Abstract
Traumatic stress exposure during critical periods of development may have essential and long-lasting effects on the physical and mental health of individuals. Two thirds of youth are exposed to potentially traumatic experiences by the age of 17, and approximately 5% of adolescents meet lifetime criteria for posttraumatic stress disorder (PTSD). The role of the stress system is the maintenance of homeostasis in the presence of real/perceived and acute/chronic stressors. Early-life stress (ELS) has an impact on neuronal brain networks involved in stress reactions, and could exert a programming effect on glucocorticoid signaling. Studies on pediatric PTSD reveal diverse neuroendocrine responses to adverse events and related long-term neuroendocrine and epigenetic alterations. Neuroendocrine, neuroimaging, and genetic studies in children with PTSD and ELS experiences are crucial in understanding risk and resilience factors, and also the natural history of PTSD.
Highlights
The term early-life stress (ELS) has been used to describe a broad spectrum of adverse and stressful events, including childhood trauma occurring during neonatal life, early and late childhood, and adolescence
Early-life stress has been associated with reduced volume of corpus callosum, insula, dorsolateral prefrontal cortex (PFC), orbitofrontal cortex (OFC), anterior cingulate gyrus, and caudate, as well as decreased cortical thickness of medial and lateral prefrontal and temporal lobe regions and reduced overall brain volume in humans [71,72]
There have been numerous studies reporting an association between ELS or childhood trauma and reduced hippocampal volume in adulthood [73]
Summary
The term early-life stress (ELS) has been used to describe a broad spectrum of adverse and stressful events, including childhood trauma occurring during neonatal life, early and late childhood, and adolescence. The DSM-5 provides an extensive description of developmental differences in symptom expression and developmentally modified criteria for children aged 6 years old and younger This set of developmentally sensitive criteria includes three symptom groups: (i) intrusion, (ii) persistent avoidance/negative alterations in cognition and mood, and (iii) alterations in arousal and reactivity. The effects of adverse and stressful events early in life may be severe and long-lasting They are associated with several clinical conditions including attention deficit hyperactivity disorder (ADHD), PTSD, bipolar disorder, panic disorder, substance abuse, generalized anxiety disorder (GAD), and major depressive disorder (MDD), as well as psychotic symptoms [20,21]. Depression appears to be the most common comorbid diagnosis of PTSD, with a range of 13% to 75%, whereas GAD was the comorbid diagnosis in 27.6% of the PTSD population in one study conducted in adolescents [22]
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