Traumatic experiences during early childhood have been consistently associated with increased risk of developing stress-related neuropsychiatric disorders later in life including depression, anxiety, and substance abuse.
1,2 Brain-imaging studies have demonstrated morphologic changes in healthy adults exposed to early-life stress,
3 children exposed to abuse,
4 and children and adults with maltreatment-related posttraumatic stress disorders (PTSDs).
5,6 These findings suggest that regional brain abnormalities may be present before the onset of disease and, thus, are a risk factor for subsequent stress-related neuropsychiatric disorders. However, retrospective clinical studies can be difficult to interpret because of the variety of experiences that can be considered traumatic, differences in the timing and intensity of the stressors, and the unknown effects of medications. Moreover, the long-term effects of stress exposure may be delayed or expressed only when the vulnerable brain system reaches maturation.
7 It is, therefore, important to clearly define and control for the type and duration of the stressor and for the developmental stage during stress exposure and at the time of brain measurement to clarify whether the reported brain abnormalities were present before illness onset or reflect the consequences of disease progression.