Stress, vulnerability and resilience, a developmental approach.
BACKGROUND
The origins of mental disorders arise often in childhood. Early life is a period of unique sensitivity with long lasting effects on mental health. However, the mechanisms for these effects remain unclear.


OBJECTIVE
This thesis describes a variety of studies using a developmental framework to promote greater understanding of the influence of nature (genotypes) and nurture (e.g., environmental risk and protective factors) on outcomes later in childhood.


METHODS
The aim of this thesis is to investigate gene and environmental influences on behavioural, emotional, and cognitive outcomes in different samples from the Netherlands and Singapore, most derived from the general population. We assessed early life influences from a neurobiological, social, and a psychological perspective by using a biopsychosocial framework.


RESULTS
Our studies support the hypothesis that all experiences during life, including early experiences in utero, will influence the expression of genes and in the end the mental health of individuals. However, genotypes influencing stress responses are found to be "plastic," which implies that they can be modulated by environmental experiences during life. In line with this, patterns of resilience are found to be context-dependent too.


CONCLUSIONS
The model of "epigenetic programming" suggests the predictive power of the environment in utero and early childhood on mental health later in life. This association is probably determined by a neurodevelopmental pathway with individual differences in neural and endocrine responses to stress.
Department of Psychological Medicine, National University Hospital, Singapore.
Birit Froukje Philippien
BF
Broekman