Traumatic stress and the autonomic brain-gut connection in development: Polyvagal Theory as an integrative framework for psychosocial and gastrointestinal pathology.

Author: Kolacz J1, Kovacic KK2, Porges SW1,3
1Traumatic Stress Research Consortium at the Kinsey Institute, Indiana University, Bloomington, Indiana.
2Division of Pediatric Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
3Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Conference/Journal: Dev Psychobiol.
Date published: 2019 Jul
Other: Volume ID: 61 , Issue ID: 5 , Pages: 796-809 , Special Notes: doi: 10.1002/dev.21852. Epub 2019 Apr 5. , Word Count: 171

A range of psychiatric disorders such as anxiety, depression, and post-traumatic stress disorder frequently co-occur with functional gastrointestinal (GI) disorders. Risk of these pathologies is particularly high in those with a history of trauma, abuse, and chronic stress. These scientific findings and rising awareness within the healthcare profession give rise to a need for an integrative framework to understand the developmental mechanisms that give rise to these observations. In this paper, we introduce a plausible explanatory framework, based on the Polyvagal Theory (Porges, Psychophysiology, 32, 301-318, 1995; Porges, International Journal of Psychophysiology, 42, 123-146, 2001; Porges, Biological Psychology, 74, 116-143, 2007), which describes how evolution impacted the structure and function of the autonomic nervous system (ANS). The Polyvagal Theory provides organizing principles for understanding the development of adaptive diversity in homeostatic, threat-response, and psychosocial functions that contribute to pathology. Using these principles, we outline possible mechanisms that promote and maintain socioemotional and GI dysfunction and review their implications for therapeutic targets.

© 2019 Wiley Periodicals, Inc.

KEYWORDS: Polyvagal Theory; autonomic nervous system; brain-gut axis; stress; trauma

PMID: 30953358 DOI: 10.1002/dev.21852