adolescence children's internalizing disorders were diagnosed. At early adolescence maternal and child's hair cortisol concentrations (HCC), maternal sensitivity, and mothers' post-traumatic symptoms evaluated. Results War-exposed children exhibited more internalizing disorders of chronic trajectory and mothers were less sensitive and more symptomatic. Three pathways elucidated the continuity of psychopathology: (a) maternal sensitivity moderated the risk of chronic psychopathology, (b) maternal post-traumatic symptoms mediated continuity of risk, (c) trauma exposure moderated the association between child internalizing disorders at late childhood and maternal HCC, which linked with child HCC. Child HCC linked with maternal post-traumatic symptoms, which were associated with child disorders in late adolescence. Conclusion Results demonstrate the complex interplay of maternal and child's biosocial factors as mediators and moderators of risk chronicity across the adolescent transition following trauma. Findings are first to utilize maternal and child's HCC as biomarkers of chronic stress v. resilience during adolescence, a period of neural reorganization and personal growth that shapes the individual's lifetime adaptation.

Original languageEnglish
Pages (from-to)4487-4498
Number of pages12
JournalPsychological Medicine
Issue number10
StatePublished - 30 Jul 2023

Bibliographical note

Publisher Copyright:
Copyright © The Author(s), 2022. Published by Cambridge University Press.


The study was supported by the Simms/Mann Foundation, the NARSAD Foundation, and the Irving B. Harris Foundation. Karen Yirmiya is grateful to the Azrieli Foundation for the award of an Azrieli Fellowship.

FundersFunder number
Irving B. Harris Foundation
NARSAD Foundation
Simms/Mann Foundation
Azrieli Foundation


    • Adolescence
    • early life stress
    • hair cortisol concentrations
    • mother sensitivity
    • psychopathology
    • trauma


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