The neuroendocrinological sequelae of stress during brain development: the impact of child abuse and neglect.

Severe stress during the sensitive periods of neurodevelopment, (which include the prenatal period, infancy, childhood and adolescence), has a long-lasting organizing effect on the brain and stress axes. Child abuse and neglect thus exert a cumulative harmful effect on neuroendocrinological development, which persists into adulthood. It is not merely the memory of the trauma which leaves a mark, but rather the effect on neurodevelopment which negatively influences the ability of adult survivors of childhood maltreatment to cope with current stressors. The victims of child abuse and neglect are likely to maltreat their own children and so perpetuate the intergenerational transmission of child maltreatment. In this paper relevant normal brain development is first summarized. Child abuse/neglect is next discussed with detailed reference to the aberrant neuroendocrinological development that is known to occur. We specifically examine effects on the hypothalamo-pituitary-adrenal and central noradrenergic-sympathoadrenomedullary stress axes and other neurotransmitter systems before turning to changes described in the cerebral volumes, corpus callosum and cortical hemispheres, prefrontal cortex and amygdalae, superior temporal gyrus, hippocampus as well as the cerebellar vermis.