Clinical relevance: Early-life stress is linked to long-term mental, physical, and cognitive issues, including anxiety, depression, obesity, and cardiovascular diseases.

  • The economic burden of early-life stress reached $748 billion in 2019 and surged to roughly $14 trillion in 2023.
  • Stress has cumulative effects, and factors like genetics, social environments, and the nature of stressors influence outcomes.
  • Unpredictable environments can make things worse, highlighting the importance of stability in early development.

Early-life stress persists as a powerful risk factor for mental and cognitive disorders that can reverberate throughout our lives. Since stress early in life has exerted influence on a wide range of mental (and physical) health issues – ranging from anxiety and depression to obesity to even cardiovascular diseases. 

It’s not just the personal toll it takes on us. It has far-reaching economic implications, too. Number crunchers calculated that, in 2019 alone, the annual economic burden of early-life stress reached $748 billion. And it’s only accelerated since then. Researchers figure that number jumped to roughly $14 trillion in 2023.

And with more than half of U.S. adults reporting some form of early-life stress – whether it stems from abuse, neglect, or simple dysfunction at home – researchers are working overtime to get a better grasp of the complex mechanisms that link these adverse childhood experiences (ACEs) to longer-term health issues.

Despite the tomes of data we already have on this topic, too many questions remain (frustratingly) unanswered, such as: 

  • What specific experiences does the developing brain perceive as “stressful?”
  • How do these stresses affect brain maturation at each stage of development?
  • And which biological molecules convert these stressors into lifelong dysfunctions?

Those questions (among others) sparked a group of academics at the University of California-Irvine to conduct an exhaustive review of the research in this area.

“Our research suggests that the unpredictability of a child’s early environment may be just as important as more traditionally recognized forms of adversity, such as abuse or neglect,” lead author and Donald Bren Professor of Pediatrics Tallie Z. Baram, MD, said in a press release. “Our review has important implications for how we approach early intervention and prevention strategies.”

The Cumulative Impact of Adverse Childhood Experiences

One of the most compelling revelations to emerge from the established research is that the impact of early-life stress is cumulative. 

Felitti’s landmark study revealed that the more kinds of stress a child endures, the greater the chance that he (or she) develops mental and physical health problems later on. Researchers have also tied early-life stress to a phenomenon known as “allostatic load,” where the body’s physiological systems break down or get knocked off kilter because of chronic stress, degenerating into long-term health issues.

While the association between ACEs and poor outcomes is apparent at the population level, trying to predict individual responses to early-life stress remains problematic, at best.

More recent work has revealed that genetic factors and social environments play a crucial role in dictating whether a child will develop resilience (or vulnerability) to these stresses. And not all forms of early-life stress leave the same “wound.” Different stressors can influence different cognitive and emotional areas.

The Scale of Early-Life Stress

The concept of early-life stress isn’t a simple one. People experience stress differently. But researchers are still trying to figure out whether different types of stress drive certain cognitive or emotional deficits.

For example, children who face more intense risk levels early on might develop exaggerated anxiety or fear responses. While those exposed to deprivation might struggle with emotional regulation issues. Differentiators like this remain pivotal to a better understanding of how different types of early-life stress leave their marks on the developing brain.

Worse still, many children face multiple forms of stress simultaneously, making it difficult to isolate the effects of any single factor. The timing, intensity, and combination of stressors can all exert profound influence on brain development. To cite one example, extreme hunger or neglect might have a more significant impact than milder or less constant stressors.

The Role of Unpredictability

Recent studies have also introduced a new dimension of early-life stress: unpredictability. As opposed to more studied catalysts, such as abuse or neglect, unpredictable sensory signals from caregivers or the environment can also wreak havoc on a young mind. Researchers have tied this to increased risk of disorders such as depression and post-traumatic stress disorder (PTSD).

To make matters worse, some of the data suggests that unpredictable experiences can also compound the effects of other forms of early-life stress, which underscores (once again) just how critical stability is in the child’s environment.

Socioeconomic and Environmental Influences

Obviously all early-life stress is not created equal.

Low-income communities – along with racial or ethnic minorities – are consistently at higher risk for exposure to stressors. These groups endure greater challenges as a result of poverty, discrimination, or even environmental factors.

And things aren’t getting any better. Researchers have started to realize that emerging threats, such as air and water pollution and the effects of climate change, can shape early childhood development. These stressors might also contribute to long-term health disparities.

Rethinking Stress

As researchers continue to peel back the nuances of early-life stress, the authors of this review posit that the traditional definitions of stress might not be enough anymore.

Rather than viewing stress solely as a physiological response to external pressures, they suggest that it might be more accurate to consider early-life stress as circumstances that disrupt brain maturation, which could descend into lingering cognitive and emotional challenges.

“We’re gradually comprehending how early-life stress can ‘reprogram’ the brain at multiple levels, from individual molecules to entire neural circuits. This knowledge presents new avenues for targeted interventions,” Baram added.

Further Reading

How Anxiety and Apathy Steer Our Decisions

Depression Accelerates Health Issues in Older Adults

Task-Sharing, Telemedicine Expand Maternal Mental Health Access