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Review
. 2019 Mar 11:10:118.
doi: 10.3389/fpsyt.2019.00118. eCollection 2019.

Developmental Trajectories of Early Life Stress and Trauma: A Narrative Review on Neurobiological Aspects Beyond Stress System Dysregulation

Affiliations
Review

Developmental Trajectories of Early Life Stress and Trauma: A Narrative Review on Neurobiological Aspects Beyond Stress System Dysregulation

Agorastos Agorastos et al. Front Psychiatry. .

Abstract

Early life stressors display a high universal prevalence and constitute a major public health problem. Prolonged psychoneurobiological alterations as sequelae of early life stress (ELS) could represent a developmental risk factor and mediate risk for disease, leading to higher physical and mental morbidity rates in later life. ELS could exert a programming effect on sensitive neuronal brain networks related to the stress response during critical periods of development and thus lead to enduring hyper- or hypo-activation of the stress system and altered glucocorticoid signaling. In addition, alterations in emotional and autonomic reactivity, circadian rhythm disruption, functional and structural changes in the brain, as well as immune and metabolic dysregulation have been lately identified as important risk factors for a chronically impaired homeostatic balance after ELS. Furthermore, human genetic background and epigenetic modifications through stress-related gene expression could interact with these alterations and explain inter-individual variation in vulnerability or resilience to stress. This narrative review presents relevant evidence from mainly human research on the ten most acknowledged neurobiological allostatic pathways exerting enduring adverse effects of ELS even decades later (hypothalamic-pituitary-adrenal axis, autonomic nervous system, immune system and inflammation, oxidative stress, cardiovascular system, gut microbiome, sleep and circadian system, genetics, epigenetics, structural, and functional brain correlates). Although most findings back a causal relation between ELS and psychobiological maladjustment in later life, the precise developmental trajectories and their temporal coincidence has not been elucidated as yet. Future studies should prospectively investigate putative mediators and their temporal sequence, while considering the potentially delayed time-frame for their phenotypical expression. Better screening strategies for ELS are needed for a better individual prevention and treatment.

Keywords: childhood adversity; early life stress; epigenetics; gene × environment interaction; neurobiology; stress; stress-related-disorders; trauma.

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Figures

Figure 1
Figure 1
Conceptual model on developmental trajectories of early life stress. Schematic model of moderating factors and allostatic neurobiological trajectory networks involved in the enduring biopsychological effects of ELS/CT. Exposure to ELS/CT can lead to disruption in critical phases of perinatal and juvenile brain development and an evolving programmed phenotype with altered allostatic processes and reduced adaptability to stress. The individual effects on ELS/CT on the organism depend on the specific genetic background and fetal programming (hit-1), the timing, duration, intensity and type of ELS/CT (hit-2) and other later-life challenges, such as additional stressors, coping strategies, support existence, life style, and aging (hit-3). Depending on their interaction, these factors explain inter-individual variation in resilience or vulnerability to altered biopsychological functioning and disparate health outcomes.

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