Chronic Stress in Children and Adolescents: A Review of Biomarkers for Use in Pediatric Research

Abstract

The incorporation of chronic stress biomarkers into pediatric research studies may provide valuable insight into the mechanisms through which stressful environments "get under the skin" and ultimately inform efforts to promote health and reduce inequities among children exposed to adversity.

Maternal Adverse Childhood Experiences, Family Strengths, and Chronic Stress in Children

“…The results of this exploratory study suggest that past maternal experiences may influence a child's risk for experiencing toxic stress, as maternal ACEs were associated with higher blood pressure levels and behavioral problems in children, while family strengths were associated with lower BMI and inflammatory markers in children. While the effect sizes detected were generally small, this is consistent with effects detected in other pediatric biomarker studies and reflects the complexity of factors that influence developing physiology (Condon, 2018a). Though additional research is needed, these findings indicate that immune and metabolic pathways may be important physiologic mechanisms linking past maternal experiences with child health.…”

“…It is notable that hair cortisol, a measure of chronic HPA axis functioning over time, did not yield any meaningful correlations in this sample. Hair cortisol is thought to offer an advantage over salivary cortisol, as salivary cortisol is sensitive to diurnal rhythms and the oral environment, and requires collection of multiple samples over time (Condon, 2018a). While other studies have detected relationships between child hair cortisol levels and other psychosocial exposures (Karlén et al, 2015), associations with past maternal history are unknown.…”

“…While stress responses may play a key role in linking past maternal history with child health, the best biological indicators of chronic stress in children have not yet been defined (Condon, 2018a). Indicators of stress may include primary mediators of the stress response, such as glucocorticoids or cytokines, secondary outcomes of the stress response, including disruptions to immune, metabolic, or cardiovascular functioning, and tertiary endpoints that represent the downstream effects of chronic stress, such as behavioral problems or chronic disease (Condon, 2018a). In the current study, we examine feasible, noninvasive measures to represent primary, secondary, and tertiary outcomes across a range of physiologic systems in an effort to encompass the complexity of the stress response and gain insight into the biological pathways linking maternal history with child health.…”

A systematic review to investigate whether the current family court process in Scotland, leads to emotionally functional adults in cases of adverse childhood experiences.

“…Exposure to stress prompts structural differences to take place causing stress hormones in the body such as adrenaline and cortisol to close down metabolic areas (Condon, 2018;McCrory et al, 2012;De Bellis et al, 2014), diverting attention to the amygdala, the brain region responsible for fear and anxiety detection, to promote protection against environmental threats (Condon, 2018). Occurrences of physiological and physical changes are markedly increased in maltreated children and can result in significant disruption in brain development.…”

“…Glucocorticoids are released as part of the physiological response to stress, causing the adrenal gland to release cortisol hormone. This produces accelerated heart rate and blood pressure levels, increasing cardiovascular tone and prohibiting non-essential bodily processes such as digestion during a traumatic experience (Condon, 2018). These effects accumulate to counteract the body's response to stress and to help re-establish homeostasis in the systems, as chronically high levels of cortisol can have damaging effects on health (Cassiers et al, 2016).…”