Academic journal article European Journal of Psychotraumatology

Pathophysiological Trajectories and Biological Consequences of Early Life Trauma

Academic journal article European Journal of Psychotraumatology

Pathophysiological Trajectories and Biological Consequences of Early Life Trauma

Article excerpt

ABSTRACT

Experience of early life stress (ELS) (childhood trauma, maltreatment, neglect, separation, physical and sexual abuse, parental loss and other severe anxiety/stress symptoms) is highly prevalent in the general population and constitutes a major public health problem (Gilbert et al., 2009). The objective of this paper is to review evidence on epidemiological risk factors, pathophysiological trajectories and neurobiological pathways exerting the enduring adverse effects of ELS and leading to compromised overall health in adulthood.

Prolonged neuropsychobiological alterations as sequelae of early trauma could mediate the risk of disease in adulthood, and lead to cumulative disadvantages and increased physical and mental morbidity in later life. In particular, a higher risk of psychiatric disorders (e.g. depression, post-traumatic stress disorder and other anxiety disorders) and their unfavourable outcomes (e.g. treatment resistance, suicide) has been associated with a history of ELS in several retrospective but also prospective studies, while the moderating interaction of ELS and pre-existing genetic vulnerability in these disorders has been extensively discussed in recent literature. Nevertheless, the chronic physical health consequences of childhood adversities may be as substantial as mental health consequences. Prior research suggests an association of ELS with cardiovascular, pulmonary and metabolic diseases, chronic inflammatory and pain syndromes, frequency of medical consultations and number of medical diagnoses. In addition, risk behaviour patterns such as substance use, and especially tobacco and alcohol consumption, are considered significantly increased in individuals with experience of ELS. Consequently, many studies have reported a negative impact of ELS on adult general mental and physical health-related quality of life, while recognizing the additive effect of the number or different types of childhood adversities is important for understanding their cumulative effect on later life adjustment (Agorastos, Pittman et al., 2014).

The distinct impact of ELS may lie in enhanced plasticity mechanisms during this period that lead to persistent functional and epigenetic alterations and to higher allostatic load over time. …

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