by Caroline von Fluegge-Chen
According to a new Harvard study that followed 6,700 Britons from age 7 to 45, lifelong distress takes a greater health toll than being stressed in either childhood or adulthood. In the unlikely event that one would endure distress during just one period, childhood is the most vulnerable time.
Biomedical scientists and brain researchers have shown how “fight or flight” stress chemicals, like epinephrine and cortisol, which flood the body when someone encounters danger, can cause lasting damage in the brain and body when a child is under prolonged or repeated and unmitigated stress, now commonly known as “toxic stress”. Toxic stress weakens the architecture of the developing brain, which can lead to lifelong problems in learning, behavior, and physical and mental health.
There are essentially three responses to stress. The positive stress response is a normal and essential part of healthy development, characterized by brief increases in heart rate and mild elevations in hormone levels. Physiology returns to normal when the stressful situation resolves.
A tolerable stress response activates the body’s alert systems to a greater degree as a result of more severe, longer-lasting difficulties, such as the loss of a loved one, a natural disaster, or a frightening injury. If the activation is time-limited and buffered by relationships with adults who help the child adapt, the brain and other organs recover from what might otherwise be damaging effects.
A toxic stress response can occur when a child experiences strong, frequent, and/or prolonged adversity—such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship—without adequate adult support. This kind of prolonged activation of the stress response systems can disrupt the development of brain architecture and other organ systems, and increase the risk for stress-related disease and cognitive impairment, well into the adult years.
Events significant enough to cause toxic stress are known as Adverse Childhood Events (ACEs). ACEs include physical/sexual abuse, neglect, violence or substance abuse in the home, parental separation or divorce, death of a loved one, etc.
Questionnaires are available to screen children for ACEs. As the number increases, so does the risk for health problems. Compared to people with no childhood trauma, adults who scored a four or more (each instance of toxic stress is given a score of 1) were twice as likely to be diagnosed with cancer or heart disease; seven times more likely to be alcoholic; six times more likely to have depression; and 12 times more likely to have attempted suicide. Adults exposed to six or more ACEs in childhood died 20 years sooner than those who had none.
One prospective study found that poor emotional functioning assessed at age 7 years was associated with higher C-reactive protein at age 42 years. Emotional distress during childhood — even in the absence of high stress during adult years — can increase the risk of developing heart disease and metabolic disorders such as diabetes in adulthood.
Teaching children and families coping mechanisms can help to constructively deal with whatever stressors come their way. Additionally, supporting the body’s HPA axis can help children become more physiologically resilient to the effects of stress.
In adult patients, when testing reveals suboptimal or low cortisol levels and the patient denies any stress, it is pertinent to ask them about childhood stressors which can have long reaching implications.
– Content Courtesy of Labrix.
Center on the Developing Child. Harvard University. http://developingchild.harvard.edu/science/key-concepts/toxic-stress/. Accessibility verified 1/4/17.
Kaiser Adverse Childhood Events Study, accessed via the CDC. https://www.cdc.gov/violenceprevention/acestudy/about.html. Accessibility verified 1/4/17.
Logan-Greene Patricia, et al. Distinct Contributions of Adverse Childhood Experiences and Resilience Resources: A Cohort Analysis of Adult Physical and Mental Health. Soc Work Health Care. 2014; 53(8): 776-797.
Winning A, et al. Psychological Distress Across the Life Course and Cardiometabolic Risk: Findings From the 1958 British Birth Cohort Study. J Amer College Card. Vol 66, Issue 14, October 2015. DOI: 10.1016/j.jacc.2015.08.021
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