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Diagnostic shortfalls in early childhood chronic stress: a review of the issues



Benjamin Klein, Lansdowne Children's Centre, 39 Mount Pleasant St, Brantford, ON N3T 1S7, Canada



Clinical effects of early childhood chronic stress should be regarded as causing a developmental brain injury. However, current diagnostic constructs fail to capture the associated disabilities in emotional-behavioural regulation of stress and attachment functions adequately. We first focus on neglect as a prototypical early childhood chronic stressor; next we explore clinical associations of neglect; and finally we cite research pertaining to possible underlying pathophysiology of the effects of early childhood chronic stress. In addition, we discuss diagnostic labels that children with histories of early childhood neglect commonly acquire, and implications for treatment.