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Published on: February 25, 2016
Child maltreatment and autonomic nervous system reactivity: identifying dysregulated stress reactivity patterns by
Katie A McLaughlin1, Margaret A Sheridan, Sonia Alves
1From the Department of Psychology (K.A.M.), University of Washington, Seattle, Washington; Developmental Medicine Center (M.A.S.), Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics (M.A.S.), Harvard Medical School, Boston, Massachusetts; Harvard Graduate School of Education (S.A.), Cambridge, Massachusetts; and Department of Psychiatry (W.B.M.), University of California San Francisco, San Francisco, California.
Insights
Child maltreatment is linked to altered physiological stress responses in adolescents. Maltreated youth showed a "threat" pattern, not the expected "sympathetic activation," indicating complex stress reactivity.
Area of Science:
- Psychophysiology
- Adolescent Psychology
- Stress and Health
Background:
- Child maltreatment (CM) disrupts stress system development, potentially linking to psychopathology.
- Existing theories predict heightened sympathetic nervous system (SNS) reactivity post-CM, but findings are inconsistent.
- A biopsychosocial model of challenge and threat offers a novel framework for understanding CM's impact on stress reactivity.
Purpose of the Study:
- To investigate the pattern of physiological stress reactivity in maltreated adolescents using a challenge/threat framework.
- To examine if maltreated adolescents exhibit a "threat" pattern (SNS activation, elevated vascular resistance, blunted cardiac output) during a social-evaluative stressor.
- To explore the association between this threat reactivity and internalizing/externalizing symptoms.
Main Methods:
- 168 adolescents (38.2% maltreated) underwent physiological monitoring (ECG, impedance cardiography, BP) during the Trier Social Stress Test.
- Key measures included pre-ejection period (PEP), cardiac output (CO), and total peripheral resistance (TPR) reactivity.
- Internalizing and externalizing symptoms were assessed to correlate with physiological responses.
Main Results:
- Maltreated adolescents showed reduced CO reactivity across all stress task components and marginally elevated TPR reactivity.
- Reduced PEP reactivity was observed during mental arithmetic, but not during speech preparation or delivery.
- Threat reactivity patterns positively correlated with externalizing symptoms.
Conclusions:
- Child maltreatment is associated with a dysregulated physiological stress response pattern, aligning with threat conceptualizations.
- This pattern, characterized by blunted cardiac output and increased vascular resistance, differs from previous predictions of heightened SNS activity.
- Findings suggest a more complex and nuanced understanding of stress reactivity following child maltreatment is needed.
Objective:
Disruptions in stress response system development have been posited as mechanisms linking child maltreatment (CM) to psychopathology. Existing theories predict elevated sympathetic nervous system reactivity after CM, but evidence for this is inconsistent. We present a novel framework for conceptualizing stress reactivity after CM that uses the biopsychosocial model of challenge and threat. We predicted that in the context of a social-evaluative stressor, maltreated adolescents would exhibit a threat pattern of reactivity, involving sympathetic nervous system activation paired with elevated vascular resistance and blunted cardiac output (CO) reactivity.
Methods:
A sample of 168 adolescents (mean age =14.9 years) participated. Recruitment targeted maltreated adolescents; 38.2% were maltreated. Electrocardiogram, impedance cardiography, and blood pressure were acquired at rest and during an evaluated social stressor (Trier Social Stress Test). Pre-ejection period (PEP), CO, and total peripheral resistance reactivity were computed during task preparation, speech delivery, and verbal mental arithmetic. Internalizing and externalizing symptoms were assessed.
Results:
Maltreatment was unrelated to PEP reactivity during preparation or speech, but maltreated adolescents had reduced PEP reactivity during math. Maltreatment exposure (F(1,145) = 3.8-9.4, p = .053-<.001) and severity (β = -0.10-0.12, p = .030-.007) were associated with significantly reduced CO reactivity during all components of the stress task and marginally associated with elevated total peripheral resistance reactivity (F(1,145) = 3.8-9.4; p = .053-<.001 [β = 0.07-0.11] and p = .11-.009, respectively). Threat reactivity was positively associated with externalizing symptoms.
Conclusions:
CM is associated with a dysregulated pattern of physiological reactivity consistent with theoretical conceptualizations of threat but not previously examined in relation to maltreatment, suggesting a more nuanced pattern of stress reactivity than predicted by current theoretical models.
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