Altered stress responses in children exposed to early adversity: a systematic review of salivary cortisol studies

Pathological stress responses are implicated in numerous disorders. Hypothalamic-pituitary-adrenal axis function is influenced by gene-environment interaction, with early-life environmental adversity having long-lasting effects. We examine the evidence that, in humans, these effects are apparent from infancy. We systematically reviewed published findings on cortisol response to a stressor, in 0-5-year-olds already exposed to adversity. Adversity was defined as a negative environmental influence present post-conception. We searched Ovid MEDLINE (1950-May 2010), EMBASE (1980-May 2010) and PsychINFO (1806-May 2010). We included peer-reviewed, English language studies that analysed salivary cortisol before and after a standardised stressor. We identified 30 studies, of which 27 reported a significant effect of adversity on the cortisol response to stress. Six of these demonstrated an effect of prenatal substance exposure. Thirteen studies found that psychosocial adversity increased cortisol reactivity. Three studies reported that cortisol reactivity could be normalised by intervention programmes. The studies were heterogeneous, both in nature of adversity studied and in stressor used, precluding meta-analysis and assessment of publication bias. Our review presents evidence that adversity disrupts the stress response from an early age. Longitudinal studies are required to determine whether effects persist, alter with time, or are reversible with intervention.     

Curt Richter: psychobiology and the concept of instinct

Curt Richter is at the origins of psychobiology in the United States. For Richter the concept of instinct was central to his research. While he had diverse interests that traversed a great range of psychobiology, the concept of instinct was fundamental to his research on specific hungers and the regulation of the internal milieu. Debates about the concept of instinct would last the bulk of Richter's experimental career, culminating in an international conference a decade after the Second World War.     

Emotional regulation: implications for the psychobiology of psychotherapy

A range of studies have contributed to understanding the psychobiology of emotional regulation. Functional imaging studies have demonstrated that cortico-limbic circuitry plays an important role in mediating processes such as reappraisal and suppression. Dorsolateral prefrontal cortex may be important in conscious reframing, while ventromedial prefrontal cortex and orbitofrontal cortex may be particularly important in emotion evaluation. Gene variants and early environments impact underlying emotional regulation and its neurobiology. It may be hypothesized that during interventions such as psychotherapy there are improvements in emotional regulation, together with the normalization of related psychobiological mechanisms.     

The psychobiology of meals

Meals are considered as bouts of behavior that, although necessary for supplying nutrients to the body, result in undesirable perturbations of homeostatically controlled parameters. If the environment dictates that an animal mainly eat very large meals, these meal-associated perturbations become potentially dangerous. When the opportunity to eat a very large meal is regular and predictable, animals adopt strategies that maximize the efficiency of the process while minimizing the threatening homeostatic disturbances. Hence, prior to the onset of meals, animals elevate their body temperatures, presumably to facilitate critical processes involved in ingestion and/or digestion. Temperature continues to rise during the meal, and as it approaches potentially dangerous levels, the meal is terminated and temperature falls to “safer” levels. Animals also undergo a slow decline of blood glucose prior to the initiation of meals, thus minimizing the postprandial elevation of blood glucose caused by the absorption of ingested carbohydrates. Analogously, prior to meals, animals undergo a decrease of metabolic rate, thus precluding the necessity for postprandial increases of metabolic rate to reach even higher absolute levels. These premeal changes of regulated parameters have been interpreted by others as indicating depletion of one or more energy supplies so that the animal is compelled to eat. Contrary to this, we interpret the changes as ones that enable the animal to prepare adequately to consume a large meal when the environment is predictable.     

The psychobiology of stress

Stressful life experience can have significant effects on a variety of physiological systems, including the autonomic nervous system, the hypothalamic-pituitary-adrenal axis, and the immune system. These relationships can be bidirectional; for example, immune cell products can act on the brain, altering mood and cognition, potentially contributing to depression. Although acute physiological alterations may be adaptive in the short term, chronic or repeated provocation can result in damage to health. The central dogma in the field of stress research assumes a stereotyped physiological response to all stressors (the generality model). However, increasing evidence suggests that specific stressful conditions and the specific way an organism appraises these conditions can elicit qualitatively distinct emotional and physiological responses (the integrated specificity model). For example, appraisals of threat (vs. challenge), uncontrollability, and negative social evaluation have been shown to provoke specific psychobiological responses. Emotional responses appear to have specific neural substrates, which can result in differentiated alterations in peripheral physiological systems, so that it is incorrect to presume a uniform stress response.     

Panic disorder: the psychobiology of external treat and introceptive distress

Panic disorder seems to be mediated by the neuronal circuitry and neurochemical systems that have evolved to respond to external threatening stimuli. Distant threats activate prefrontal cortex (involved in complex planning of avoidance strategies), while immediate threats activate midbrain structures (involved in fast reflexive behaviors). Panic disorder may, however, also involve more specific interoceptive mechanisms. For example, the association between respiratory dysfunction and panic disorder has bolstered a false suffocation alarm hypothesis. Genetic and environmental contributors to panic disorder are beginning to be delineated. Effective pharmacotherapy and psychotherapy are able to normalize the relevant psychobiology.     

谁是最大的受害群体:群际受害者竞争

长期冲突的群体双方都致力于建构自己的最大受害者角色,他们认为自己比对方遭受了更多、更不公平、更不合理的伤害,这种现象称之为群际受害者竞争。群体通过强调冲突给自身造成的伤害后果的严重性与不公平性、伤害的处理方式等,努力声称内群体比对方遭受了更多的伤害。集体受害感、冲突责任归因、记忆的选择性、消除威胁的内在需要以及其他心理特点是群际受害者竞争的心理基础。通过构建"共同的受害者-侵犯者"认同以及增加群际接触等可以降低群际受害者竞争的水平,促进群际关系的和谐。今后的研究需要进一步完善群际受害者竞争的机制,深入探讨群际受害者竞争的其他影响因素,争取在干预策略上有所突破,关注非暴力冲突的群体情境中群际受害者竞争的特点,了解第三方群体对谁是最大受害者群体的认知和评价机制。     

Choosing to Suffer: Reflections on an Enigma

Most people pursue pleasure and seek to avoid pain. Some individuals, however, choose a life characterized by pain and suffering. The author describes the most common varieties of such behavior patterns: asceticism, martyrdom, penance and masochism. Critical psychodynamics are discussed and the author proposes a synthesis of the motivation underlying pain/suffering seeking behavior.     

The psychobiology of parenting in mammals

Parental behavior denotes a vareity of genetically programmed activities in which parents help their young to survive to maturity. A highly successful research has been devoted to the psychoneuroendocrine bases of parenting in two species, rat and sheep. As a result empirical data along with conceptual formulations have been obtained which provide a model for generating hypothesis for the study of other species. This review was written to draw the attention to this research because of its enormous potential significance for problems pertaining to human infant care. It discusses the current status of research on the physiological bases of parental behavior,     

The two sides of adversity: the effect of distant versus recent adversity on updating emotional content in working memory

Previous research suggests that adversity can have both adaptive and maladaptive effects, yet the emotional and working memory processes that contribute to more or less adaptive outcomes are unclear. The present study sought to investigate how updating emotional content differs in adolescents who have experienced past, recent, or no adversity. Participants who had experienced distant adversity (N?=?53), no adversity (N?=?58), or recent adversity only (N?=?20) performed an emotion n-back task with emotional facial expressions. Results revealed that the distant adversity group exhibited significantly faster reaction times (RTs) than the no adversity and recent adversity only groups. In contrast, the recent adversity only group exhibited significantly slower RTs and more errors than the distant adversity and no adversity groups. These results suggest an emotion and executive control pathway by which both the benefits and negative effects of adversity may be conferred. Results also highlight the importance of time in assessing the impact of adversity.     

The use of on-line computers in psychobiology

This paper examines several areas in the use of laboratory computers in psychobiology, specifically how they are being used, the problems in languages and software, in interfacing computers to experimental configurations, and in the hardware involved. The paper defines the experimental tasks and data requirements which tend to distinguish computer usage in physiological research from other areas of psychology and the tasks which absolutely necessitate the use of a computer and in what mode. Finally we present our views of the dangers of computer use and misuse and make our own subjective evaluation of how well computers are living up to their end of the bargain, how well scientists are doing at their end, and where we should go from here.     

The adversity of secret relationships

Are secret romantic relationships alluring or aversive? Previous research suggests that romantic secrecy (i.e., keeping a romantic relationship secret from others) creates a cognitive preoccupation that enhances romantic attraction. In contrast, we predicted that romantic secrecy interferes with relationship interdependence and thereby decreases relationship quality. Three studies of secrecy in ongoing romantic relationships confirmed this prediction. In Study 1, romantic secrecy predicted lower levels of initial relationship quality and decreased relationship quality over a 2‐week period. In Study 2, relationship burden mediated partially the negative association between romantic secrecy and relationship quality. In Study 3, the negative association between romantic secrecy and relationship quality was primarily explained by decreased relationship satisfaction. The importance of understanding romantic secrecy is discussed.     

The psychobiology of trait shame in young women: extending the social self preservation theory

OBJECTIVE: The social self preservation theory (SSPT) proposes that social evaluative threat evokes the emotion of shame, which then shapes a coordinated psychobiological response. While this is supported in acute stress studies, there is no data on chronic experiences of shame. DESIGN: We investigated the association of trait shame with activity of the hypothalamic-pituitary-adrenal (HPA) axis, of the sympathetic nervous system (SNS), and regulation of inflammation in n = 56 young women. MAIN OUTCOME MEASURES: Daily profiles of salivary cortisol and alpha-amylase were assessed as indices of HPA axis and SNS activity, respectively. Inflammatory regulation was assessed by lipopolysaccharide-stimulated production and glucocorticoid inhibition of interleukin-6 in vitro. RESULTS: Trait shame was associated with SNS (r = .49; p = .001), but not HPA activity (r = .14; ns). Shame was associated with inflammatory activity (r = .35; p = .006) and glucocorticoid sensitivity (r = -0.43; p = .001). Relationships were not mediated by HPA and SNS activity. CONCLUSIONS: Results support SSPT predictions with respect to chronic shame experience and inflammation. Results further suggest the importance of SNS activation related to shame, and the possibility that HPA activation may be limited acute experiences of shame.     

Smiling in the face of adversity: the interpersonal and intrapersonal functions of smiling

This study examined hypothesized interpersonal and intrapersonal functions of smiling in positive and negative affective contexts. Smiles were measured during a lab-based monologue task following either happy or sad emotion-evoking films. Psychological adjustment and social integration were measured longitudinally using data obtained in years prior to and after the experimental task. Duchenne (genuine) smiles predicted better long-term adjustment and this effect was mediated independently by both social integration and undoing of negative emotion during the monologue. These effects were observed only in the negative affective context. Non-Duchenne smiles were not related to psychological adjustment. Neither Duchenne nor non-Duchenne smiles during the monologue task were related to personality variables assessed in this study.     

Phonological representations in deaf children: the importance of early linguistic experience

It is argued that the development of phonological representations in deaf children does not necessarily depend on auditory speech experience, neither at the perception nor at the production level. Instead, this development depends upon early experience of an input in which all phonological contrasts are well specified, independently of input modality. This is argued on the basis of the studies investigating phonological and morpho-phonological abilities of profoundly deaf children early exposed to Cued Speech. The paper is concluded with some speculations about the effect of early exposure to CS on the development of language specific processes housed in the left-hemisphere.     

The Case of Helen D.: A Woman Who Learned to Suffer

Despite our earnest wish to be useful to patients, we sometimes fail. Part of the difficulty often has to do with the expectations that the patient brings to therapy. Another contribution to an impasse may be the psychiatrist's theoretical orientation. This review illustrates a playful distortion of the doctor-patient relationship so as to develop an alliance with a difficult patient. The involvement of part of her family in the long-term treatment facilitated her growth out of a biopsychosocial swamp.