Pubertal stress recalibration reverses the effects of early life stress in postinstitutionalized children

Abstract

Nonhuman animal models reveal that the hypothalamic–pituitary–adrenocortical (HPA) axis calibrates to the harshness of the environment during a sensitive period in infancy. Humans exposed to depriving institutional care in infancy show reduced HPA axis responsivity, even years after they are placed in supportive, well-resourced families. This study examined whether puberty opens a window of opportunity to recalibrate the HPA axis toward more typical reactivity when children shift from harsh deprived conditions in infancy into supportive conditions in childhood and adolescence. Participants (n = 129 postinstitutionalized, 68.2% female; n = 170 comparison, 52.4% female) completed 3 annual sessions beginning at ages 7 to 15 (M = 11.28, SD = 2.31). Each session assessed pubertal stage via nurse examination and cortisol reactivity to the Trier social stress test for children. The linear mixed-effects model controlling for sex and between-individual differences in pubertal stage showed a significant group by pubertal stage interaction: within-individual increases in pubertal stage were associated with increases in cortisol stress reactivity for postinstitutionalized youth but not nonadopted comparison youth. This study indicates that pubertal development reopens a window of opportunity for the HPA axis to recalibrate based on significant improvements in the supportiveness of the environment relative to that in infancy. The peripubertal period may be an important time in development where the caregiving environment has a substantial impact on the HPA axis and, perhaps, other stress-mediating systems. Future research is needed to examine the mechanisms of recalibration and whether HPA recalibration impacts physical and psychological health.

Neurobiological Markers of Resilience to Early-Life Adversity During Adolescence

“…While the aforementioned work has focused on identifying mechanisms of risk, emerging evidence indicates puberty may offer a window of resilience for adolescents exposed to ELA (129,132,133). Recent research in internationally-adopted PI youth suggests that pubertal onset may present a stress recalibration opportunity for HPA axis functioning (specifically, cortisol reactivity to a social stressor) (7,134). These adolescents experienced extreme social deprivation during early HPA axis development, followed by high-resource environments post-adoption (135).…”

“…Adolescence is a developmental period marked by heightened plasticity, sensitivity to the social environment, and the rapid development of critical functions related to self-regulation, reward processing, and affective learning (6). Adolescence may present a unique opportunity for cultivating resilience by targeting the aforementioned domains, particularly in light of recent evidence that puberty provides a "recalibration" window for specific biological systems following ELA (7). Intervention during adolescence may be particularly beneficial given that the transitions associated with this developmental stage are normatively stressful, and the onset of anxiety, mood, and substance use disorders is most common during this period (8).…”

Programming effects of peripubertal stress on spatial learning

“…The peripubertal period, involving time-windows right before and after puberty, comprises drastic hormonal, neurobiological and behavioral changes (Andersen and Teicher, 2008; Blakemore, 2008; Casey et al, 2010; Paus et al, 2008; Romeo et al, 2016; Spear, 2000; Tzanoulinou and Sandi, 2016). In particular, this period involves marked changes in the responsivity of the hypothalamic-pituitary-adrenal (HPA) axis to stressful experiences (McCormick et al, 2017; Romeo et al, 2016), and this transition can be modified by experiences (Gunnar et al, 2019), particularly stressful ones (Kumsta et al, 2017; Márquez et al, 2013; McCormick et al, 2017; Romeo et al, 2016). Strikingly, individual differences in the adaptation of the glucocorticoid response to repeated stress exposure during the peripubertal period in rats were found to predict subsequent changes in emotional and social phenotypes observed during adolescence (Papilloud et al, 2019) and adulthood (Walker et al, 2018; 2017).…”

Associations of waking cortisol with DHEA and testosterone across the pubertal transition: Effects of threat-related early life stress

“…Specifically, greater severity of exposure to a variety of life stressors prior to puberty (i.e., parental divorce, maltreatment, community violence) was associated with a blunted cortisol awakening response King 4 in early puberty but a heightened cortisol response in later puberty . Recently, using an accelerated longitudinal design, Gunnar et al (2019) found that within-individual increases in pubertal stage moderated the association between a history of institutionalization and cortisol responses to social stress; the cortisol responses of previously institutionalized children became more similar to those of never-adopted children as they progressed through puberty. The biological mechanisms underlying changes in the effects of ELS on cortisol regulation during puberty remain unclear Romeo, 2013).…”