Date of Award

January 2021

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Ashley Hagaman

Second Advisor

Michelle Silva


Background. This study aims to assess the association between perceived stress and maternal responses to child developmental behavior, utilizing hypothalamic-pituitary-adrenal (HPA) axis biomarkers to measure maternal stress: cortisol, cortisone, DHEA and testosterone.

Methods. This study was conducted using data collected from a randomly selected sample of mother-infant dyads from the Bachpan cohort. This analysis focuses on data collected at baseline and 36 months postpartum. Of the women who screened positive for depressive symptoms at baseline (n=889) and provided responses to the 36-month questionnaire assessing perceived stress, a sub-sample (n=90) provided hair cortisol concentration (HCC) samples and completed a questionnaire concerning parental responses to child misbehavior. A series of bivariate correlations and regression statistics adjusting for the education, socioeconomic status, age and sample clustering were used to assess the relationship between stress and response to child misbehavior.

Results. Mothers utilized negotiation and reason most frequently per week, followed by diversion, scolding, and yelling in response to child misbehavior. Testosterone levels exhibited significantly strong associations with spanking (=-0.989, p<0.01) as well as shaming (=0.544, p<0.05) in response to misbehavior. Other associations include cortisol and shaming (=0.038, p<0.10); cortisone and slapping child (=-0.017, p<0.05); DHEA and timeouts(=0.035, p<0.01).

Discussion. Maternal perception of stress significantly impacts their methods of parenting tactics used in response to child misbehavior. The correlation between parental responses increases the likelihood of engaging in other associated responsive behaviors.

Conclusion. This assessment found biomarkers to be significantly correlated with the expression of parenting tactics. Public health interventions targeting reduction of maternal parenting stress are recommended to lessen the impact of biopsychosocial associations with negative parenting skills in order to construct supportive developmental environments and improve child health outcomes.


This is an Open Access Thesis.

Open Access

This Article is Open Access