The Neurobiology of Intervention and Prevention in Early Adversity

Annu Rev Clin Psychol. 2016:12:331-57. doi: 10.1146/annurev-clinpsy-032814-112855. Epub 2015 Dec 7.

Abstract

Early adverse experiences are well understood to affect development and well-being, placing individuals at risk for negative physical and mental health outcomes. A growing literature documents the effects of adversity on developing neurobiological systems. Fewer studies have examined stress neurobiology to understand how to mitigate the effects of early adversity. This review summarizes the research on three neurobiological systems relevant to interventions for populations experiencing high levels of early adversity: the hypothalamic-adrenal-pituitary axis, the prefrontal cortex regions involved in executive functioning, and the system involved in threat detection and response, particularly the amygdala. Also discussed is the emerging field of epigenetics and related interventions to mitigate early adversity. Further emphasized is the need for intervention research to integrate knowledge about the neurobiological effects of prenatal stressors (e.g., drug use, alcohol exposure) and early adversity. The review concludes with a discussion of the implications of this research topic for clinical psychology practice and public policy.

Keywords: HPA axis; adversity; amygdala; epigenetics; intervention; prefrontal cortex.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Amygdala / physiopathology*
  • Animals
  • Child
  • Child Development / physiology*
  • Epigenesis, Genetic / physiology*
  • Humans
  • Hypothalamo-Hypophyseal System / metabolism
  • Hypothalamo-Hypophyseal System / physiopathology*
  • Pituitary-Adrenal System / metabolism
  • Pituitary-Adrenal System / physiopathology*
  • Prefrontal Cortex / physiopathology*
  • Stress, Psychological / metabolism
  • Stress, Psychological / physiopathology*