This article is part of a series on Early Intervention: Bridging the gap between practice and academia, edited by Jörg M. Fegert and Ute Ziegenhain.

Review

Early stress exposure: Concepts, findings, and implications, with particular emphasis on attachment disturbances

Thomas G O'Connor and Mary E Spagnola

Department of Psychiatry, Wynne Center for Family Research, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY, 14642, USA

author email corresponding author email

Child and Adolescent Psychiatry and Mental Health 2009, 3:24doi:10.1186/1753-2000-3-24

Published:	4 September 2009

Abstract

Background

Early intervention and preventive interventions are attracting increasing attention in the child and adolescent mental health field because recent research findings offer new insights into risk mechanisms and because of the growing expectation that they may hold clues to reducing suffering and health cost burdens for society and the individual.

Methods

A selective review of the literature is provided to examine alternative models for understanding the impact of early risk exposure and how these findings may be translated to intervention and prevention; we pay particular attention to the role of child-parent attachment relationship quality as a major potential source of risk or protection.

Results

In this qualitative review, we conclude that sharply contrasting models for understanding early exposure to risk have not been adequately empirically examined in human work. In the case of attachment disturbances, one good context for studying early risk and intervention, sizable questions remain about conceptual models and assessment practices.

Conclusion

Implications of these findings, and limits of the findings, for existing conceptual models of child and adolescent psychopathology and clinical practice are highlighted.