Allostatic load in children: The cost of empathic concern

Proc Natl Acad Sci U S A. 2023 Sep 26;120(39):e2217769120. doi: 10.1073/pnas.2217769120. Epub 2023 Sep 19.


Early-life adversity affects long-term health outcomes but there is considerable interindividual variability in susceptibility to environmental influences. We proposed that positive psychological characteristics that reflect engagement with context, such as being concerned about people or performance on tasks (i.e., empathic concern), could moderate the interindividual variation in sensitivity to the quality of the early environment. We studied 526 children of various Asian nationalities in Singapore (46.6% female, 13.4% below the poverty line) with longitudinal data on perinatal and childhood experiences, maternal report on empathic concern of the child, and a comprehensive set of physiological measures reflecting pediatric allostatic load assessed at 6 y of age. The perinatal and childhood experiences included adversities and positive experiences. We found that cumulative adverse childhood experience was positively associated with allostatic load of children at 6 y of age at higher levels of empathic concern but not significantly associated at lower levels of empathic concern. This finding reveals evidence for the importance of empathic concern as a psychological characteristic that moderates the developmental impact of environmental influences, serving as a source for vulnerability to adversities in children.

Keywords: allostasis; caring; diathesis-stress; differential susceptibility; early-life stress.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adverse Childhood Experiences*
  • Allostasis*
  • Asian
  • Child
  • Empathy
  • Family
  • Female
  • Humans
  • Male
  • Pregnancy