ReviewEarly life adversity reduces stress reactivity and enhances impulsive behavior: Implications for health behaviors
Highlights
► Stress experience during early life leads to reduced stress reactivity in adulthood. ► Reduced stress reactivity accompanies a disinhibited behavioral style. ► Disinhibited behavior can increase risk of substance abuse.
Introduction
Most models of stress reactivity and health outcomes assume that large stress reactions are harmful and that smaller responses are by definition better for the individual (Lovallo, 2005, Lovallo and Gerin, 2003). We have recently advanced the alternative hypothesis that both exaggerated and diminished stress reactivities indicate systems dysregulation with negative health implications (Carroll et al., 2009, Lovallo, 2011). There has been little consideration of the pathways by which individuals become more or less stress reactive than normal. We will review data from our studies and others suggesting that one pathway to low stress reactivity is the experience of stressful or adverse circumstances in childhood and adolescence. Ultimately, this pathway may lead to disinhibited behavior that can increase risk for alcoholism and other substance use disorders.
This review will focus on studies of persons whose adverse experiences occurred in childhood and adolescence and who were studied as adolescents and young adults. We exclude studies of persons prenatally exposed to stress or those studied as infants, children, or in old age. With minor exceptions the review is confined to persons lacking serious psychiatric comorbidities. Although some studies have examined hypothalamic–pituitary–adrenocortical axis (HPA) reactivity using pharmacological challenges, we primarily confine this review to cortisol responses to behavioral and psychosocial stressors. We also exclude studies of recent but transient life stressors (Chida and Hamer, 2008, Luecken and Lemery, 2004) and touch only briefly on studies of resting or basal levels of cortisol secretion.
Section snippets
Adversity and stress reactivity in the Oklahoma Family Health Patterns Project
In a series of earlier studies conducted with patients undergoing alcoholism treatment at the VA Medical Center in Oklahoma City, we had observed that the alcohol treatment groups had lower cortisol and heart rate stress responses than matched controls (Bernardy et al., 1996, Errico et al., 1993, Lovallo et al., 2000, Panknin et al., 2002). Because these patients had an average daily alcohol consumption of approximately one fifth of hard liquor for 8-years, it was impossible to determine if the
Integrative model
The present results reflect an impact of early adverse experience on a range of critical functions including stress axis reactivity, cognition, and emotional regulation, alterations that can contribute to impulsive behavioral tendencies, risk taking, poor health behaviors, and addiction risk. We summarize these relationships schematically in Fig. 2. This constellation of results, incorporating components of the emotions and motivated behavior, are likely to derive from pervasive alterations in
The impact of adversity on health and psychological and behavioral dysfunction
The effects of adverse rearing conditions have been studied in a number of other contexts, and these projects provide a framework for evaluating the data from the OFHP.
Brain function
Impulsivity and poor behavioral regulation in offspring from abusive families implicates subtle impairments of prefrontal cortex regulation over behavior that may persist into adulthood; in contrast, effective prefrontal function can contribute to adaptive regulation of emotional states and effective coping behaviors (Egan et al., 2003). Although a lengthy discussion of frontolimbic mechanisms is beyond the scope of the present paper, a couple of points focus attention on mechanisms associated
Cause and effect?
The evidence above points to a pattern in which disrupted parenting, family discord, and related forms of adversity are associated with externalizing behaviors, risk taking, and a tendency to engage in substance abuse. This pattern raises the question of the respective roles of the environment, a genetic diathesis, or an interaction of the two. In the case of substance use disorders, there is a good deal of evidence for contributing family environment factors.
Physical maltreatment plays a
Protective effects
The prior review indicates a set of risk factors for substance use disorders. Other work indicates that some life-history factors may be protective against such outcomes, and that some persons may be less susceptible to adversity than others (Belsky and Pluess, 2009, Hinshaw, 1992). Constructive parenting styles contribute directly to positive adjustment in the offspring, engendering good parenting as adults (Kerr et al., 2009). Positive parenting and parental warmth are positively associated
Implications for health behaviors
Social scientists carrying out studies of harsh social conditions and health outcomes have commented on the degree to which stress response systems may adapt to the social environment (Ellis et al., 2006) a process termed “biological sensitivity to context” (Ellis and Boyce, 2008). The present study differs from their model in critical ways. Ellis and Boyce (2008) postulate a U-shaped function relating high, low, and high stress reactivity to rearing in benign, normal, and stressful
Acknowledgments
This is supported by the Department of Veterans Affairs Medical Research Service, the National Institutes of Health, and NIAAA, grants AA12207 and AA19691. The content is solely the view of the authors and does not necessarily represent the official view of the National Institutes of Health or the VA.
References (121)
- et al.
Altered functioning of the executive control circuit in late-life depression: episodic and persistent phenomena
The American Journal of Geriatric Psychiatry
(2009) Hypothalamic–pituitary–adrenocortical responses to psychological stress and risk for smoking relapse
International Journal of Psychophysiology
(2006)- et al.
Pathological gambling severity is associated with impulsivity in a delay discounting procedure
Behavioural Processes
(2003) - et al.
Decision-making and addiction (part I): impaired activation of somatic states in substance dependent individuals when pondering decisions with negative future consequences
Neuropsychologia
(2002) - et al.
Altered cortisol response in sober alcoholics: an examination of contributing factors
Alcohol
(1996) - et al.
Decreased adrenocorticotropic hormone and cortisol responses to stress in healthy adults reporting significant childhood maltreatment
Biological Psychiatry
(2007) - et al.
Hypothalamic–pituitary–adrenal axis response to stress in male DUI recidivists
Accident Analysis and Prevention
(2008) - et al.
Hormonal and behavioral homeostasis in boys at risk for substance abuse
Drug and Alcohol Dependence
(1999) - et al.
A.E. Bennett Research Award. Developmental traumatology. Part II: brain development
Biological Psychiatry
(1999) - et al.
The BDNF val66met polymorphism affects activity-dependent secretion of BDNF and human memory and hippocampal function
Cell
(2003)
The stress response systems: universality and adaptive individual differences
Developmental Review
Diminished cortisol responses to psychosocial stress associated with lifetime adverse events a study among healthy young subjects
Psychoneuroendocrinology
Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study
American Journal of Preventive Medicine
Effects of a therapeutic intervention for foster preschoolers on diurnal cortisol activity
Psychoneuroendocrinology
Reduced amygdala activation in young adults at high risk of alcoholism: studies from the Oklahoma family health patterns project
Biological Psychiatry
Salivary alpha amylase-cortisol asymmetry in maltreated youth
Hormones and Behavior
Persistent central nervous system effects of an adverse early environment: clinical and preclinical studies
Physiology & Behavior
A key role for corticotropin-releasing factor in alcohol dependence
Trends in Neurosciences
Effects of childhood trauma on HPA-axis reactivity in women free of lifetime psychopathol
Progress in neuro-psychopharmacology & biological psychiatry
Childhood parental divorce and cortisol in young adulthood: evidence for mediation by family income
Psychoneuroendocrinology
Cardiovascular reactivity: mechanisms and pathways to cardiovascular disease
International Journal of Psychophysiology
Cortisol secretion patterns in addiction and addiction risk
International Journal of Psychophysiology: Official Journal of the International Organization of Psychophysiology
Individual differences in response to stress and risk for addiction
Do low levels of stress reactivity signal poor states of health?
Biological Psychology
Lifetime adversity leads to blunted stress axis reactivity: studies from the Oklahoma Family Health Patterns Project
Biological Psychiatry
Early caregiving and physiological stress responses
Clinical Psychology Review
Negative relationships in the family-of-origin predict attenuated cortisol in emerging adults
Hormones and Behavior
Cortisol response to stress in female youths exposed to childhood maltreatment: results of the youth mood project
Biological Psychiatry
Dopaminergic reward pathways and effects of stress
Salivary cortisol responses and the risk for substance abuse in prepubertal boys
Biological Psychiatry
Salivary cortisol responses in prepubertal boys: the effects of parental substance abuse and association with drug use behavior during adolescence
Biological Psychiatry
Suppression of the HPA axis stress-response: implications for relapse
Alcoholism, Clinical and Experimental Research
Cardiovascular and neuroendocrine adjustment to public speaking and mental arithmetic stressors
Psychophysiology
The association of childhood personality on sexual risk taking during adolescence
The Journal of School Health
The importance of a positive family history of alcoholism, parental rejection and emotional warmth, behavioral problems and peer substance use for alcohol problems in teenagers: a path analysis
Journal of Studies on Alcohol
Beyond diathesis stress: differential susceptibility to environmental influences
Psychological Bulletin
Ethanol and neuromodulator interactions: a cascade model of reward
Progress in Alcohol Research
Childhood sexual abuse by a family member, salivary cortisol, and homicidal behavior of female prison inmates
Nursing Research
Disinhibited social behavior among internationally adopted children
Development and Psychopathology
Adoption study demonstrating two genetic pathways to drug abuse
Archives of General Psychiatry
Effect of childhood physical abuse on cortisol stress response
Psychopharmacology
Are large physiological reactions to acute psychological stress always bad for health?
Social and Personality Psychology Compass
Role of genotype in the cycle of violence in maltreated children
Science
Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene
Science
Maternal expressed emotion predicts children's antisocial behavior problems: using monozygotic-twin differences to identify environmental effects on behavioral development
Developmental Psychology
Childhood neurobehavior disinhibition amplifies the risk of substance use disorder: interaction of parental history and prenatal alcohol exposure
Journal of Developmental and Behavioral Pediatrics
Trajectories of alcohol and drug use and dependence from adolescence to adulthood: the effects of familial alcoholism and personality
Journal of Abnormal Psychology
How low socioeconomic status affects 2-year hormonal trajectories in children
Psychological Science
Chronic psychosocial factors and acute physiological responses to laboratory-induced stress in healthy populations: a quantitative review of 30 years of investigations
Psychological Bulletin
Early environmental predictors of the affective and interpersonal constructs of psychopathy
International Journal of Offender Therapy and Comparative Criminology
Cited by (241)
The effects of childhood trauma on stress-related vulnerability factors and indicators of suicide risk: An ecological momentary assessment study
2024, Journal of Affective DisordersAdverse childhood experience and young adult's problematic Internet use: The role of hostility and loneliness
2024, Child Abuse and NeglectPsychometric validation of the French version of the adverse childhood experiences international questionnaire (ACE-IQ)
2023, Children and Youth Services Review