title: Causal effects of the early caregiving environment on development of stress response systems in children.
abstract: Disruptions in stress response system functioning are thought to be a central mechanism by which exposure to adverse early-life environments influences human development. Although early-life adversity results in hyperreactivity of the sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal (HPA) axis in rodents, evidence from human studies is inconsistent. We present results from the Bucharest Early Intervention Project examining whether randomized placement into a family caregiving environment alters development of the autonomic nervous system and HPA axis in children exposed to early-life deprivation associated with institutional rearing. Electrocardiogram, impedance cardiograph, and neuroendocrine data were collected during laboratory-based challenge tasks from children (mean age = 12.9 y) raised in deprived institutional settings in Romania randomized to a high-quality foster care intervention (n = 48) or to remain in care as usual (n = 43) and a sample of typically developing Romanian children (n = 47). Children who remained in institutional care exhibited significantly blunted SNS and HPA axis responses to psychosocial stress compared with children randomized to foster care, whose stress responses approximated those of typically developing children. Intervention effects were evident for cortisol and parasympathetic nervous system reactivity only among children placed in foster care before age 24 and 18 months, respectively, providing experimental evidence of a sensitive period in humans during which the environment is particularly likely to alter stress response system development. We provide evidence for a causal link between the early caregiving environment and stress response system reactivity in humans with effects that differ markedly from those observed in rodent models.
authors.affiliation: Department of Psychology, University of Washington, Seattle, WA 98112; mclaughk@uw.edu.
authors.forename: Katie A
authors.initials: KA
authors.lastname: McLaughlin
authors.affiliation: Developmental Medicine Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115;
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Sheridan
authors.affiliation: Institute for Child Development, 011467 Bucharest, Romania;
authors.forename: Florin
authors.initials: F
authors.lastname: Tibu
authors.affiliation: Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD 20742;
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Fox
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA 70112; and.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Zeanah
authors.affiliation: Developmental Medicine Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115; Harvard Graduate School of Education, Cambridge, MA 02138.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Nelson
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology; D017028:Caregivers; D002674:Child, Institutionalized / Q000523:psychology*; D002675:Child, Preschool; D004562:Electrocardiography; D005581:Foster Home Care / Q000523:psychology*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D007223:Infant; D008137:Longitudinal Studies; D010913:Pituitary-Adrenal System / Q000502:physiology; D012383:Romania; D013315:Stress, Psychological / Q000503:physiopathology* / Q000523:psychology*; D013997:Time Factors
chemical_list: D006854:Hydrocortisone
keywords: HPA axis; autonomic nervous system; childhood adversity; early-life stress; stress reactivity