Lessons from coping with stress (1): Stress and the brain

Venue: Worldwide

Action Time: Spring 2020

Main characters: all parents and children of the world

 

Fran is a healthy and wonderful newborn baby. He was born at Peter’s Hospital in Zagreb, and a few hours after giving birth he had to go on cold because of the collapse of the maternity ward. While his parents are now amazed at the warmth of their home, they wonder, “What will Fran be like when he grows up? Will he be successful in school? Will he get along with his peers and be happy? ”

Lucia is a girl at the age of 8. She can’t go to school because of the COVID-19 virus pandemic and the Zagreb earthquake. She is at home with one parent, while the other parent has to work. Shee follows the school on television and on a tablet. She has not played with her friends for weeks, posting messages on social networks and making a video call. Lucia’s mom wonders, “What will Lucia be like when she grows up? Will she be successful in school? Will Lucia meet her peers and be happy? ”Lucia’s dad now has no time to think about the future, she is happy that everyone is healthy and safe when he gets home from work.

These are just some of the children currently in Zagreb, Croatia and around the world.

The answers to their parents’ questions depend on how the brain of these children will develop depending on the physical, emotional and social support of their parents, the wider family and the community during childhood.

 

Genes and (or) environment

 

Recent brain research provides a wealth of data on brain development, the most immature of all organs at birth, after birth. Previously, genetic factors were thought to determine brain development, but today it is known that brain development is determined to a significant extent by the experiences a child experiences during childhood. Research shows that like proteins, fats and vitamins, interactions with other people are vital for brain development.

Different experiences may have different effects on brain development. This is because of the plasticity of the brain – the ability of the brain to evolve depending on the experience and demands of the environment.

As Fran and Lucia grow, so their ability to develop speech, problem-solving, and relationships with other people will depend on the experiences they have as they grow up. This is not to say that genetic factors do not influence the development of a child, certainly they do. But more and more data from various studies shows that experiences influence the expression of a gene in the developing brain. Thus, positive experiences affect the proper development of the brain, and negative experiences can cause a genetically healthy child not to reach its potential, but to develop intellectual and emotional difficulties.

 

How the brain develops

To understand how experiences affect brain development, we need to understand how the brain works. The brain is made up of different regions that are responsible for certain functions, such as identifying what we see, processing spoken language, or threat assessment. Within each of these brain regions are millions of neurons or nerve cells that send messages to each other via synapses. These trillions of nerves, synapses and neural pathways allow communication of different brain areas and function together in a coordinated way. The number and organization of neural connections in the brain determine everything from the ability to recognize the letters of the alphabet to participating in complex social relationships.

Brain development consists of making connections between neurons and changing them. Constant new synapses are created between cells while others cease to function or are removed. It happens throughout life. Early in childhood, the brain is genetically programmed to produce more synapses than it will actually use. At 8 months old, a baby can have a whopping 1000 trillion synapses in his brain! This synapse formation occurs at different times in different parts of the brain.

Development continues by maintaining the synapses used and removing those synapses that are not used. So we can think of the brain as a set of large boxes and many more paths connecting them. When no path is used, it heals and is no longer passable. It is possible to build new paths, which requires extra effort and clearing the ground. Once the path is passable, it is necessary to walk as often as possible to stay firm.

Removing or “trimming” the synapse allows the brain to retain the purposeful links and remove the unused ones. In short, removing synapses increases the efficiency of the brain to do what it needs to do. However, the brain operates on a “use or remove” policy, so that “excessive removal” of neural connections can occur when the child does not receive the normally expected experiences or stimulation in early development. Some areas of the brain, such as those responsible for vision, become less plastic or variable when the removal of synapses in that area of the brain is complete. Therefore, it is necessary for the brain to receive stimulation or stimulation in order to properly form neural connections before closing the “window of opportunity”. So, for example, ophthalmologists are now removing congenital cataracts as early as possible in infancy because it is known that if one waits for a child to grow older, neural connections between the eyes and the brain will not develop properly and the child will never be able to see.

 

How relationships shape the brain

The brain shapes and changes throughout life depending on what we use it for. Language learning is a good example of how experiences contribute to each person’s unique brain development pattern. The ability to speak and understand someone else’s speech requires only the minimal level of communication experienced by almost all children. However, which language a child learns to speak depends on the language he is listening to and his brain will adapt to this particular language. A baby’s brain at the age of 3 months can distinguish several hundred different spoken sounds, much more than is present in his mother tongue. Over the next few months, the baby’s brain will organize itself more effectively so that it recognizes only those spoken sounds that are part of the language the baby regularly listens to. During early childhood, the brain retains the ability to re-learn the sounds it has “discarded”, so young children are usually able to easily and easily learn new languages. After about 10 years, the plasticity of this function is greatly reduced; therefore, it is difficult for most people to learn to speak a foreign language (especially significantly different from their mother tongue) as native speakers if they begin to learn it only in adolescence or adulthood.

More importantly, early experiences can determine how well a child has developed their native language. Children of mothers who talk to them often learn almost 300 words more at the age of two than their peers whose mothers rarely speak to them. Furthermore, research shows that just exposure to a language such as listening to a language from a television or talking to an adult has little effect on a child’s brain development. In order to develop optimal language skills, children need to communicate directly with others, so that parents’ attitude that it is not important to talk to young children is too small to understand what is being said is not correct.

It has long been known that children from families of lower socioeconomic status often do not reach the same intellectual levels as children from families of high socioeconomic status. Recent brain research provides insights into the reasons for these facts. Parents who are daily engaged in the struggle to meet their children’s basic needs such as food and safety do not have the resources, information or time they need to provide children with stimulating experiences that stimulate optimal brain development. Infants and infants who rarely talk directly, who have few toys and opportunities to explore and experiment in their environment, will not be able to fully develop neural connections and pathways that facilitate later learning. The foregoing is therefore not related or to a much lesser extent linked to socioeconomic status per se, as is sometimes mistakenly assumed.

One of the most important tasks of a child is to satisfy their needs in the world in which they live. Due to his or her immaturity, a child cannot accomplish this alone, which is why he or she needs adults. The child constantly evaluates whether his or her need for food and comfort is satisfied or ignored, whether it can affect the adults around him or is completely helpless.

If adults consistently respond to the child’s calls and provide what they need, the child will increasingly use these adults as sources of protection and security. When provided with protection, the child will focus on research, thus allowing his brain to experience all the attractions of this world.

If the child’s needs are met only occasionally and his pleas for solace are ignored or “met” with harsh words and actions, the child will focus on ensuring that his needs are met. His brain will not get the stimulation he needs to develop healthy cognitive and social skills, and the child will have difficulty interacting with people and completing tasks.

Children who receive caring and supportive care from their parents and other adults in the early years of life have a good basis for success in life. The secure relationships they develop with significant adults are an important basis for emotional development. Studies of people who have succeeded despite the many challenges in their lives show that these people have had at least one stable, supportive relationship with an adult (usually a parent, relative or teacher) who started early in life.

 

What is stress

Stress is an inevitable part of life. Human beings experience stress early, even before birth. Dealing with new and unfamiliar situations and people with children can be demanding and can be a source of stress. Life sometimes brings unexpected situations to children as well as adults that do not represent a daily experience. Not many children today are experiencing extremely negative experiences that are a lasting characteristic of their childhood.

Various situations and events (stressors) that pose a threat and danger to the safety and / or life of the child cause a stress response in the body that allows for adaptation to the resulting conditions. It is important to emphasize that stress is a highly subjective experience, that is, it depends on the individual’s assessment of whether an external event will become a stressor. Let’s imagine a plane. A person who loves travel and is not afraid of airplanes, this scene can cause excitement and joy. The pilot can be associated with a routine, a workplace. To a person who is afraid of flying an airplane, the thought of an airplane can be a stressor. Any change can also be stressful, even when it is positive and when we have chosen it ourselves. Moving to another city, moving to a better job, for example, is still stressful to most people. That is why it is very important not to judge what is “normal” to cause stress and what is not, especially in children and young people. For many situations, children are judged important, dangerous, and lacking adequate coping strategies, even though they need to share a favorite toy or the fact that mom has given birth to a new baby. When it seems that “objective” something should cause more stress, for example, a car breaks down in an adult, it is possible that its subjective experience may be less intense than that of a child sharing a toy, because he / she estimates the situation is important, not so dangerous and that he / she has the necessary coping strategies.

In trauma, the situation is slightly different. Traumatic experiences are those experiences that pose a threat to life, health and integrity (or threat to happen) and cause in all persons some form of psychological trauma and traumatic reactions, regardless of subjective assessment and earlier level of functioning. It can only be subjective what kind of cancers will occur and how intense they will be, but traumatic stress will occur in any case.

 

Based on differences in the intensity and duration of the stress response, three types of stress can be distinguished in children:

Positive stress refers to the reaction of an organism that is short-lived and mild to moderate. The triggers for this type of stress can be going to kindergarten or school, vaccinating or meeting new people. This type of stress leads to milder changes in the body that may include rapid heartbeat or minor changes in hormone levels. The key is the presence of a caring adult who helps the child cope with the stressor, thus providing a protective effect that stimulates the return of the stress response to the initial level. In the context of a stable and supportive relationship with an adult, positive stress is part of normal development and an important opportunity to learn and apply healthy and adaptive responses to unpleasant experiences. This level of stress may also be associated with better achievement in some tasks, such as the often mentioned “positive anxiety” a child may have before an important game or public appearance.

 

Tolerable stress refers to the response that occurs when exposed to experiences that are not common and present a greater level of danger or threat. Stressors can include the death or serious injury or illness of a family member, a frightening accident, a conflicting separation or divorce of a parent, a natural disaster, war or terrorism. Supporting close adults in these situations significantly reduces the risk of long-term adverse health effects from over-activation of the stress response system. The basic characteristic that makes this form of stress response bearable is supporting a relationship with an adult that promotes the child’s adjustment and sense of control, thus reducing the physiological response to stress. In some circumstances, tolerable stress can even have positive effects, but in the absence of supportive relationships, it can become toxic to a child’s development.

Toxic stress is the intense, frequent or prolonged activation of an organism’s response to stress without adult support. Stressors that trigger this type of reaction to stress are childhood neglect and abuse, severe poverty, domestic violence, substance abuse and mental disorders of parents. This type of childhood stress can disrupt brain development and impair the functioning of the nervous, endocrinological, immune and other organ systems and lead to various physical and mental disorders and diseases.

The positive aspects of stress are diminished when stress overcomes the child’s ability to cope effectively. Intense and long-term stress in childhood with the lack of a supportive relationship with an adult can lead to a variety of short- and long-term adverse health effects.

 

Brain level stress

Chronic childhood stress can cause brain volume to become smaller, especially the hippocampus and prefrontal cortex, areas in the brain that are responsible for learning, memory, regulation of feelings and behavior. Exposure to an ongoing threat or threat in chronic stress increases the activity of the amygdala, a nucleus in the brain that triggers a stress response in the body and leads to an increase in stress hormones such as adrenaline and cortisol.

Children exposed to chronic stress and trauma are at greater risk for developing post-traumatic stress disorder (PTSD), depression, self-harm, eating disorders, attention disorders, drug and alcohol problems, risky sexual behaviors and delinquency. These effects are partly caused by the effects of chaotic, stressful and traumatic experiences on brain development. Children with PTSD and depression have increased levels of stress hormones, adrenaline and cortisol, even when not exposed to stress and traumatic experiences. This means that their stress response system in the body is constantly activated, when not needed.

 

Healthy coping with stress is learning

We come into the world completely incapable of living independently. But we are focused on others. We need others to meet our physical needs and development. We need others for protection and security in this world. And then when everything’s fine. And especially when things go wrong.

Learning to cope with stress is an important part of a child’s healthy development. The support of parents and / or other significant loved ones is necessary for children to learn strategies for healthy coping with stress. Thus, children acquire the skills they need to adapt to new and potentially life-threatening situations.

We will be writing about how to be an effective support to the child and the development of his brain in the second part of the topic entitled Lessons from coping with stress (1)

Written by: Vlatka Boričević Maršanić, PhD – MD, Specialist Psychiatrist, Subspecialist of Child and Adolescent Psychiatry , Mia Roje Đapić, MSc. of psychology and professor Gordana Buljan Flander, PhD, Clinical psychologist – psychotherapist

 

Literature:

Alisic E, Zalta AK, van Wesel F, et al. Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis. Br J Psychiatry 2014; 204:335.

Bucci M, Marques SS, Oh D, Harris NB. Toxic stress in children and adolescents. Adv Pediatr. 2016;63(1):403-428.

Campbell JA, Walker RJ, Egede LE. Associations between adverse childhood experiences, high-risk behaviors, and morbidity in adulthood. Am J Prev Med 2016; 50: 344–52.

Cronholm PF, Forke CM, Wade R, et al. Adverse childhood experiences: Expanding the concept of adversity. Am J Prev Med 2015;49:354–61.

Daelmans B, Darmstadt GL, Lombardi J, et al. Early childhood development: the foundation of sustainable development. Lancet 2017; 389: 9–11.

Flaherty EG, Thompson R, Dubowitz H, et al. Adverse childhood experiences and child health in early adolescence. JAMA Pediatr 2013;167:622–9.

Flaherty EG, Thompson R, Litrownik AJ, et al. Adverse childhood exposures and reported child health at age 12. Acad Pediatr 2009;9:150–6.

Felitti VJ. Adverse childhood experiences and adult health. Acad Pediatr. 2009;9(3): 131–132

Garner AS, Shonkoff JP; Committee on Psychosocial Aspects of Child and Family Health; Committee on Early Childhood, Adoption, and Dependent Care; Section on Developmental and Behavioral Pediatrics. Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics. 2012;129(1).

Gunnar MR, Quevedo K. The neurobiology of stress and development. Annu Rev Psychol. 2007;58:145–173

Harvard University Center on the Developing Child. Brain architecture. 2018. https://developingchild.harvard. edu/science/key-concepts/brain-architecture.

Hughes K, Bellis MA, Hardcastle KA, et al. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health 2017;2:e356–66.

Luby JL, Barch D, Whalen D, Tillman R, Belden A. Association Between Early Life Adversity and Risk for Poor Emotional and Physical Health in Adolescence: A Putative Mechanistic Neurodevelopmental Pathway. JAMA Pediatr. 2017 Dec 1;171(12):1168-1175.

Luecken, L. J., Hagan, M. J., Wolchik, S. A., Sandler, I. N., and Tein, J. Y. (2016). A longitudinal study of the effects of child-reported maternal warmth on cortisol stress response 15 years after parental divorce. Psychosom. Med. 78, 163–170.

McEwen BSNasca CGray JD. Stress Effects on Neuronal Structure: Hippocampus, Amygdala, and Prefrontal Cortex. Neuropsychopharmacology. 2016 Jan;41(1):3-23.

McLaughlin, K.A.,Sheridan,M.A.,Gold,A.L.,Duys,A.,Lambert,H.K.,Peverill,M.,etal., 2016. Maltreatment exposure, brain structure, and fear conditioning in children and adolescents. Neuropsychopharmacology 41(8),1956–1964.

Metzler M, Merrick MT, Klevens J, Ports KA. Adverse childhood experiences and life opportunities: shifting the narrative. Child Youth Serv Rev 2017; 72: 141–49.

Muhammad, A., Carroll, C., Kolb, B., 2012. Stress during development alters dendritic morphology in the nucleus accumbens and prefrontal cortex. Neuroscience 216, 103–109.

National Scientific Council on the Developing Child. (2010). Early Experiences Can Alter Gene Expression and Affect Long-Term Development: Working Paper 10. http:// www.developingchild.harvard.edu

Nemeroff CB. Paradise Lost: The Neurobiological and Clinical Consequences of Child Abuse and Neglect. Neuron. 2016 Mar 2;89(5):892-909. doi: 10.1016/j.neuron.2016.01.019.

Park AT, Leonard JA, Saxler PK, Cyr AB, Gabrieli JDE, Mackey AP. Amygdala-medial prefrontal cortex connectivity relates to stress and mental health in early childhood. Soc Cogn Affect Neurosci. 2018 Apr 1;13(4):430-439.

Teicher MH, Andersen SL, Polcari A, Anderson CM, Navalta CP. Developmental neurobiology of childhood stress and trauma. . 2002;25(2):397-426. Psychiatric Clinics of North America

Thornberry TP, Ireland TO, Smith CA. The importance of timing: The varying impact of childhood and adolescent maltreatment on multiple problem outcomes. Dev Psychopathol 2001;13:957–79.

 

Disclaimer: This is unofficial translation provided for information purposes. Zagreb Child and Youth Protection Center cannot be held legally responsible for any translation inaccuracy. 

Print Friendly, PDF & Email