Examining stress reactivity in neonates: relations between cortisol and behavior.

The association between cortisol and behavioral reactivity to a medical heel stick and a neurobehavioral exam was examined in 100 healthy African American neonates, who have been underrepresented in this area of research. Using continuous measures, behavioral distress was associated with cortisol reactivity to both stressors. High levels of behavioral distress, however, were associated with cortisol reactivity only in response to the neurobehavioral exam. In contrast, low levels of behavioral distress were associated with cortisol reactivity only in response to the heel stick. The results highlight potentially important parameters for exploring the relation between biological and behavioral reactivity to stress such as the operationalization of behavioral distress and the context in which a stress response is elicited.