Early Childhood Stress Research Articles

Early childhood stress and behavioural problems in children following the 2023 Kahramanmaraş earthquake in Turkey

Early childhood stress and behavioural problems in children following the 2023 Kahramanmaraş earthquake in Turkey

Screen Time, Outdoor Play, and Sleep Routines in Early Childhood: Longitudinal Associations with Parenting Stress during Toddler to Preschool Years

IntroductionOur study examined the longitudinal relationship between parenting stress and screen time, outdoor play, and sleep routines in preschool-aged children. MethodWe conducted a descriptive quantitative analysis of a prospective observational cohort study of 300 families with an 18-month-old toddler who were followed for 2 years. Parenting stress was measured using a subscale of the Parenting Stress Index-4 Short Form at child age 18 months. Screen time, outdoor play, and sleep routines were parent-reported at child age 36 months. Multivariable regression estimated associations between parenting stress and screen time behaviors, outdoor play, and sleep routines. ResultsData from 280 children (42.1% female) showed that 39.6% did not have rules around screen time and 82% of families reported frequently having the TV on without anyone watching. In adjusted models, a 1-SD increase in parenting stress at 18 months was associated with an increased odds of having a TV on without anyone watching (OR 1.26, 95% CI: 1.01, 1.57) and a decreased odds of not having rules about the amount of screen time at 36 months (OR 0.75, 95% CI: 0.58, 0.96). DiscussionIncreased parenting stress in early childhood was associated with some suboptimal screen time behaviors and sleep routines when children were preschool-aged.

Single mothers' perceptions of neighborhood social cohesion, parenting stress, adverse childhood experiences in early childhood and Black children's behavior problems in middle childhood and adolescence.

This study examined the roles of neighborhood social cohesion, adverse childhood experiences (ACEs), and parenting stress in early childhood on child behavioral outcomes in middle childhood and adolescence among socioeconomically disadvantaged Black families. To test a model linking perceptions of neighborhood social cohesion, single mothers' parenting stress, ACEs, and behavior problems in middle childhood and adolescence. We used four waves of longitudinal data from a subsample of 800 unmarried Black mothers and their children (at child birth and ages 3, 5, 9, and 15) from the Future of Families and Child Wellbeing Study, a nationally representative data set. Structural equation modeling with latent variables was used to measure direct and indirect effects. Mothers' perceptions of neighborhood social cohesion were significantly and negatively associated parenting stress (β = -0.34, p < 0.05); parenting stress was significantly and positively related to adverse childhood experiences (β = 0.40, p < 0.05) and behavior problems (β = 0.32, p < 0.05); Adverse childhood experiences were significantly and positively related to behavior problems (β = 0.26, p < 0.05); and behavior problems were indirectly influenced by neighborhood social cohesion through adverse childhood experiences (β = -0.14, p < 0.05) and parenting stress (β = 0.10, p < 0.05). Neighborhood factors may play a significant role in parenting stress, adverse childhood experiences in early childhood, and children's behavior problems in middle childhood and adolescence among some single mothers and children in economically and socially disadvantaged Black families. Interventions that enhance neighborhood social cohesion and foster supportive interactions among community members and organizations are recommended.

Pre-COVID respiratory sinus arrhythmia moderates associations between COVID-19 stress and child externalizing behaviors: Testing neurobiological stress theories.

Exposure to stress related to the COVID-19 pandemic contributes to psychopathology risk, yet not all children are negatively impacted. The current study examined a parasympathetic biomarker of stress sensitivity, respiratory sinus arrhythmia (RSA), as a moderator of the effects of exposure to pandemic stress on child internalizing and externalizing behaviors in a sample of children experiencing economic marginalization. Three to five years pre-pandemic, when children were preschool-aged, RSA during baseline and a challenging parent-child interaction were collected. Mid-pandemic, between November 2020 and March 2021, children's exposure to pandemic stress and internalizing and externalizing behaviors were collected. Results demonstrated that children who, pre-pandemic, demonstrated blunted parasympathetic reactivity (i.e., no change in RSA relative to baseline) during the dyadic challenge exhibited elevated risk for externalizing behaviors mid-pandemic. Further, this risk was greatest for children exposed to high and moderate levels of pandemic stress. Consistent with diathesis stress and polyvagal frameworks, these conditional effects suggest that blunted parasympathetic reactivity in response to stress in early childhood may escalate the development of externalizing behaviors following stress exposure at school age.

A Qualitative Study of Maternal Perceptions of Stress and Parenting During Early Childhood

ObjectiveExposure to maternal stress in early childhood can increase risk for learning and behavior challenges. We sought to gain in-depth understanding of how mothers perceive stressors to impact child wellbeing and identify mothers’ strategies for navigating stressors with their young children. MethodsWe recruited English- and Spanish-speaking mothers from a primary care clinic serving predominantly publicly insured children. Twenty-one mothers (aged >18 years) of children (aged 6–29 months) participated in in-depth, semi-structured interviews to discuss their experiences and beliefs regarding stress and parenting. Interviews were recorded, transcribed verbatim, and analyzed using the constant comparative method associated with a grounded theory approach. ResultsWe developed the following hypothesized explanatory model based on our key thematic findings: Mothers described a dyadic model of stress, whereby both their children’s and their own experiences of and responses to stressors are interdependent. Mothers use preventive and responsive buffering to mitigate the impact of stress on their children; however, their access to resources, including social and financial support, shapes their capacity for implementing such strategies. Affection and other forms of relational support may function to protect against the negative impacts of stress. ConclusionIn the setting of poverty-related chronic stressors, mothers play an active role in mitigating the impact of stress on their children’s wellbeing through responsive caregiving. Policies aimed at reducing poverty-related stress exposures and experiences among low-income families may be key interventions for promoting responsive caregiving during a critical time in child development.

Major stress in early childhood strengthens the association between peripheral inflammatory activity and corticostriatal responsivity to reward

BackgroundSevere, chronic stress during childhood accentuates vulnerability to mental and physical health problems across the lifespan. To explain this phenomenon, the neuroimmune network hypothesis proposes that childhood stressors amplify signaling between peripheral inflammatory cells and developing brain circuits that support processing of rewards and threats. Here, we conducted a preliminary test of the basic premises of this hypothesis. Methods180 adolescents (mean age = 19.1 years; 68.9 % female) with diverse racial and ethnic identities (56.1 % White; 28.3 % Hispanic; 26.1 % Asian) participated. The Childhood Trauma Interview was administered to quantify early adversity. Five inflammatory biomarkers were assayed in antecubital blood — C-reactive protein, tumor necrosis factor-a, and interleukins-6, −8, and −10 — and were averaged to form a composite score. Participants also completed a functional MRI task to measure corticostriatal responsivity to the anticipation and acquisition of monetary rewards. ResultsStress exposure and corticostriatal responsivity interacted statistically to predict the inflammation composite. Among participants who experienced major stressors in the first decade of life, higher inflammatory activity covaried with lower corticostriatal responsivity during acquisition of monetary rewards. This relationship was specific to participants who experienced major stress in early childhood, implying a sensitive period for exposure, and were evident in both the orbitofrontal cortex and the ventral striatum, suggesting the broad involvement of corticostriatal regions. The findings were independent of participants’ age, sex, racial and ethnic identity, family income, and depressive symptoms. ConclusionsCollectively, the results are consistent with hypotheses suggesting that major stress in childhood alters brain-immune signaling.

Narrative review on the relationship between toxic stress and occupational performance in early childhood

Resumen Introducción La primera infancia es una etapa crucial para el desarrollo humano, donde el ambiente ejerce una influencia significativa en la formación y funcionamiento cerebral. La presencia de experiencias adversas puede desencadenar estrés tóxico, lo que a su vez puede obstaculizar de los hitos propios del desarrollo infantil. Objetivo El presente estudio tiene como objetivo describir las principales experiencias adversas en la infancia que provocan estrés tóxico en niños y niñas de 0 a 6 años, considerando también sus implicancias en la salud mental y el desempeño ocupacional. Método Se realizó una revisión narrativa utilizando bases de datos como Web of Science, EBSCO, Scopus y Psychology Database. Se seleccionaron diez artículos relevantes para el análisis. Resultados La búsqueda reveló que la pobreza, la violencia infantil y la discriminación, son las tres experiencias adversas más comunes que generan estrés tóxico. Además, se identificaron factores protectores que pueden mitigar el impacto de estas experiencias adversas, fortaleciendo la resiliencia infantil. Entre estos factores las características positivas de la crianza destacan como el principal elemento protector. Conclusión Aunque no se encontró una relación directa entre el estrés tóxico y el desempeño ocupacional en la literatura revisada, se concluye que este último se ve afectado indirectamente debido a su conexión con la salud mental y el desarrollo infantil, aspectos relevantes de la participación en actividades de la vida diaria. Lo anterior destaca la importancia de ampliar la investigación en el campo de la terapia ocupacional, ya que puede contribuir significativamente a la promoción y prevención de la salud mental en la infancia.

Early learning difficulties, childhood stress, race, and risk of cognitive impairment among US adults over age 50: A cross-sectional analysis.

Most literature linking childhood factors to cognitive health outcomes has focused on educational attainment-defined as years of education attained. However, less has been studied about the other aspects of education, such as early learning problems, and stressful family environments. This study examined whether early learning problems and childhood stressors were associated with mid- and later life cognitive impairment among US adults, and if these associations varied by race. We conducted a cross-sectional analysis using the Health and Retirement Study (HRS) along with respondents' early educational experiences from the 2015 to 2017 Life History Mail Survey (N = 9703). Early learning problems were defined as having any of the following: scholastic problems (reading, writing, mathematics), speaking/language issues, and sensorimotor issues- hearing, vision, speech, and motor-coordination. Cognitive status was classified as three levels (normal, cognitively impaired not demented [CIND], and demented) using the HRS Langa-Weir algorithm. Multinomial logistic regression models using generalized logits, estimated relative risk ratios (RRRs), and 95% confidence intervals (CI) with adjustment for sociodemographic factors. Having at least one early learning problem was associated with increased risk of later life cognitive impairment (RRR: 1.75, 95% CI: 1.34-2.29 for dementia, RRR: 1.42, 95% CI: 1.20-1.67 for CIND). Parental death before the age of 16 was associated with 17% higher risk of CIND in later life (RRR: 1.17, 95% CI: 1.01-1.34). However, learning problem-related differences in risk of cognitive impairment were dependent on race (learning problems × race, p = 0.0001). In the demented group, Blacks were 2.7 times more likely to be demented (RRR: 2.66, 95% CI: 1.69-4.17) amongst older adults that experienced childhood learning problems. Early life exposures predicted risk of cognitive impairment. Policies and interventions that enhance diagnosis of early learning problems and improve childhood social contexts are needed to promote healthy cognitive aging amongst Americans, regardless of race.

Physical Activity and Chronic Stress in Early Life: Findings From the 2015 Pelotas (Brazil) Birth Cohort.

The association of physical activity through early childhood on children's chronic stress still is unclear. Therefore, the aim of the present study is to test the association of physical activity through early childhood (1-4y) with chronic stress, measured by hair cortisol at age 4. Longitudinal study including children from the 2015 Pelotas (Brazil) Birth Cohort. Cortisol at age 4 was measured using a hair sample, which provided cortisol concentration from the past months. Physical activity was measured using accelerometers at 1, 2, and 4years. Linear regression models were used to assess the association between physical activity and chronic stress. Trajectory models were also applied to examine chronic stress in relation to physical activity patterns throughout early childhood. Children with valid physical activity and hair cortisol data were included in the analyses (N = 1475). Three groups of physical activity trajectories between 1 and 4years were identified: low, medium, and high. No association between physical activity at 1, 2, and 4years and chronic stress at age 4 was observed. However, children in the "high" physical activity trajectory presented low cortisol concentration; the magnitude of the regression coefficient was slightly larger in girls (β = -0.125; 95% confidence interval, -0.326 to 0.074) than boys (β = -0.051; 95% confidence interval, -0.196 to 0.09). There was no clear association between physical activity and chronic stress in early childhood. Trajectories models suggest that higher activity throughout early childhood may positively impact chronic stress; however, more studies are needed to confirm that hypothesis.

Characterizing experiential elements of early-life stress to inform resilience: Buffering effects of controllability and predictability and the importance of their timing.

Key theoretical frameworks have proposed that examining the impact of exposure to specific dimensions of stress at specific developmental periods is likely to yield important insight into processes of risk and resilience. Utilizing a sample of N = 549 young adults who provided a detailed retrospective history of their lifetime exposure to numerous dimensions of traumatic stress and ratings of their current trauma-related symptomatology via completion of an online survey, here we test whether an individual's perception of their lifetime stress as either controllable or predictable buffered the impact of exposure on trauma-related symptomatology assessed in adulthood. Further, we tested whether this moderation effect differed when evaluated in the context of early childhood, middle childhood, adolescence, and young adulthood stress. Consistent with hypotheses, results highlight both stressor controllability and stressor predictability as buffering the impact of traumatic stress exposure on trauma-related symptomatology and suggest that the potency of this buffering effect varies across unique developmental periods. Leveraging dimensional ratings of lifetime stress exposure to probe heterogeneity in outcomes following stress - and, critically, considering interactions between dimensions of exposure and the developmental period when stress occurred - is likely to yield increased understanding of risk and resilience following traumatic stress.

Epigenetic Changes Associated with Different Types of Stressors and Suicide.

Stress is associated with various epigenetic changes. Some stress-induced epigenetic changes are highly dynamic, whereas others are associated with lasting marks on the epigenome. In our study, a comprehensive narrative review of the literature was performed by investigating the epigenetic changes that occur with acute stress, chronic stress, early childhood stress, and traumatic stress exposures, along with examining those observed in post-mortem brains or blood samples of suicide completers and attempters. In addition, the transgenerational effects of these changes are reported. For all types of stress studies examined, the genes Nr3c1, OXTR, SLC6A4, and BDNF reproducibly showed epigenetic changes, with some modifications observed to be passed down to subsequent generations following stress exposures. The aforementioned genes are known to be involved in neuronal development and hormonal regulation and are all associated with susceptibility to mental health disorders including depression, anxiety, personality disorders, and PTSD (post-traumatic stress disorder). Further research is warranted in order to determine the scope of epigenetic actionable targets in individuals suffering from the long-lasting effects of stressful experiences.

Parental stress mediates the effects of parental risk factors on dysfunctional parenting in first-time parents: A dyadic longitudinal study.

Both parental psychological well-being (e.g., depressive symptoms) and parental relationship functioning (e.g., negative communication) are common parental risk factors for dysfunctional parenting. The spillover process from these parental characteristics to dysfunctional parenting is assumed to be amplified by parental stress, which is particularly common among mothers and fathers of young children. However, few studies have examined dyadic spillover processes from parental risk factors and parental stress on parenting in early childhood. In the current study, we first examined direct actor and partner effects of parents' depressive symptoms and negative communication at 10months postpartum on dysfunctional parenting at 48months postpartum in 168 primiparous mixed-gender couples. Second, we analyzed indirect effects via one's own and the partner's parental stress at 36months postpartum using Actor-Partner Interdependence Mediation Models (APIMeM). We found direct actor effects for mothers' depressive symptoms and negative communication on their dysfunctional parenting. Additionally, indirect actor effects were found for depressive symptoms and negative communication among mothers and fathers. Specifically, mediating effects of depressive symptoms and negative communication on one's dysfunctional parenting through one's parental stress were found. There were no indirect partner effects through parental stress. These findings highlight the important role of parental stress in early childhood as a mediator between both individual and relationship parental risk factors and dysfunctional parenting. These results further underscore the importance of longitudinal dyadic analyses in providing early and tailored interventions for both mothers and fathers of young children.

Parenting Style to Reduce Academic Stress in Early Childhood during The New Normal

Abstract. At home, the role of parents is not only as a facilitator but also as a coach and companions in children's activities during the new normal era, especially in learning activities. The purpose of this study is to analyse parenting style to reduce academic stress in early childhood age 3 to 6 years during new normal era. This study uses a method derived from the literature review (SLR), the systematic mappingstudy (SMS). A systematic mapping study is a systematic literature review that using predetermined protocols and filters. The research conducted an online search on the indexed electronic database of Google Scholar. The Researcher used 14 main articles according to the research topic and matched the keywords. However, other sources that support the theory of child development and parenting style are still needed. The results showed that good parenting through active involvement, responsiveness, caring, sensitivity to children's emotions, communication, and empowerment would ensure positive developmental outcomes during the new normal era. The parenting style to reduce the level of academic stress in early childhood during the new normal by maintaining positive relationships and interactions, facilitating children's needs for remote learning, providing learning assistance, encouraging children to express emotions, creating constructive family rules, showing appreciation to children and parents actively participating in seminars and training on positive parenting. Findings have implications for parents whose children are actively learning and try to use positive parenting style to reduce academic stress during the new normal.Keywords: Parenting style; academic stress; early childhood; new normal; covid-19.

Exploring the effects of weaning age on adult infectious disease mortality among 18th-19th century Italians.

The developmental origins of health and disease (DOHaD) hypothesis describes how early childhood stress affects morbidity and mortality later in life. The role of early childhood stress in mortality from infectious disease is understudied. Stressors in early childhood that weaken the immune system may result in increased susceptibility to infectious disease in adulthood. Weaning is one of the earliest potential periods of significant stress in early childhood. This research investigates the effect of weaning after ~6months of age on cholera mortality among 18th-19th-century Italian populations by determining if earlier breastfeeding cessation is associated with earlier mortality, analyzing childhood dietary variation and physiological stress markers, and determining if age-at-weaning completion differs between catastrophic and attritional populations. Serial dentin stable carbon and nitrogen isotope analyses from canines are compared between catastrophic (n=45) and attritional groups (n=23). Canines are sectioned serially from crown to apex, and the increment's δ15 N and δ13 C are used to estimate age-at-weaning completion. Catastrophic and attritional groups exhibit similar age-at-weaning completion (~2.8 years). Seventy-four percent of individuals lack elevated δ15 N values in dentin that formed during infancy. Age-at-weaning completion was not a predisposing factor in cholera mortality in adulthood in this sample. Age-at-weaning completion may not be significantly associated with infectious disease mortality because weaning completion likely occurred after infants had adapted to consuming contaminated weanling foods. Individuals without detectable weaning curves may represent infants who received supplementary foods since birth or were weaned before the age of 6-9months.

Early Holocene Human Burials from Fa Hien-lena and Kuragala, Sri Lanka

Few human burials from Sri Lankan archaeological contexts have been described. Here we report on the analysis of two early Holocene skeletons, FH8, a young adult female skeleton excavated from Fa Hien-lena and dated to 10,640-10,139 cal BP, and BK1, a middle adult male skeleton excavated at Kuragala and dated to 7,170-6,950 cal BP. The skeletons are both highly fragmentary, which poses challenges for their thorough analysis. However, this paper describes the archaeological context, mortuary treatment and archaeothanatology of the burials, post-mortem taphonomy of human remains, the osteobiography of both individuals, and some general observations on their morphology relative to one another and a broader range of late Pleistocene and Holocene foragers. The results demonstrate common elements of funerary treatment between these two burials, such as interment on the left side with right hands placed near or over the face. The FH8 individual died at a young age and shows some signs of early childhood stress. Both skeletons show moderate to high degrees of tooth wear for their relative ages, and no evidence for dental disease. The body size estimates of FH8 and BK1 fall in the range that would be expected of tropical or temperate forest foragers, although BK1 has a relatively low body mass relative to stature, which aligns his phenotype with populations of more arid environments. We demonstrate that much can be potentially learned about human populations and prehistoric behaviours from skeletal analyses.

Are Black Girls Exhibiting Puberty Earlier? Examining Implications of Race-Based Guidelines.

Are Black Girls Exhibiting Puberty Earlier? Examining Implications of Race-Based Guidelines.

Bidirectional relationships between parenting stress and child behavior problems in multi-stressed, single-mother families: A cross-lagged panel model.

Investigations on the bidirectional relationships between parenting stress and child behavior problems are important to inform intervention strategies; however, prior research has provided inconsistent findings. Using a national sample of multi-stressed single-mother families from the Fragile Families and Child Wellbeing study, the present study examined the bidirectional relationships between maternal parenting stress and children's behavioral problems spanning from early childhood through adolescence at the child's ages 3, 5, 9, and 15. Reciprocal transactions were found between parenting stress and behavior problems in early childhood between the ages 3 and 5. From age 5 to age 15, our findings also suggest that children's behavior problems at an earlier time point predict mothers' parenting stress at a later time point. Unexpectedly, the lagged effects of parenting stress on child behavior problems in school ages were not significant in our sampled data. Early childhood interventions should address mitigating both parenting stress and their toddlers' behavior problems. During middle childhood and adolescence, interventions to directly address children's behavior problems are critical both to the well-being of mothers and to assist in the reduction in levels of behavior problems.

Epigenetic mechanisms and stress coping in mood disorders

IntroductionExperimental data from both clinical and preclinical studies have unequivocally shown positive correlations between stress and depression, stress, depression and epigenetic changes.ObjectivesThe aim of this research is to analyze clinical trials on coping mechanisms and their interaction with epigenetic mechanisms in patients with mood disorders. Generally, we studied the interaction between these two mechanisms and its effects on the onset, recurrence and progression of these disorders.Methods109 articles were analyzed, of which 37 were considered relevant. 72 studies were excluded based on titles and abstracts. Regarding the coping mechanisms, 10 longitudinal and cross-sectional studies were selected. Longitudinal studies are defined here by a follow-up period longer than 6 months.ResultsThere is a consistent association in the literature between the degree of methylation of the NR3C1 gene, stress and affectivity disorders. The analyzed studies showed that methylation of the NR3C1 gene is associated with both stress and mood disorders. FKBP5 influences glucocorticoid receptor sensitivity and stress response. SLC6A4 gene methylation has been systematically associated with stress and affectivity disorders. Higher BDNF methylation has also been found in people who report high levels of stress at work. The data collected suggest that SKA2 methylation may serve as a biomarker for certain features of depression, such as suicidal ideation, and is not directly involved in the etiology of mood disorders.ConclusionsThe results suggest that environmental stress and adversity in early childhood may change biological systems through epigenetic mechanisms and have long-term consequences, increasing the risk for unfavorable prognosis of mood disorders.DisclosureNo significant relationships.

Parameterizing Toxic Stress in Early Childhood: Maternal Depression, Maltreatment, and HPA-Axis Variation in a Pilot Intervention Study.

Adverse experiences superseding a child's capacity to sustain regulation of emotion and adaptive function are theorized to constitute "toxic stressors"when they induce a deleterious biological response within an individual. We ascertained presumptive parameters of toxic stressamong 164 low-income infants and toddlers (ages 4-48months) from 132 families enrolled in Early Head Start (EHS). We randomized a subset of these families into a pilot intervention arm of parenting education (the Incredible Years, TIY), which supplemented the EHS curriculum. Official report child abuse and neglect (CAN) and child behavior were serially ascertained over the course of the study. We observed relatively low associations among maternal depression, CAN, caregiver-child relationship quality, hair cortisol, and adverse child behavioral outcomes. Moreover, despite poverty and thehigh prevalence (51%) of CAN in this sample, the frequency of clinical-level internalizing and externalizing behavior among the children did not exceed that of the general population, by their parents' report. The pilot supplementation of EHS with TIY improved attendance in group meetings but did not significantly reduce adverse behavioral outcomes or CAN. This study revealed marked independence of standard indices of toxic stress (child maltreatment, maternal depression, caregiver emotional unavailability) which have been presumed to be risk factors for the development of psychopathology. That they were weakly inter-correlated, and only modestly predictive of child behavioral outcomes in this EHS sample, caution against presumptions about the toxicity of individual stressors, highlight the importance of ascertaining risk (and compensatory influences) comprehensively, suggest buffering effects of programs like EHS, and demonstrate the need for greater understanding of what parameterizes resilience in early childhood.

Childhood Trauma and Psychosocial Stress Affect Treatment Outcome in Patients With Psoriasis Starting a New Treatment Episode.

ObjectiveTraumatic childhood experiences and psychosocial stress may predispose the evolvement of somatic diseases. Psoriasis is a multifactorial chronic inflammatory skin disease that often associates with current and past stress. Both may entail pathological alterations in major stress axes and a balance shift in the level of T helper type 1 (Th1) and 2 (Th2) cytokines, affecting the development and course of psoriasis. Until now, it is unclear whether traumatic stress experiences during the childhood or current stress are more frequent in psoriatic compared to skin-healthy individuals, and if they interact with treatment outcome.MethodIn a prospective cohort study, the impact of acute and early childhood stress on the course of dermatological treatment were studied in patients with moderate to severe psoriasis (PSO). Patients were examined before (T1) and about 3 months after (T2) the beginning of a new treatment episode. Assessments included clinical outcomes (Psoriasis Area and Severity Index—PASI, Structured Clinical Interview SCID-I) and patient-reported outcomes (PRO) (Childhood Trauma Questionnaire-CTQ, Perceived Stress Scale-PSS, itching/scratching, Dermatology Life Quality Index-DLQI, Hospital Anxiety and Depression Scale, Body Surface Area, Self-Administered PASI).ResultsN = 83 PSO patients (median age 53.7, IQR 37.8, 62.5) and n = 66 skin-healthy control subjects (HC) (median age 51.5, IQR 33.3, 59.2) participated. PSO had higher CTQ physical neglect than HC, as well as higher PRO levels. The positive impact of improved skin on the skin-related quality of life was moderated by the perceived stress. Acute stress at T1 had a positive effect both on the skin severity and the skin-related quality of life. CTQ total closely interacted with baseline psoriasis severity, and was associated with higher improvement from T1 to T2.ConclusionOne might tentatively conclude, that chronic psychosocial stressors like childhood maltreatment may predispose the manifestation of psoriasis. The latter may be amplified by acute psychological stressors. In addition, the present evidence suggests that systemic therapies work well in PSO, with childhood trauma and acute psychosocial stress. Both should therefore be routinely assessed and addressed in PSO.