Measuring Toxic Stress in Childhood and Youth: A Systematic Review

Abstract

Introduction: Toxic stress among children/youth is a significant public health concern that has been linked to serious morbidities and premature mortality in adulthood. Uniformity in measurement of a toxic stress variable for use in scholarly research can aid in a more comprehensive understanding of its indicators and implications.

Method: The purpose of this systematic review was to aggregate, organize, and summarize the literature around current practices for operationalizing toxic stress among children/youth. A strategic methodology was conducted according to PRISMA guidelines, and two databases were consulted for relevant studies.

Results: Over 30 different measurement tools were identified across 13 included studies, ranging from biomarkers and physiological indicators to scales, diagnoses, and other assessment instruments.

Discussion: By synthesizing current measurement methods, this review informs research and clinical communities of different approaches to toxic stress measurement, advances standardization efforts, and justifies the necessity of a singular, scientifically validated tool.

Keywords: Adverse childhood experiences; Physiological stress; early life stress; systematic review.