The process by which individuals' previous experiences and environments systematically alter their health and functioning across the life span. 

University of Illinois at Chicago

Toxic stress occurs when a child has underwent a traumatic event for so long that the body fails to recover fully. This type of stress is considered "toxic," because of its high correlations with modified gene expression, increased allostatic load, and issues with cognitive and social-emotional development.

Toxic Stress

Johnson, S. B., Riley, A. W., Granger, D. A., & Riis, J. (2013). The science of early life toxic stress for pediatric practice and advocacy. Pediatrics, 131(2), 319-327.

The science of early life toxic stress for pediatric practice and advocacy

Biological Embedding

Adverse health effects of toxic stress during childhood can include:
- Maladaptive coping skills 
- Poor stress management 
- Unhealthy lifestyles
- Mental illness
- Physical disease

Adverse Health Effects of Toxic Stress

The toxic stress response affects the neuroendocrine-immune network, and that response leads to a prolonged and abnormal cortisol response. The resultant immune dysregulation increases the risk of infections in children. The toxic stress response is believed to play a role in the pathophysiology of depressive disorders, behavioral dysregulation, PTSD, and psychosis. 

Toxic Stress Response

Resilience is the ability to properly adapt to adversity despite the conditions. It is dynamic and plays a large role in a toxic stress response. Factors that predict resilience in children experiencing adversity include a solid relationship between the child and parent, child and teacher, adequate social support, and parent's sense of efficacy. Focusing on early interventions to strengthen resilience factors may help to minimize a toxic stress response. 

Resilience in Toxic Stress

Factors believed to increase vulnerability to early toxic stress include a child's increased sensitivity to both psychological and physiologic stress with decreased resources for social and psychological support to help with stress coping skills. Other sources of vulnerability may include poor social support, abusive parenting, developmental delays, and maladaptive behaviors in response to adversity. 

Vulnerability in Toxic Stress

A child risks maladaptive stress responses when exposed to childhood adversity and toxic stress. The first several years of life are sensitive periods of time for increased neuroplasticity, after which it begins to wane. If primary preventive measures are implemented during the early, sensitive windows of development, appropriate stress responses to adversity may result. Screening is a means to identify those children who would benefit from both preventive measures and, if need be, therapeutic interventions.

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