Stress and physiology in clinical research with risk-exposed children: from mechanism to application

Abstract

Research findings from diverse studies converge in suggesting that the experience of early severe and protracted stress is associated with a wide range of behavioural and physical health problems. The public health and clinical implications of these findings are substantial, but their successful applications to improve child health have been limited. What is clear is that this successful application depends, at least in part, on a clear understanding of the mechanisms involved. The current review considers the likely role of stress physiology and the Hypothalamic-Pituitary-Adrenal (HPA) axis, one dominant model for explaining how early stress exposures may have lasting effects on mental and physical health. In addition to highlighting illustrative findings, we consider the practical barriers and challenges for increasing the presence of biological markers in clinical research.