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

Hunter, A.L., Minnis, H. and Wilson, P. (2011) Altered stress responses in children exposed to early adversity: A systematic review of salivary cortisol studies. Stress, 14(6), pp. 614-626. (doi:10.3109/10253890.2011.577848)

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Publisher's URL: http://dx.doi.org/10.3109/10253890.2011.577848

Abstract

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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wilson, Dr Philip and Minnis, Professor Helen
Authors: Hunter, A.L., Minnis, H., and Wilson, P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:Stress
Publisher:Informa Healthcare
ISSN:1607-8888
ISSN (Online):1025-3890
Published Online:15 June 2011
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