Psychological Stress in Children: Effects on the Immune Response

Stress is part of life — but while a little bit of it (good stress) may keep us active and alert, and sometimes even motivate us, the long-term type (bad stress) can have negative effects on our health.  Elevated blood pressure and heart disease are just some examples of the so-called “stress-related diseases”.  In addition to good stress and bad stress, there is another type of stress — toxic stress.

Professor Pat Levitt defines toxic stress as “a term used by psychologists and developmental neurobiologists to describe the kinds of experiences, particularly in childhood, that can affect brain architecture and brain chemistry. They typically are experiences that are bad for an individual during development such as severe abuse. Toxic stress has been defined also in terms of violence, other sorts of experience that a child can have that can be very powerful in a negative way on the brain.”

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Image credit: deviantART, licensed under CC BY-ND 3.0.

However, what makes stress toxic or not is — as for other types of stress — the way we respond to it.  Indeed, there are three kinds of responses to stress: positive, tolerable, and toxic. These terms refer to the stress response and its effects on the body, not to the stressful event or experience itself. Then, a toxic stress response can occur “when a child experiences strong, frequent, and/or prolonged adversity—such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship—without adequate adult support. This kind of prolonged activation of the stress response systems can disrupt the development of brain architecture and other organ systems, and increase the risk for stress-related disease and cognitive impairment, well into the adult years.”

Now, results from a study published in the Journal of Immunology (March 1, 2014), “Psychological Stress in Children May Alter the Immune Response“, show that psychological stress in children may contribute to an imbalance in the immune response, and not only — it can also contribute to a pathological effect on the cells that produce insulin, thus potentially leading to the development of type-1 diabetes.

The researchers examined the association between high psychological stress in the family and the immune response of 5-year old children. The study was carried out using immune cells obtained from the blood of 26 high-stressed children and 52 children without high stress within the family.  High psychological stress was defined as being exposed to stressors in three or four domains — serious life events, parenting stress, lack of social support, and parental worries.

Children in high-stress families showed signs of immunosuppression, had high levels of cortisol (a biological marker of stress), and had low levels of C-peptide — low levels of this peptide indicate poor functioning of the cells that produce insulin. In addition, these children had immune markers related to autoimmune responses, which indicate the immune system may be causing damage to healthy tissues.

Analysis of the background variable “single parent” showed that high-stressed children are likely to live with a single parent, compared with children in the control groups. On the basis of this result, the researchers speculate that children living with a single parent are more exposed to psychological stress — or less protected from it — than children living with more than one caregiver.

Perhaps, the effects on the immune system should be added to those already considered to be part of the toxic stress response.

15 Responses

  1. Helena Kibreab
    Helena Kibreab at | | Reply

    Continuous stress can be very harmful to the mind and body, but never did I think that children can have such longtime effects. They can be passed down to the next generation and so on. Children are sensitive, and for them to be constantly subjected to stressful events at home will lead to severe repercussion. One of the repercussions is lack of development, what else does toxic shock subject the innocent child to?
    As if that the child is continuously exposed to a stressful environment is not bad enough, their genome can be altered .This may occur due to higher levels of cortisol in the body, which can lead to diseases such as cancer. Children inherit approximately 23.000 genes from their parents, and those genes may have positive or negative chemical markings on them. These markings represent whether the child has had a joyful or a stressful past, and they regulate gene expression. The chemical markings can either switch a gene on or off, which will expose the child to many health problems.

    References

    http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=7&ved=0CE8QFjAG&url=http%3A%2F%2Fdevelopingchild.harvard.edu%2Findex.php%2Fdownload_file%2F-%2Fview%2F666%2F&ei=m_99U9CYCZDQsQSp-IGQBw&usg=AFQjCNHrLwDT02y1RaNB_MhlZf4j_OPTjg

  2. Michael Tucker
    Michael Tucker at | | Reply

    After reading the abstract for the study “Psychological Stress in Children May Alter the Immune Response” I believe there is a key component that should also be included. When looking at the children’s immune systems with relation to stress, the group that was under stress should have also had their diet compared to the control group. It was stated that the highest stress levels were likely children with a single parent. Children living with a single parent have also been shown to have a poor diet resulting in childhood obesity (Huffman, Kanikireddy & Patel, 2010). This could also be a factor not only effecting the immune system but also leading to the diseases discussed such as heart disease or diabetes. I would like to see a study done in the future that looks at the effects of both diet and stress on the immune system of children.

    Huffman, F., Kanikireddy, S., & Patel, M. (2010). Parenthood—a contributing factor to childhood obesity. International Journal of Environmental Research and Public Health, 7, 2800–2810. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922726/

  3. James Padgett
    James Padgett at | | Reply

    Chronic stress undoubtedly has a profound effect on the immune system. Even a short experience with chronic stress, such as studying for finals, can cause sickness and other health issues. The effects on the immune systems of those who have stressors which last months or even years would be even more severe. In an article I found called “Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry”, it talks about a conducted study on the effects on the immune system of stress. The results showed that those who were introduced to low level stressors such as studying for exams, had their cellular immunity lowered but their humoral immunity remained in tact. However, those who were exposed to chronic toxic stress showed to have both their cellular and humoral immunity lowered. There is definite evidence that shows that the immune system suppression could be considered an effect of chronic activation of the stress response system. It would be interesting to know how long the period is from the time the chronic stressor is removed until the adaptive immunity begins functioning at full capacity, if ever?

    Here is the link to the article referenced in my post:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/

  4. Melanie Washington
    Melanie Washington at | | Reply

    It is very interesting how children exposed to high stressful environment can cause toxic stress. I did not know that stress could have this great of impact on the body especially the immune system. So is there a way to treat or reverse the symptoms of toxic stress? I came across an article (Behavioral immunization:Immunity to Self-Antigens Contributes to Psychological Stress Resilience) about how a concept termed “behavioral immunization” can use immunological memory to enhance psychological stress resilience. One experiment described in this article , they exposed mice to a predator odor to promote stress and immunized the mice with their self antigens and added an adjuvant to the vaccine. The results were the group of mice that had the vaccine showed lower levels of anxiety and were less likely to be startled to the sound to the of the predator than the control group that only had adjuvant. They also were able to recover psychology faster than the control group. This is very similar to how vaccines work in the immune system when dealing with bacterial and viral pathogens. To answer the question about possible reversal or treatment to toxic stress, it is possible by being vaccinated with your own antigens to induce not only psychological memory but also immunological memory. The immune system will no longer be suppressed and psychology you are able to recover using your own antigens. This could also be used to help soldiers with PTSD and patients who suffer from other psychology diseases.

  5. Kathleen Crosby
    Kathleen Crosby at | | Reply

    I already had knew that long-term stress responses would harm the immune system, but never realized that certain types of stress had different effects. With toxic stress, there is the potential of halting the development of brain architecture in children. With this inhibition, there can be many long-lasting effects, such as behavioral problems or even mental health issues (http://www.albertafamilywellness.org/brain-development-addiction/positive-tolerable-toxic-stress). The immune system is very fragile and with stress, there can be longer wound healing time, premature aging, and a higher chance of developing cancer (http://consumer.healthday.com/encyclopedia/stress-management-37/stress-health-news-640/the-immune-system-and-stress-645924.html). Toxic stress is the most harmful of the three types and if children are to be exposed to it, someone should come up with a better way for the children to cope, whether it be medication or a relaxation technique like meditation.

    1. Eunhye Huh
      Eunhye Huh at | | Reply

      I agree that toxic stress is the most harmful of the three types of stress when children are exposed to it. When I was young, I did not know how to handle my stress, and as a result, I had a shingles before since my immune system did not work properly. Doctor who I met to cope with it was surprised about the fact that I was too young to get the shingle, so I know that getting stress is the first thing that children should avoid. I know that there are many researches are going on to treat or reverse the symptoms of stress for children. In my point of view, it will be awesome if we do not get any stress but that is not possible. So, people should be aware of that, and develop a way or method how to deal with the stress like using therapeutic medication for children.

      1. Claudia Cross
        Claudia Cross at | | Reply

        Toxic stress not only causes effects on the immune system, it causes effects on the neurological state depending on the trigger. For example, while working with social services (DFACTS) neglect above sexual abuse of children has been shown to trigger neurological effects on children due to toxic stress. Children that were neglected suffered from more anxiety and social problems than those that were sexually abused. As insidious as both forms of stress are more psychotherapy should be focused these children as well to reduce the stress as it is unpredictable.

  6. Shantasia
    Shantasia at | | Reply

    Stress has an effect on the immune system of adults so I am not surprised that it has the same effect on children. I am surprised that psychological stress could play a role in the onset of type 1 diabetes. I found a study that showed that the incidence of type 1 diabetes in Israel children increased after the second Lebanon War. Living in an area that has gone through a war is a toxic stress for children, and the body responds to stress by releasing cortisol. Does a high level of cortisol trigger the T cells to attack the insulin producing beta cells?
    After doing some research, I found that cortisol responds to stress by preventing insulin from being taken up by cells. A consistently high level of cortisol causes high blood sugar levels and leads to the cells being resistant to insulin. Teaching children how to positively deal with stress can lower the cortisol levels and possibly stop the negative effects on the immune system.

    Sources:
    Increase in the incidence of type 1 diabetes in Israeli children following the Second Lebanon War
    http://www.apa.org/research/action/immune.aspx
    http://dujs.dartmouth.edu/fall-2010/the-physiology-of-stress-cortisol-and-the-hypothalamic-pituitary-adrenal-axis#.U34ou_ldWSo

    1. Elaheh
      Elaheh at | | Reply

      This is an important point brought up. In article on toxic stress by Harvard (http://developingchild.harvard.edu/index.php/key_concepts/toxic_stress_response/), it is stated that “threatening” of the body causes the release of cortisol. So if a child is experiencing toxic stress on a regular basis, such as in a war or a household with familial problems, there will be that release of cortisol due to the toxic stress. This type of stress occurring for long periods of time can be harmful to the brain and/or cause the immune system to weaken, causing illness.

  7. Kimberly Beeson
    Kimberly Beeson at | | Reply

    This is such a difficult concept to break open. Unfortunately, for many children there is no easy solution that would allow removal of the “toxic” situation. One also has to wonder if children are experiencing an abnormal amount of toxic stress then most likely there are other basic needs not being met.
    While this blog is not asking for problem solving techniques, addressing the question of “What can we do to improve immunity in at-risk children?” would be a decent starting point. Early identification of possible triggering situations with enhanced parental education about the importance of lowering childhood stress for not only increased immunity but overall well-being is needed. Physician education and community awareness are cheap alternatives to an already over-burdened health system.

    1. Shantasia
      Shantasia at | | Reply

      I agree that community education programs would be a great resource for children that have toxic stress. Unfortunately some parents do not have the time or money to help their children deal with stressful issues. Another solution to the issue could be to have school based programs that could teach students how to deal with stress. The program could be something fun that will allow students to feel safe enough to open up about their problems.

  8. cnesbitt1
    cnesbitt1 at | | Reply

    I have always heard about the lifestyles of adults being influenced by traumatic childhood experiences, but this concept of childhood toxic stress effecting brain development and potentially suppressing the immune system is quite interesting. With one of the factors of toxic stress in children being on their ability to produce insulin and 15,600 of youth being diagnosed with Type 1 Diabetes each year, I think it would be a good idea to start paying close attention to the amount of stress in children earlier rather than later. Are there possible behavioral signs displayed by children who are under toxic stress that parents should be aware of and if noticed what could treatment involve?

    I found that parents could notice both psychological and physical observations and the child should definitely be evaluated by a professional. The American Academy of Pediatrics (AAP) is well on its way to identifying how physicians can be aware of children who may be suffering from toxic stress, which evolve a 3 step program and an informational campaign for the parents. AAP suggests therapy as an option for those children under toxic stress, but I also found that Vitamin D is essentially for insulin production in beta-cells, so maybe we can provide these children with supplements that are high in Vitamin D and possibly decrease their chances of developing Type 1 Diabetes. Overall it is going to take a community effort to help these children.

    Sources
    http://developingchild.harvard.edu/resources/stories_from_the_field/tackling_toxic_stress/pediatricians_take_on_toxic_stress/
    http://professional.diabetes.org/admin/UserFiles/0%20-%20Sean/FastFacts%20March%202013.pdf
    https://www.vitamindcouncil.org/health-conditions/type-i-diabetes/#

  9. Jin Oh Yun
    Jin Oh Yun at | | Reply

    I always thought that stress can be harmful to our health. However, I did not recognize that toxic stress increase cortisol levels and decrease C-peptide levels before reading the blog posting. There are many negative health effects that can be induced by toxic stress. Is there any method to protect children from Toxic?
    The article from New York Times (http://opinionator.blogs.nytimes.com/2013/10/30/protecting-children-from-toxic-stress/?_php=true&_type=blogs&_r=0) suggests that the ability of parents to understand child`s cues and the reflective capacity that respond with awareness to their children`s behavior. Techniques such as; the parent’s ability to identify stress-like behaviors in children, using intervention programs to relieve stress on families in poverty, and making sure children have basic necessities are things that can help reduce the harmful physiological effects of high stress.. Although some people says that effects of stress can prevent and mitigate to using medical solution, understanding the meaning of children`s behavior can be other way to do it.

  10. DeAshley
    DeAshley at | | Reply

    I find it interesting that stress can cause immunosuppression. I grow in a single parent household and I never experienced high levels in stress which would increase my immune response. So my concern is, was this study only done in one particular location and was it then determined that children from single parent backgrounds are observe to have weaker immune systems? According to the study, children who are exposed to different types of stress at an early age are prone to weaker immune responses. In order to effectively reduce stress-related diseases that are attained in adulthood, the exposure to stress at early ages must be reduced. One way to reduce stress levels is for parents to provide a healthier home environment and to decrease the stress that children observe from their parents’ behaviors. Another way is by mediation exercises according to the Huffington Post to decrease brain level functions.

    I feel stress affects everyone in a slightly unique way, and different types of people including children face certain types of stressors. Everyone has different peptides that bind differently to receptors in the immune system. With that being said, I feel that we cannot just specifically say that most stress comes from single parent homes, when only one study has been done to determine this.

  11. Claudia Cross
    Claudia Cross at | | Reply

    Environmental factors can and will play crucial roles the onset and severity of the immune response in adults and children. In fact, ones diet, exercise, and stress is detrimental to the health of people. Toxic stress was noted as the accelerator of type 1 diabetes in children. Another example of how toxic stress can cause adverse effects on immunity is an article I came across: http://www.ncbi.nlm.nih.gov/m/pubmed/19691916/?i=16&from=irritabe bowel syndrome and child abuse; which correlated posttraumatic stress disorder from child abuse to irritable bowel syndrome, (IBS). Although, not a disease, IBS is indicative among children that have been sexually abused.

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