Structure provided by parents in middle childhood predicts cortisol reactivity in adolescence among the offspring of parents with bipolar disorder and controls Mark A. Ellenbogen a, * , Sheilagh Hodgins b a Centre for Research in Human Development, Concordia University, 7141 Sherbrooke Street West, Montre´al, Que´bec H4B 1R6, Canada b Department of Forensic Mental Health Sciences, Institute of Psychiatry, King’s College University of London, London, United Kingdom Received 22 July 2008; received in revised form 10 December 2008; accepted 16 December 2008 1. Introduction There is growing evidence that the functioning of the hypothalamic—pituitary—adrenal (HPA) axis may be deter- mined, in part, by early prenatal and postnatal environmen- tal experience (Fride et al., 1986; Lyons et al., 2000; Seckl and Meaney, 2004; Levine, 2005). The handling of rat pups for 15 min daily during the first 2 weeks of life resulted in less fearfulness in response to novelty, lower plasma glucocorti- coid levels, a decreased HPA response to stress, increased glucocorticoid receptors in the hippocampus and frontal cortex, and decreased corticotropin-releasing hormone (CRH) gene expression in the hypothalamus and amygdala Psychoneuroendocrinology (2009) 34, 773—785 KEYWORDS Cortisol; Adolescence; Hypothalamic—pituitary— adrenal axis; Parenting; Affective disorders Summary Recent studies suggest that childhood exposure to adversity influences later func- tioning of the hypothalamic—pituitary—adrenal (HPA) axis. Parenting style in childhood, a putative moderator of adversity, may be important in determining HPA reactivity in adolescence. As part of a prospective, longitudinal study, saliva was collected at awakening and 30 and 60 min later over 2 days among 27 offspring of parents with bipolar disorder (high risk; 16.7 Æ 1.5 years) and 26 offspring of parents with no mental disorders (low risk; 16.2 Æ 1.7 years). In addition, 24 of the high risk and 22 of the low risk adolescents completed the ‘‘Trier Social Stress Test’’ (TSST). Parents had rated their parenting style when their offspring were 6—13 years of age. Low levels of structure (i.e. organization and consistency) provided by parents in middle childhood were predictive of an elevated cortisol response following awakening (b = À0.36; p < 0.05) and during the TSST (b = À0.33; p < 0.05), even while controlling for risk group. These associations were independent of other indices of environmental risk, and of adolescents’ mood and behavior. The level of structure provided by parents in childhood predicted independent measures of cortisol reactivity in adolescence, suggesting that parenting style may regulate different aspects of HPA reactivity. # 2009 Elsevier Ltd. All rights reserved. * Corresponding author. Tel.: +1 514 848 2424x7543; fax: +1 514 848 2815. E-mail address: mark.ellenbogen@concordia.ca (M.A. Ellenbogen). available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/psyneuen 0306-4530/$ — see front matter # 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.psyneuen.2008.12.011