Moderate versus severe early life stress: Associations with stress reactivity and regulation in 10–12-year-old children
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Early life stress (ELS) is expected to increase reactivity of the hypothalamic-pituitary-adrenocortical (HPA) axis; however, several recent studies have shown diminished cortisol reactivity among adults and children with ELS exposure. The goal of this study was to examine cortisol activity in 10-12-year-old internationally adopted children to determine if moderate and severe ELS have different impacts on the HPA axis. Salivary cortisol and two measures of autonomic activity were collected in response to the Trier Social Stress Test for Children (TSST-C). Three groups reflecting moderate, severe, and little ELS were studied: early adopted children who came predominantly from foster care overseas (early adopted/foster care (EA/FC), n=44), later adopted children cared for predominantly in orphanages overseas (late adopted/post-institutionalized (LA/PI), n=42) and non-adopted (NA) children reared continuously by their middle- to upper-income parents in the United States (n=38). Diminished cortisol activity was noted for the EA/FC group (moderate ELS), while the LA/PI group (severe ELS) did not differ from the NA group. Overall, few children showed cortisol elevations to the TSST-C in any group. The presence/absence of severe growth delay at adoption proved to be a critical predictive factor in cortisol activity. Regardless of growth delay, however, LA/PI children exhibited higher sympathetic tone than did NA children. These results suggest that moderate ELS is associated with diminished cortisol activity; however, marked individual differences in cortisol activity among the LA/PI children suggest that child factors modify the impact of severe ELS. Lack of effects of severe ELS even for growth delayed children may reflect the restorative effects of adoption or the generally low responsiveness of this age group to the TSST-C.
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Children deprived of a stable responsive caregiver show high insecure and disorganized attachment and atypical affective development, including heightened emotional reactivity, accelerated amygdala development, poor emotion regulation, and atypical stress reactivity.
“Children deprived of a stable and responsive caregiver exhibit high levels of insecure and disorganized attachment and atypical affective development characterized by heightened emotional reactivity, accelerated functional development of the amygdala, poor emotion regulation, and atypical stress reactivity.(25, 32–37)”
From Neglect as a violation of species-expectant experience: neurodevelopmental consequences (2017) · cites this paper as [35]
Moderate stress early in life is associated with reduced cortisol reactivity to subsequent stressors, compared with mild or severe stress early in life.
“Partial evidence for this notion in humans has been shown with moderate stress early in life being associated with reduced cortisol reactivity to subsequent stressors, compared with mild or severe stress early in life (Gunnar et al., 2009, Hagan et al., 2014).”
From The impact of developmental timing for stress and recovery (2015) · cites this paper as Gunnar et al., 2009
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“Partial evidence for this notion in humans has been shownwith moderate stress early in life being associated with reduced cortisol reactivity to subsequent stressors, compared with mild or severe stress early in life (Gunnar et al., 2009; Hagan et al., 2014).”
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- Authors
- Gunnar, M. R., Frenn, K., Wewerka, S. S., & Van Ryzin, M. J.
- Affiliations
- University of Minnesota (US)
- Corresponding author
- Gunnar, Megan R.
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2009-01
- Volume
- 34
- Issue
- 1
- Pages
- 62-75
- ISSN
- 0306-4530 (ISSN-L)
- PMC
- PMC2670489
- OpenAlex
- W2164168492
- Cited by
- 363
- References
- 71
- Citations by year
- 2026: 11 · 2025: 6 · 2024: 8 · 2023: 15 · 2022: 17 · 2021: 30 · 2020: 24 · 2019: 20 · 2018: 24 · 2017: 24 · 2016: 29 · 2015: 35 · 2014: 17 · 2013: 23 · 2012: 23
- FWCI
- 7.97
- Type
- journal article
- Language
- en
- Update notices
- erratum (2010-02-01)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Minnesota
- Centers for Disease Control and Prevention
- National Institute of Mental Health (MH066208, MH068857, R01MH068857, K05MH066208)
- National Center for Research Resources (M01RR000400)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Safety Research › Child Welfare and Adoption
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- early life stress, hypothalamic-pituitary-adrenal axis, cortisol response, stress regulation, internationally adopted children, foster care, orphanages, growth delay, sympathetic tone, autonomic nervous system activity, Trier Social Stress Test for Children
- MeSH terms
- Adoption, Body Height, Body Weight, Child, Female, Growth Disorders, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Individuality, Male, Saliva, Stress, Psychological
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