Child Maltreatment and Autonomic Nervous System Reactivity: Identifying Dysregulated Stress Reactivity Patterns by Using the Biopsychosocial Model of Challenge and Threat
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OBJECTIVE: Disruptions in stress response system development have been posited as mechanisms linking child maltreatment (CM) to psychopathology. Existing theories predict elevated sympathetic nervous system reactivity after CM, but evidence for this is inconsistent. We present a novel framework for conceptualizing stress reactivity after CM that uses the biopsychosocial model of challenge and threat. We predicted that in the context of a social-evaluative stressor, maltreated adolescents would exhibit a threat pattern of reactivity, involving sympathetic nervous system activation paired with elevated vascular resistance and blunted cardiac output (CO) reactivity. METHODS: A sample of 168 adolescents (mean age =14.9 years) participated. Recruitment targeted maltreated adolescents; 38.2% were maltreated. Electrocardiogram, impedance cardiography, and blood pressure were acquired at rest and during an evaluated social stressor (Trier Social Stress Test). Pre-ejection period (PEP), CO, and total peripheral resistance reactivity were computed during task preparation, speech delivery, and verbal mental arithmetic. Internalizing and externalizing symptoms were assessed. RESULTS: Maltreatment was unrelated to PEP reactivity during preparation or speech, but maltreated adolescents had reduced PEP reactivity during math. Maltreatment exposure (F(1,145) = 3.8-9.4, p = .053-<.001) and severity (β = -0.10-0.12, p = .030-.007) were associated with significantly reduced CO reactivity during all components of the stress task and marginally associated with elevated total peripheral resistance reactivity (F(1,145) = 3.8-9.4; p = .053-<.001 [β = 0.07-0.11] and p = .11-.009, respectively). Threat reactivity was positively associated with externalizing symptoms. CONCLUSIONS: CM is associated with a dysregulated pattern of physiological reactivity consistent with theoretical conceptualizations of threat but not previously examined in relation to maltreatment, suggesting a more nuanced pattern of stress reactivity than predicted by current theoretical models.
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ELA is robustly linked to stronger emotional reactivity across several measurement methods.
“research has demonstrated a robust link between ELA and heightened emotional reactivity.62 This association has been found across multiple measurement methods—from self-reported emotional reactivity91 to cardiovascular responses92,93 and amygdala reactivity.90”
From Early life adversity and health-risk behaviors: Proposed psychological and neural mechanisms (2018) · cites this paper as [92]
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Self-citation
- Authors
- McLaughlin, K. A., Sheridan, M. A., Alves, S., & Mendes, W. B.
- Affiliations
- Boston Children's Hospital (US)
- Corresponding author
- McLaughlin, Katie A.
- Venue
- Psychosomatic Medicine
- Published
- 2014-09
- Volume
- 76
- Issue
- 7
- Pages
- 538-546
- ISSN
- 0033-3174 (ISSN-L)
- PMC
- PMC4163065
- OpenAlex
- W2017925404
- Cited by
- 149
- References
- 73
- Citations by year
- 2026: 10 · 2025: 10 · 2024: 12 · 2023: 11 · 2022: 14 · 2021: 16 · 2020: 13 · 2019: 13 · 2018: 12 · 2017: 12 · 2016: 15 · 2015: 10
- FWCI
- 14.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health (K01MH092555, K01MH092526)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Safety Research › Child Welfare and Adoption
- Keywords
- child abuse, autonomic reactivity, threat reactivity, social stress, Trier Social Stress Test, pre-ejection period, cardiac output, systemic vascular resistance, sympathetic nervous system, internalizing problems, externalizing problems, biopsychosocial model, adolescents, stress response dysregulation
- MeSH terms
- Adolescent, Autonomic Nervous System, Blood Pressure, Cardiography, Impedance, Child Abuse, Electrocardiography, Female, Humans, Male, Stress, Psychological, Vascular Resistance
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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