Identifying pathways from early adversity to psychopathology: A review on dysregulated HPA axis functioning and impaired self-regulation in early childhood

This article reviews the evidence for theoretical models postulating that early adversity can set in motion a deleterious developmental cascade, involving changes in hypothalamic-pituitary-adrenal (HPA) axis activity that subsequently affect the development of self-regulation in early childhood. Focusing on the first five years of life, we describe studies showing that experiences of severe deprivation or maltreatment may both lead to a hypoactive HPA axis in children. However, it is too early yet to conclude what effects exposure to adverse conditions such as poverty or family instability have on young children’s HPA axis, with both low and high levels of cortisol having been observed under these circumstances. Both patterns of HPA axis dysregulation have been associated with impairments in executive functions, which are important for self-regulation. There is promising evidence that interventions targeting parenting behaviour have the potential to remediate adversity-related biological and behavioural alterations.