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Blunted stress reactivity as a mechanism linking early psychosocial deprivation to psychopathology during adolescence

Nature Mental Health (2024)Cite this article

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Abstract

Early psychosocial deprivation is associated with alterations in stress-response system development and later psychopathology. Using data from the Bucharest Early Intervention Project, we examined whether blunted reactivity to social stress served as a mechanism linking early deprivation to later psychopathology in 135 youths, 89 of whom were raised in institutions during early childhood (46 randomly assigned to foster care intervention). At 12 and 16 years, cortisol and sympathetic nervous system reactivity were assessed using the Trier Social Stress Test. Bifactor scores of general and specific psychopathology were estimated from caregiver and teacher reports. Blunted cortisol reactivity at 12 years mediated the association between deprivation and general psychopathology at 16 years, whereas blunted sympathetic nervous system reactivity mediated externalizing-specific problems. Increased stress reactivity did not mediate intervention effects on psychopathology. Early deprivation may shape stress-response system development in a way that confers broad risk for mental health problems during adolescence.

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Fig. 1: CONSORT flow diagram.
Fig. 2: Path model linking early deprivation to psychopathology factors via stress reactivity.
Fig. 3: Path model linking foster care intervention to psychopathology factors via stress reactivity.

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Data availability

Data for this study are not publicly available, but will be made available to individuals upon reasonable request (m.wade@utoronto.ca).

Code availability

The Mplus code for the primary and supplementary models is available from the corresponding author upon reasonable request (m.wade@utoronto.ca).

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Acknowledgements

We thank the families and the children that participated in this study, as well as the research team and staff in Romania for their support and investment in this project. Funding was from the National Institute of Mental Health (grant no. R01MH091363 to C.A.N., N.A.F. and C.H.Z.). The funding source had no role in the design of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; or decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Applied Psychology and Human Development, University of Toronto, Toronto, Ontario, Canada

    Mark Wade

  2. Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Margaret A. Sheridan

  3. Boston Children’s Hospital of Harvard Medical School, Boston, MA, USA

    Stacy S. Drury & Charles A. Nelson

  4. Department of Biomedical Sciences, Stefan cel Mare University of Suceava, Suceava, Romania

    Florin Tibu

  5. Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA, USA

    Charles H. Zeanah

  6. Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA

    Nathan A. Fox

  7. Harvard Graduate School of Education, Cambridge, MA, USA

    Charles A. Nelson

  8. Department of Psychology, Harvard University, Cambridge, MA, USA

    Katie A. McLaughlin

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Contributions

N.A.F., C.A.N. and C.H.Z. designed and carried out the larger project. K.A.M. and M.A.S. conceptualized and supervised the collection and processing of all stress reactivity data. S.S.D. processed the cortisol data for this specific study. F.T. processed the sympathetic nervous system data for this specific study under the supervision of K.A.M. M.W. processed the mental health data and performed all statistical analyses for this specific study. K.A.M. verified the underlying data. F.T. was part of the team in Romania responsible for participant recruitment and data collection. K.A.M., M.A.S. and S.S.D. provided expertise around physiological data collection and analysis, while N.A.F., C.H.Z. and C.A.N. provided expertise around study design, methods and the sociopolitical context in Romania at the time. In addition to performing analyses, M.W. conceptualized this specific paper and wrote the initial draft. All other authors reviewed the paper and provided critical edits and comments. All authors consented to the submission of this paper in its final form.

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Correspondence to Mark Wade.

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Competing interests

M.W. has received grant funding from the Canadian Institutes of Health Research, Social Sciences and Humanities Research Council of Canada, Society for Research on Child Development, American Psychological Foundation and the Connaught Foundation. M.A.S. has received grant funding from the National Institute of Mental Health (NIMH), National Science Foundation (NSF) and the Robert Wood Johnson Foundation. S.S.D. has received grant support from the National Institute of Health (NIH), WT Kellogg Foundation, the Pincus Family Foundation and the Centre for Disease Control and Prevention. F.T. has received grant funding from ERA-NET NEURON. C.H.Z. has received grant support from the NIMH, the Palix Foundation, the Irving Harris Foundation, the Substance Abuse and Mental Health Services Administration, the Lumos Foundation and the Inter-American Development Bank. He has received royalties from Guilford Press and Harvard University Press. He has received consulting fees from the National Society for the Prevention of Cruelty to Children. He has received honoraria for lectures to professional audiences. N.A.F. has received grant support from the NIMH, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), N.S.F., the National Institutes of Health Environmental influences on Child Health Outcomes (NIH ECHO) consortium, the Russell Sage Foundation and the Lumos Foundation. He has received royalties from Guilford Press and Harvard University Press. He has received honoraria for lectures to professional audiences. C.A.N. has received grant support from the NIH, the Jacobs Foundation, the John D. and Catherine T. MacArthur Foundation, the James S. McDonnel Foundation, the Binder Family Foundation, the Lumos Foundation, the Bill and Melinda Gates Foundation and Harvard University. He has received royalties from the Massachusetts Institute of Technology and Harvard University Press. He has also received honoraria for lectures to professional audiences and legal consulting fees. K.A.M. has received grant funding from the NIMH, Jacobs Foundation, One Mind Institute and the Brain and Behavior Research Foundation.

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Nature Mental Health thanks Michael Kaess, Jana Marinka Kreppner and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Supplementary Table 1, Figs. 1 and 2, Methods and Results.

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Wade, M., Sheridan, M.A., Drury, S.S. et al. Blunted stress reactivity as a mechanism linking early psychosocial deprivation to psychopathology during adolescence. Nat. Mental Health (2024). https://doi.org/10.1038/s44220-024-00249-7

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