College of Science and Health Theses and Dissertations

Date of Award

Spring 6-9-2023

Degree Type


Degree Name

Master of Arts (MA)



First Advisor

Jocelyn Carter, PhD

Second Advisor

Kathryn Grant, PhD


Youth with chronic medical conditions (CMC) may be at-risk for increased stressors. For adolescents with CMC, maladaptive stress responsivity could lead to worse psychological and physiological effects from the stressors themselves. The current study aimed to understand the relation between affective and physiological responses to stress, environmental context, and longer-term health outcomes in youth with and without CMC. A sample of 141 adolescents, 73 with CMC and 68 without CMC, were randomly matched on age and gender. Participants completed self-report questionnaires at two time points, 6 months apart. Cortisol samples were collected during different timepoints of the Trier Social Stress Test (TSST). Correlations assessed differences in the relation between affective and cortisol responses, and how chronic environmental stressors impacted affective and cortisol responses differentially in youth with and without CMC. ANOVAs assessed differences in affective and cortisol responses, and in neighborhood stress between youth with and without CMC. Linear regressions assessed the impact of affective and cortisol responses at Time 1 on health outcomes reported at Time 2. Results revealed cortisol reactivity of adolescents without CMC was related to change in positive affect. Among those with CMC, adolescents experienced less positive affect before the stressor task. In addition, those with higher levels of neighborhood stress were associated with more anxiety and less positive affect. Furthermore, higher crime was associated with lower peak cortisol reactivity and more negative affect. Finally, those who experienced more negative affect prior to the acute stress later reported less pain-free days and lower quality of health.

SLP Collection


Included in

Psychology Commons