Child abuse and autonomic nervous system hyporesponsivity among psychiatrically impaired children

• Published in: Child abuse & neglect Vol. 34; no. 7; pp. 507 - 515
• Main Authors: Ford, Julian D, Fraleigh, Lisa A, Albert, David B, Connor, Daniel F
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.07.2010; Elsevier; Elsevier Science Ltd
• Subjects: Adolescent; Adolescents; At Risk Persons; At risk youth; Autonomic nervous system; Autonomic Nervous System - physiology; Behavior Disorders; Biological and medical sciences; Child; Child Abuse; Child abuse & neglect; Child Abuse - psychology; Child Abuse, Sexual - psychology; Child protection; Child psychology; Child Sexual Abuse; Child Welfare; Children; Clinical Diagnosis; Diagnosis, Differential; Emotional abuse; Emotional Disturbances; Female; Heart rate; Humans; Incidence; Intelligence; Logistic Models; Male; Medical sciences; Mental Disorders - psychology; Metabolism; Nervous system; Neurology; Patients; Pediatrics; Physically Handicapped; Physiology; Prevalence; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public Agencies; Regression (Statistics); Regression analysis; Sexual Abuse; Stress; Stress Variables; Symptoms (Individual Disorders); Victimology; Autonomic nervous system; Child abuse; Human; Reactivity; Risk factor; Sexual abuse; Victimology; Stress
• ISSN: 0145-2134; 1873-7757
• DOI: 10.1016/j.chiabu.2009.11.005

Abstract Objective Sexually or physically abused children are at risk for neurobiological dysregulation as well as for internalizing and disruptive behavior disorders. Stress-related autonomic nervous system (ANS) down-regulation has been proposed as a sequela of abuse and was investigated in the present study. Methods Child Protective Services documented incidents of abuse were recorded for children in a sample of 262 pediatric psychiatric inpatients, as well as demographic, physical and intellectual functioning, and diagnostic and medication prescription data. Before and after a mildly stressful blood draw, noninvasive assessments of ANS activity were obtained. Results Controlling for all other variables in logistic regression analyses, a history of physical abuse (45% overall prevalence) was associated with poststressor ANS hyporesponsivity (i.e., heart rate deceleration). Conclusions Results suggest that a history of physical (but not sexual) abuse is associated with stressor-related ANS down-regulation in psychiatrically impaired children and adolescents. Practice implications Stressor-related autonomic hyporesponsivity secondary to physical abuse may contribute to the impairment of severely emotionally disturbed children. Differential diagnosis of psychiatrically impaired children should include identification of those who have a history of physical abuse, and their treatment should address stressor-related hyporeactivity.