The role of social buffering on chronic disruptions in quality of care: evidence from caregiver-based interventions in foster children

Abstract

There is growing evidence that social support can buffer the physiological stress response, specifically cortisol reactivity. We use a developmental framework to review the importance of social buffering in early childhood, a period of heightened plasticity for programming of the hypothalamic-pituitary-adrenal (HPA) axis. The social environment, in which parents play the largest role in early life, is a critical agent in the developmental trajectory of the HPA axis. A prevailing model of social buffering primarily focuses on the role of social support in the context of acute stressors and cortisol response. This review expands this model to provide evidence of the mechanism of social buffering, or lack thereof, across periods of chronic stress by applying the social buffer model to children involved in the child welfare system. We also highlight current interventions that capitalize on the mechanism of social buffering to modify HPA axis functioning across childhood. Last, we synthesize our findings using the social buffering framework to inform future targeted interventions.

Keywords: Neglect; cortisol; development; intervention; social support.

Figures

Figure 1. Working conceptual model of social buffer theory extension

An acute stressor evokes an increase in cortisol reactivity. An effective social buffer can moderate (i.e., dampen) this cortisol reactivity. However, the effectiveness of the social buffer during an acute stressor is dependent on the quality of the parent–child relationship over time. Parents who provide consistent, supportive care are more effective social buffers for their children than those who are not. Over time, these processes (depicted in gray) shape overall functioning of the HPA axis, as indicated by diurnal cortisol, and are moderated by chronic stress, which can take many forms including but not limited to neglect, maltreatment, and socioeconomic adversity. Additionally, we recognize other pathways that likely affect this model and warrant further investigation. The quality of the social buffer may directly impact diurnal cortisol, and the nature of the acute stressor (i.e., lack of food or shelter vs. physical abuse) likely interacts with the quality of the social buffer and social buffering capacity.