Doctoral Dissertations

Date of Award


Degree Type


Degree Name

Doctor of Philosophy


Social Work

Major Professor

Terri Combs-Orme

Committee Members

Debora R. Baldwin, Rebecca Bolen, Matthew Arthur Cooper, John Orme


This multi-manuscript dissertation concentrates on child stress, an important area of attention for social workers. Many children we work with are exposed to chronic stressors such as poverty, child maltreatment, and other forms of stressors and/or trauma. These experiences can be damaging to a child’s development, especially if they occur early in life, and the effects may be long-lasting. The first manuscript provides an overview of the human stress response and its potential deleterious effects on child brain development. It highlights specific brain regions affected by stress, and possible physical and mental health consequences of stress later in life.Building on this knowledge, and acknowledging the importance of the biological underpinnings of stress, the second manuscript examines the ways in which physiological stress is being measured in school-based intervention research. 20 studies that used physiological measures of stress, over the last ten years, identified the following physiological stress measures: salivary cortisol (11 studies), serum cortisol (1 study), heart rate (4 studies), ambulatory heart rate (2 studies), heart rate variability (2 studies), resting blood pressure (3 studies), ambulatory blood pressure (3 studies), sodium handling (2 studies), alpha amylase (1 study), and skin conductance (1 study). I discuss each biological measure, its role in the human stress response, sensitivity to intervention effects and feasibility issues of each measure in a school setting.The third manuscript presents results of a deep breathing intervention for stress reduction in 5-year-old children using a multiple-baseline across individuals design. Five children in pre-kindergarten or kindergarten received a 5-minute deep breathing intervention daily for four weeks. Salivary cortisol, pulse rate and a perceived stress faces scale were used to measure stress. Although results were inconclusive, I found that deep breathing may be beneficial for stress reduction in some children and five-year-olds are able to participate in a deep breathing intervention. A scripted deep-breathing protocol is presented and limitations for stress measurement with young children and barriers to intervention delivery in a school setting are discussed.

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