Early stress and dissociation: Psychopathological pathways

Objectives In the last two centuries, researchers tried to investigate the complex effects of early life stress on developing brain as well as the mechanisms underlying dissociation that may be frequently linked to traumatic experiences. Clinically, dissociation may be found in many psychiatric disorders and may be defined as the disruption of important human functions such as memory, identity, consciousness, thinking, emotions, body representation, motor control as well as behavior. The aim of the present review was to selectively review data about the link between traumatic experiences, dissociation and psychopathological patways. Methods A detailed search regarding the association between traumatic experiences, dissociation, and psychopathological patways has been carried out. Results Based on the most relevant included studies (n = 16), a chronic hypothalamic pityuitary adrenal (HPA) axis dysregulation (that may include both hyperactivity and hypoactivity) has been found in subjects with childhood traumatic experiences. The dysregulated stress system in subjects who have suffered from early traumatic conditions is able to promote important neuroendocrine and immune impairments together with inducing inflammatory-related conditions. Exposure to early-life traumatic experiences may be also linked to relevant psychopathological and neurocognitive consequences with multiple psychopathological conditions that may be developed in individuals with a positive history of traumatic experiences. Importantly, early adversities are closely related to enhanced chronicity, suicidal behavior, and poorer treatment response. Conclusions Although dissociation may be diagnosed both in acute and chronic conditions, many clinicians are, unfortunately, not able to correctly detect these conditions. The main implications related to the link between trauma, dissociation, and most relevant psychopathological conditions are discussed.