In ‘Stress in children: how do we keep it healthy?; Stress viewed from the perspective of Youth Health Care’, the authors Dr Frans Pijpers (NCJ), Dr Yvonne Vanneste (NCJ) and Prof. Dr Frans Feron (Maastricht University) first discuss Early Life Stress. What is it, what are the four stressors (acute, chronic, concrete and abstract), and what are the three types of stress (positive, tolerable and chronic)?

The second chapter discusses the structure and functioning of the stress network. The authors identify five stress networks: reptilian, mammalian, human, emotion and reward, and compassion stress networks. They also identify the seven stress hormones and neurotransmitters: adrenaline, cortisol, CRF (Corticotropin-Releasing Factor), ACTH (Adrenocorticotropic Hormone), vasopressin, serotonin, dopamine and oxytocin. They then explain that the stress network functions in an integrated, interactive and non-linear way. The five stress networks in the brain function as components of a single functional system, despite their anatomical and physiological diversity. This chapter also addresses individual stress patterns and the window of tolerance.

The third chapter discusses the impact on health and development. It maps out the effects on the five stress networks, among other things. Attention is also paid to the influence on brain development and the consequences later in life. Finally, this chapter discusses the other consequences of Early Life Stress: molecular ageing, epigenetic changes and genetic variants, and changes in the immune system.

The fourth chapter discusses points of focus for prevention and care. An important aspect is to bring the stress network into balance and keep it balanced. The stress network functions optimally within a certain bandwidth, the window of tolerance. The stress system is then in balance and there is positive stress. When these limits are exceeded, the allostatic load is too high. The allostatic load arises through an intensive interaction between the stressor, the individual stress pattern and the social environment. Factors that play a role include:

  • severity, nature (concrete or imagined), duration, timing, accumulation and chronicity of the stressors;
  • the individual stress pattern: functioning of the stress network;
  • the support and care provided by the social environment, in the first year primarily by parents and possibly grandparents, and later by family, childcare providers, neighbours, teachers and peers.

According to the authors, an integrated approach to Early Life Stress requires identifying the various factors: allostatic load, stressors, individual stress pattern, resilience, self-regulation, coping style, social environment, and sensitivity and attachment. The authors identify four positive developments in prevention and care:

  • personalised medicine
  • aligning with parents and children in youth health care
  • positive health
  • the JGZ Prevention Agenda and Early Life Stress

The publication can be downloaded here.