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Published in: Child and Adolescent Psychiatry and Mental Health 1/2009

Open Access 01-12-2009 | Review

Early stress exposure: Concepts, findings, and implications, with particular emphasis on attachment disturbances

Authors: Thomas G O'Connor, Mary E Spagnola

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2009

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Abstract

Background

Early intervention and preventive interventions are attracting increasing attention in the child and adolescent mental health field because recent research findings offer new insights into risk mechanisms and because of the growing expectation that they may hold clues to reducing suffering and health cost burdens for society and the individual.

Methods

A selective review of the literature is provided to examine alternative models for understanding the impact of early risk exposure and how these findings may be translated to intervention and prevention; we pay particular attention to the role of child-parent attachment relationship quality as a major potential source of risk or protection.

Results

In this qualitative review, we conclude that sharply contrasting models for understanding early exposure to risk have not been adequately empirically examined in human work. In the case of attachment disturbances, one good context for studying early risk and intervention, sizable questions remain about conceptual models and assessment practices.

Conclusion

Implications of these findings, and limits of the findings, for existing conceptual models of child and adolescent psychopathology and clinical practice are highlighted.
Literature
1.
go back to reference Cowen EL, Wyman PA, Work WC: Resilience in highly stressed urban children: concepts and findings. Bull NY Acad Med. 1996, 73: 267-284. Cowen EL, Wyman PA, Work WC: Resilience in highly stressed urban children: concepts and findings. Bull NY Acad Med. 1996, 73: 267-284.
2.
go back to reference Cowen EL, Gesten EL, Wilson AB: The Primary Mental Health Project (PMHP): evaluation of current program effectiveness. Am J Community Psychol. 1979, 7: 293-303. 10.1007/BF00890693.CrossRefPubMed Cowen EL, Gesten EL, Wilson AB: The Primary Mental Health Project (PMHP): evaluation of current program effectiveness. Am J Community Psychol. 1979, 7: 293-303. 10.1007/BF00890693.CrossRefPubMed
3.
go back to reference Domitrovich CE, Cortes RC, Greenberg MT: Improving young children's social and emotional competence: a randomized trial of the preschool "PATHS" curriculum. J Primary Prevention. 2007, 28: 67-91. 10.1007/s10935-007-0081-0.CrossRef Domitrovich CE, Cortes RC, Greenberg MT: Improving young children's social and emotional competence: a randomized trial of the preschool "PATHS" curriculum. J Primary Prevention. 2007, 28: 67-91. 10.1007/s10935-007-0081-0.CrossRef
4.
go back to reference O'Connor TG: The Persisting Effects of Early Experiences on Psychological Development. Developmental Psychopathology, Risk, disorder, and adaptation. Edited by: Cicchetti D, Cohen D. 2006, New York: Wiley, 3: 202-234. 2 O'Connor TG: The Persisting Effects of Early Experiences on Psychological Development. Developmental Psychopathology, Risk, disorder, and adaptation. Edited by: Cicchetti D, Cohen D. 2006, New York: Wiley, 3: 202-234. 2
6.
go back to reference Belsky J, Fearon RM: Early attachment security, subsequent maternal sensitivity, and later child development: does continuity in development depend upon continuity of care giving?. Attachment Hum Dev. 2002, 4: 361-387. 10.1080/14616730210167267.CrossRef Belsky J, Fearon RM: Early attachment security, subsequent maternal sensitivity, and later child development: does continuity in development depend upon continuity of care giving?. Attachment Hum Dev. 2002, 4: 361-387. 10.1080/14616730210167267.CrossRef
7.
go back to reference Kurstjens S, Wolke D: Effects of maternal depression on cognitive development of children over the first 7 years of life. J Child Psychol Psychiatry. 2001, 42: 623-636. 10.1111/1469-7610.00758.CrossRefPubMed Kurstjens S, Wolke D: Effects of maternal depression on cognitive development of children over the first 7 years of life. J Child Psychol Psychiatry. 2001, 42: 623-636. 10.1111/1469-7610.00758.CrossRefPubMed
8.
go back to reference Gluckman P, Hanson M: The fetal matrix. 2005, NY, NY: Cambridge University Press Gluckman P, Hanson M: The fetal matrix. 2005, NY, NY: Cambridge University Press
9.
go back to reference Fleming AS, O'Day DH, Kraemer GW: Neurobiology of mother-infant interactions: experience and central nervous system plasticity across development and generations. Neuroscience Biobehav Reviews. 1999, 23: 673-685. 10.1016/S0149-7634(99)00011-1.CrossRef Fleming AS, O'Day DH, Kraemer GW: Neurobiology of mother-infant interactions: experience and central nervous system plasticity across development and generations. Neuroscience Biobehav Reviews. 1999, 23: 673-685. 10.1016/S0149-7634(99)00011-1.CrossRef
10.
go back to reference Hensch TK: Critical period regulation. Ann Rev Neurosci. 2004, 27: 549-579. 10.1146/annurev.neuro.27.070203.144327.CrossRefPubMed Hensch TK: Critical period regulation. Ann Rev Neurosci. 2004, 27: 549-579. 10.1146/annurev.neuro.27.070203.144327.CrossRefPubMed
11.
go back to reference O'Connor TG, Rutter M, Beckett C, Kreppner JM, Keaveney L, the English and Romanian Adoptees Study Team: The effects of global severe privation on cognitive competence: Extension and Longitudinal Follow-up. Child Dev. 2000, 71: 376-390. 10.1111/1467-8624.00151.CrossRefPubMed O'Connor TG, Rutter M, Beckett C, Kreppner JM, Keaveney L, the English and Romanian Adoptees Study Team: The effects of global severe privation on cognitive competence: Extension and Longitudinal Follow-up. Child Dev. 2000, 71: 376-390. 10.1111/1467-8624.00151.CrossRefPubMed
12.
go back to reference Barker DJ, (Ed.): Fetal and infant origins of adult disease. 1992, London: Tavistock Barker DJ, (Ed.): Fetal and infant origins of adult disease. 1992, London: Tavistock
13.
go back to reference Scott SB, Spender Q, Doolan M, Jacobs B, Aspland H: Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice. BMJ. 2001, 323: 194-198. 10.1136/bmj.323.7306.194.PubMedCentralCrossRefPubMed Scott SB, Spender Q, Doolan M, Jacobs B, Aspland H: Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice. BMJ. 2001, 323: 194-198. 10.1136/bmj.323.7306.194.PubMedCentralCrossRefPubMed
14.
go back to reference Olds DL, Kitzman H, Cole R, Robinson J, Sidora K, Luckey DW, Henderson CR, Hanks C, Bondy J, Holmberg J: Effects of nurse home-visiting on maternal life course and child development: age 6 follow-up results of a randomized trial. Pediatrics. 2004, 114: 1550-1559. 10.1542/peds.2004-0962.CrossRefPubMed Olds DL, Kitzman H, Cole R, Robinson J, Sidora K, Luckey DW, Henderson CR, Hanks C, Bondy J, Holmberg J: Effects of nurse home-visiting on maternal life course and child development: age 6 follow-up results of a randomized trial. Pediatrics. 2004, 114: 1550-1559. 10.1542/peds.2004-0962.CrossRefPubMed
15.
go back to reference Coplan JD, Trost RC, Owens MJ, Cooper TB, Gorman JM, Nemeroff CB, Rosenblum LA: Cerebrospinal fluid concentrations of somatostatin and biogenic amines in grown primates reared by mothers exposed to manipulated foraging conditions. Arch Gen Psychiatry. 1998, 55: 473-477. 10.1001/archpsyc.55.5.473.CrossRefPubMed Coplan JD, Trost RC, Owens MJ, Cooper TB, Gorman JM, Nemeroff CB, Rosenblum LA: Cerebrospinal fluid concentrations of somatostatin and biogenic amines in grown primates reared by mothers exposed to manipulated foraging conditions. Arch Gen Psychiatry. 1998, 55: 473-477. 10.1001/archpsyc.55.5.473.CrossRefPubMed
16.
go back to reference Harlow H, Suomi S: The nature of love-simplified. Am Psychologist. 1970, 25: 161-168. 10.1037/h0029383.CrossRef Harlow H, Suomi S: The nature of love-simplified. Am Psychologist. 1970, 25: 161-168. 10.1037/h0029383.CrossRef
17.
go back to reference Hofer MA: Hidden regulators in attachment, separation, and loss. Monographs Soc Research Child Dev. 1994, 59 (2-3): 192-207. 10.2307/1166146.CrossRef Hofer MA: Hidden regulators in attachment, separation, and loss. Monographs Soc Research Child Dev. 1994, 59 (2-3): 192-207. 10.2307/1166146.CrossRef
18.
go back to reference Weaver IC, Cervoni N, Champagne FA, D'Alessio AC, Sharma S, Seckl JR, Dymov S, Szyf M, Meaney MJ: Epigenetic programming by maternal behavior. Nature Neuroscience. 2004, 7: 847-854. 10.1038/nn1276.CrossRefPubMed Weaver IC, Cervoni N, Champagne FA, D'Alessio AC, Sharma S, Seckl JR, Dymov S, Szyf M, Meaney MJ: Epigenetic programming by maternal behavior. Nature Neuroscience. 2004, 7: 847-854. 10.1038/nn1276.CrossRefPubMed
19.
go back to reference Sanchez MM, Ladd CO, Plotsky PM: Early adverse experience as a developmental risk factor for later psychopathology: Evidence from rodent and primate models. Dev Psychopathol. 2001, 13: 419-449. 10.1017/S0954579401003029.CrossRefPubMed Sanchez MM, Ladd CO, Plotsky PM: Early adverse experience as a developmental risk factor for later psychopathology: Evidence from rodent and primate models. Dev Psychopathol. 2001, 13: 419-449. 10.1017/S0954579401003029.CrossRefPubMed
20.
go back to reference Parfitt DB, Walton JR, Corriveau EA, Helmreich DL: Early life stress effects on adult stress-induced corticosterone secretion and anxiety-like behavior in the C57BL/6 mouse are not as robust as initially thought. Hormones Behav. 2007, 52: 417-426. 10.1016/j.yhbeh.2007.06.002.CrossRef Parfitt DB, Walton JR, Corriveau EA, Helmreich DL: Early life stress effects on adult stress-induced corticosterone secretion and anxiety-like behavior in the C57BL/6 mouse are not as robust as initially thought. Hormones Behav. 2007, 52: 417-426. 10.1016/j.yhbeh.2007.06.002.CrossRef
21.
go back to reference Freud A, Burlingham D: The writings of Anna Freud: Infants without families. 1973, International Universities Press, III: 1939-1945. Freud A, Burlingham D: The writings of Anna Freud: Infants without families. 1973, International Universities Press, III: 1939-1945.
22.
go back to reference Provence S, Lipton RC: Infants reared in institutions. 1962, New York: International Universities Press Provence S, Lipton RC: Infants reared in institutions. 1962, New York: International Universities Press
23.
go back to reference Tizard B, Rees J: The effect of early institutional rearing on the behavioral problems and affectional relationships of four-year-old children. J Child Psychol Psychiatry. 1975, 16: 61-73. 10.1111/j.1469-7610.1975.tb01872.x.CrossRefPubMed Tizard B, Rees J: The effect of early institutional rearing on the behavioral problems and affectional relationships of four-year-old children. J Child Psychol Psychiatry. 1975, 16: 61-73. 10.1111/j.1469-7610.1975.tb01872.x.CrossRefPubMed
24.
go back to reference O'Connor TG, Marvin RS, Rutter M, Olrick J, Britner PA, the English and Romanian Adoptees Study Team: Child-parent attachment following early institutional deprivation. Dev Psychopathol. 2003, 15: 19-38. 10.1017/S0954579403000026.CrossRefPubMed O'Connor TG, Marvin RS, Rutter M, Olrick J, Britner PA, the English and Romanian Adoptees Study Team: Child-parent attachment following early institutional deprivation. Dev Psychopathol. 2003, 15: 19-38. 10.1017/S0954579403000026.CrossRefPubMed
25.
go back to reference O'Connor TG, Zeanah CH: Attachment disorders: Assessment strategies and treatment approaches. Attachment Hum Dev. 2003, 5: 223-244. 10.1080/14616730310001593974.CrossRef O'Connor TG, Zeanah CH: Attachment disorders: Assessment strategies and treatment approaches. Attachment Hum Dev. 2003, 5: 223-244. 10.1080/14616730310001593974.CrossRef
26.
go back to reference Smyke AT, Dumitrescu A, Zeanah CH: Attachment disturbances in young children. I: The continuum of caretaking casualty. Journal of the American Academy of Child and Adolescent Psychiatry. 2002, 41: 972-982. 10.1097/00004583-200208000-00016.CrossRefPubMed Smyke AT, Dumitrescu A, Zeanah CH: Attachment disturbances in young children. I: The continuum of caretaking casualty. Journal of the American Academy of Child and Adolescent Psychiatry. 2002, 41: 972-982. 10.1097/00004583-200208000-00016.CrossRefPubMed
27.
go back to reference Zeanah CH, Smyke AT, Koga SF, Carlson E: Attachment in institutionalized and community children in Romania. Child Dev. 2005, 76: 1015-1028. 10.1111/j.1467-8624.2005.00894.x.CrossRefPubMed Zeanah CH, Smyke AT, Koga SF, Carlson E: Attachment in institutionalized and community children in Romania. Child Dev. 2005, 76: 1015-1028. 10.1111/j.1467-8624.2005.00894.x.CrossRefPubMed
28.
go back to reference O'Connor TG, Rutter M, the English and Romanian Adoptees Study Team: Attachment disorder behavior following early severe deprivation: Extension and longitudinal follow-up. J Am Acad Child Adol Psychiatry. 2000, 39: 703-712. 10.1097/00004583-200006000-00008.CrossRef O'Connor TG, Rutter M, the English and Romanian Adoptees Study Team: Attachment disorder behavior following early severe deprivation: Extension and longitudinal follow-up. J Am Acad Child Adol Psychiatry. 2000, 39: 703-712. 10.1097/00004583-200006000-00008.CrossRef
29.
go back to reference Tizard B, Hodges J: The effect of early institutional rearing on the development of eight-year-old children. J Child Psychol Psychiatry. 1978, 19: 99-118. 10.1111/j.1469-7610.1978.tb00453.x.CrossRefPubMed Tizard B, Hodges J: The effect of early institutional rearing on the development of eight-year-old children. J Child Psychol Psychiatry. 1978, 19: 99-118. 10.1111/j.1469-7610.1978.tb00453.x.CrossRefPubMed
30.
go back to reference Rutter M, Colvert E, Kreppner J, Beckett C, Castle J, Groothues C, Hawkins A, O'Connor TG, Stevens S, Sonuga-Barke E: Early adolescent outcomes for institutionally-deprived and non-deprived adoptees. I: Disinhibited attachment. J Child Psychol Psychiatry. 2007, 48: 17-30. 10.1111/j.1469-7610.2006.01688.x.CrossRefPubMed Rutter M, Colvert E, Kreppner J, Beckett C, Castle J, Groothues C, Hawkins A, O'Connor TG, Stevens S, Sonuga-Barke E: Early adolescent outcomes for institutionally-deprived and non-deprived adoptees. I: Disinhibited attachment. J Child Psychol Psychiatry. 2007, 48: 17-30. 10.1111/j.1469-7610.2006.01688.x.CrossRefPubMed
31.
go back to reference Carter CS: Neuroendocrine perspectives on social attachment and love. Psychoneuroendocrinol. 1998, 23: 779-818. 10.1016/S0306-4530(98)00055-9.CrossRef Carter CS: Neuroendocrine perspectives on social attachment and love. Psychoneuroendocrinol. 1998, 23: 779-818. 10.1016/S0306-4530(98)00055-9.CrossRef
32.
33.
go back to reference Kraemer G: A psychobiological theory of attachment. Behavioral Brain Sciences. 1992, 15: 494-551. Kraemer G: A psychobiological theory of attachment. Behavioral Brain Sciences. 1992, 15: 494-551.
34.
go back to reference Suomi SJ: Attachment in rhesus monkeys. Handbook of attachment. Edited by: Cassidy J, Shaver P. 1999, New York: Guilford Press, 181-197. Suomi SJ: Attachment in rhesus monkeys. Handbook of attachment. Edited by: Cassidy J, Shaver P. 1999, New York: Guilford Press, 181-197.
35.
go back to reference Eluvathingal TJ, Chugani HT, Behen ME, Juhasz C, Muzik O, Maqbool M, Chugani DC, Makki M: Abnormal brain connectivity in children after early severe socioemotional deprivation: a diffusion tensor imaging study. Pediatrics. 2006, 117: 2093-2100. 10.1542/peds.2005-1727.CrossRefPubMed Eluvathingal TJ, Chugani HT, Behen ME, Juhasz C, Muzik O, Maqbool M, Chugani DC, Makki M: Abnormal brain connectivity in children after early severe socioemotional deprivation: a diffusion tensor imaging study. Pediatrics. 2006, 117: 2093-2100. 10.1542/peds.2005-1727.CrossRefPubMed
36.
go back to reference Gunnar MR, Vazquez DM: Low cortisol and a flattening of expected daytime rhythm: potential indices of risk in human development. Dev psychopathol. 2001, 13: 515-538. 10.1017/S0954579401003066.CrossRefPubMed Gunnar MR, Vazquez DM: Low cortisol and a flattening of expected daytime rhythm: potential indices of risk in human development. Dev psychopathol. 2001, 13: 515-538. 10.1017/S0954579401003066.CrossRefPubMed
37.
go back to reference Minnis H, Green J, O'Connor TG, Liew A, the RADAR team: An exploratory study of the association between reactive attachment disorder and attachment narratives in early school-age children. J Child Psychol Psychiatry. 2009, 50: 931-42. 10.1111/j.1469-7610.2009.02075.x.CrossRefPubMed Minnis H, Green J, O'Connor TG, Liew A, the RADAR team: An exploratory study of the association between reactive attachment disorder and attachment narratives in early school-age children. J Child Psychol Psychiatry. 2009, 50: 931-42. 10.1111/j.1469-7610.2009.02075.x.CrossRefPubMed
38.
go back to reference Minnis H, Everittt K, Pelosi AJ, Dunn J, Knapp M: Children in foster care: mental health, service use and costs. European Journal of Child and Adolescent Psychiatry. 2006, 15: 63-70. 10.1007/s00787-006-0452-8.CrossRef Minnis H, Everittt K, Pelosi AJ, Dunn J, Knapp M: Children in foster care: mental health, service use and costs. European Journal of Child and Adolescent Psychiatry. 2006, 15: 63-70. 10.1007/s00787-006-0452-8.CrossRef
39.
go back to reference Ainsworth MDS, Blehar MC, Waters E, Wall S: Patterns of attachment: A psychological study of the strange situation. 1978, Hillsdale, NJ: Erlbaum Ainsworth MDS, Blehar MC, Waters E, Wall S: Patterns of attachment: A psychological study of the strange situation. 1978, Hillsdale, NJ: Erlbaum
40.
go back to reference O'Connor TG: Attachment disorders in infancy and childhood. Child and adolescent psychiatry: Modern approaches. Edited by: Rutter M, Taylor E. 2002, Blackwell Scientific publications, 776-792. fourth O'Connor TG: Attachment disorders in infancy and childhood. Child and adolescent psychiatry: Modern approaches. Edited by: Rutter M, Taylor E. 2002, Blackwell Scientific publications, 776-792. fourth
41.
go back to reference Chisholm K: A three year follow-up of attachment and indiscriminate friendliness in children adopted from Romanian orphanages. Child Development. 1998, 69: 1092-1106.CrossRefPubMed Chisholm K: A three year follow-up of attachment and indiscriminate friendliness in children adopted from Romanian orphanages. Child Development. 1998, 69: 1092-1106.CrossRefPubMed
42.
go back to reference Bakerman-Kranenburg , van Ijzendoorn , Juffer F: Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bull. 2003, 129: 195-215. 10.1037/0033-2909.129.2.195.CrossRef Bakerman-Kranenburg , van Ijzendoorn , Juffer F: Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bull. 2003, 129: 195-215. 10.1037/0033-2909.129.2.195.CrossRef
43.
go back to reference Buckner JD, Lopez C, Dunkel S, Joiner TE: Behavior management training for the treatment of reactive attachment disorder. Child Maltreatment. 2008, 13 (3): 289-297. 10.1177/1077559508318396.PubMedCentralCrossRefPubMed Buckner JD, Lopez C, Dunkel S, Joiner TE: Behavior management training for the treatment of reactive attachment disorder. Child Maltreatment. 2008, 13 (3): 289-297. 10.1177/1077559508318396.PubMedCentralCrossRefPubMed
44.
go back to reference Nelson CA, Zeanah CH, Fox NA, Marshall PJ, Smyke AT, Guthrie D: Cognitive recovery in socially deprived young children: the Bucharest Early Intervention Project. Science. 2007, 318 (5858): 1937-1940. 10.1126/science.1143921.CrossRefPubMed Nelson CA, Zeanah CH, Fox NA, Marshall PJ, Smyke AT, Guthrie D: Cognitive recovery in socially deprived young children: the Bucharest Early Intervention Project. Science. 2007, 318 (5858): 1937-1940. 10.1126/science.1143921.CrossRefPubMed
Metadata
Title
Early stress exposure: Concepts, findings, and implications, with particular emphasis on attachment disturbances
Authors
Thomas G O'Connor
Mary E Spagnola
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2009
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/1753-2000-3-24

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