A developmentally informed perspective on the relation between stress and psychopathology: when the problem with stress is that there is not enough

Abstract

A common tenet of several prominent theories of stress and psychopathology (e.g., stress exposure) is that experiencing high rates of life stressors is associated with greater risk for negative mental health outcomes. Although there has been substantial empirical support for this position, another possibility that has received considerably less attention to date is that early life stressors may share a curvilinear rather than monotonic relation with psychological well-being. In what has been termed the "steeling effect," "stress inoculation," and "antifragility," exposure to moderate stressors early in life may confer resilience to potential detrimental effects of later stressors. An interesting implication of this model is that low levels of early life stressors, relative to normatively moderate rates, may be associated with greater sensitivity to future stressors. The present article reviews preliminary evidence consistent with this possibility, drawing on behavioral and neurobiological studies in animal models, and the more modest literature on neurocognitive, psychological, and psychophysiological functioning in humans. Limitations of the clinical literature and possible directions for future research are discussed, including naturalistic longitudinal studies with clinical outcomes, and for research examining moderators and mechanisms, across multiple levels of analysis (e.g., cognitive, immunological, and neurobiological).

Figure 1

A model of potential mediational and moderational processes underlying the steeling effect. Note: For context, the pathway through which severe early life stressors confer heightened risk for negative mental health outcomes is included in gray font. + indicates a positive relation; − indicates a negative relation.

Figure 2

Risk for psychopathology as a function of the interaction between early and recent life stressors.