Psychosocial short stature (PSS) is a growth disorder that is observed between the ages of 2 and 15, caused by extreme emotional deprivation or

stress Stress may refer to: Science and medicine * Stress (biology), an organism's response to a stressor such as an environmental condition * Stress (linguistics), relative emphasis or prominence given to a syllable in a word, or to a word in a phrase ...

. The symptoms include decreased

growth hormone Growth hormone (GH) or somatotropin, also known as human growth hormone (hGH or HGH) in its human form, is a peptide hormone that stimulates growth, cell reproduction, and cell regeneration in humans and other animals. It is thus important in h ...

(GH) and

somatomedin Somatomedins are a group of proteins produced predominantly by the liver when growth hormones act on target tissue. Somatomedins inhibit the release of growth hormones by acting directly on anterior pituitary and by stimulating the secretion of so ...

secretion, very

short stature Short stature refers to a height of a human which is below typical. Whether a person is considered short depends on the context. Because of the lack of preciseness, there is often disagreement about the degree of shortness that should be called ' ...

, weight that is inappropriate for the height, and immature skeletal age. This disease is a progressive one, and as long as the child is left in the stressing environment, their cognitive abilities continue to degenerate. Though rare in the population at large, it is common in

feral children A feral child (also called wild child) is a young individual who has lived isolated from human contact from a very young age, with little or no experience of human care, social behavior, or language. The term is used to refer to children who h ...

and in children kept in abusive, confined conditions for extended lengths of time. It can cause the body to completely stop growing but is generally considered to be temporary; regular growth will resume when the source of stress is removed.

Cause

Children with PSS have extremely low levels of

. These children possibly have a problem with growth hormone inhibiting hormone (GHIH) or growth hormone releasing hormone (GHRH). The children could either be unresponsive to GHRH, or too sensitive to GHIH. Children who have PSS exhibit signs of

failure to thrive Failure to thrive (FTT), also known as weight faltering or faltering growth, indicates insufficient weight gain or absence of appropriate physical growth in children. FTT is usually defined in terms of weight, and can be evaluated either by a low ...

. Even though they appear to be receiving adequate

nutrition Nutrition is the biochemical and physiological process by which an organism uses food to support its life. It provides organisms with nutrients, which can be metabolized to create energy and chemical structures. Failure to obtain sufficient ...

, they do not grow and develop normally compared to other children of their age. An environment of constant and extreme

causes PSS. Stress-released hormones in the body such as epinephrine and

norepinephrine Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic chemical in the catecholamine family that functions in the brain and body as both a hormone and neurotransmitter. The name "noradrenaline" (from Latin '' ad' ...

engage what is known as the

fight-or-flight response The fight-or-flight or the fight-flight-or-freeze response (also called hyperarousal or the acute stress response) is a physiological reaction that occurs in response to a perceived harmful event, attack, or threat to survival. It was first des ...

. The heart speeds up, and the body diverts resources away from processes that are not immediately important; in PSS, the production of growth hormone (GH) is thus affected. As well as lacking growth hormone, children with PSS exhibit

gastrointestinal The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...

problems due to the large amounts of epinephrine and norepinephrine, resulting in their bodies lacking proper

digestion Digestion is the breakdown of large insoluble food molecules into small water-soluble food molecules so that they can be absorbed into the watery blood plasma. In certain organisms, these smaller substances are absorbed through the small intest ...

of nutrients and further affecting development. While the cure for PSS is questionable, some studies show that placing the child affected with the disease in a foster or

group home A group home, congregate living facility, or care home (the latter especially in British English and Australian English) is a residence model of medical care for those with complex health needs. Traditionally, the model has been used for children ...

increases growth rate and

socialization In sociology, socialization or socialisation (see spelling differences) is the process of internalizing the norms and ideologies of society. Socialization encompasses both learning and teaching and is thus "the means by which social and cul ...

skills.

Society and culture

One case was a child who was admitted to a hospital with an extremely low weight. One nurse took over his care, and he began to rapidly gain weight and his growth hormone levels increased during this time. The child was so dependent on the nurse emotionally that when she left, his levels returned to what they had been when he was admitted to the hospital, and once she returned, they stabilized once more. When a police raid in 1987 released the children held by an Australian cult known as The Family, one twelve-year-old girl weighed under 20 kg (44 lbs) and was under 120 cm (4 ft) tall. She grew 11 cm (4 in) in the following year, and her growth hormone levels returned to normal.

Fictional characters

In Günter Grass's 1959 novel ''

The Tin Drum ''The Tin Drum'' (german: Die Blechtrommel, ) is a 1959 novel by Günter Grass. The novel is the first book of Grass's ' ('' Danzig Trilogy''). It was adapted into a 1979 film, which won both the 1979 Palme d'Or and the Academy Award for Bes ...

'' (''Die Blechtrommel''), the character Oskar Matzerath "willfully stunted his growth at three feet tall as a three-year-old, although later in the novel he grows to four feet one inch" in reaction to the stress he experiences – the petit-bourgeois German society. In the novel ''

Les Misérables ''Les Misérables'' ( , ) is a French historical novel by Victor Hugo, first published in 1862, that is considered one of the greatest novels of the 19th century. In the English-speaking world, the novel is usually referred to by its origin ...

'' by Victor Hugo, eight-year old Cosette had been abused, neglected and enslaved by the Thènardier family. The extreme abuse and neglect she faces is described as very stressful for her, and as a result she is described as simultaneously being as short as a child half her age and having an expression more appropriate for an older woman. She recovers after she is adopted by Jean Valjean and is of average height as an adult. In '' One Flew Over the Cuckoo's Nest'', Chief Bromden claims that one of Nurse Ratched's orderlies, Williams, a black man with dwarfism, gained his short stature from seeing white men rape his mother. In the novel ''

Flowers in the Attic ''Flowers in the Attic'' is a 1979 Gothic novel by V. C. Andrews. It is the first book in the Dollanganger series, and was followed by '' Petals on the Wind'', ''If There Be Thorns'', '' Seeds of Yesterday'', '' Garden of Shadows'', '' Christoph ...

'' by V.C. Andrews, twins Cory and Carrie Dollanganger are locked in an attic (with their two older siblings). The stress of their grandmother's abuse and lack of attention from their mother — along with arsenic poisoning and lack of outdoor play opportunities — stunts the twins' growth. Later in the series, Carrie is described as being eight years old, yet her physical appearance is that of a three-year-old.

References

External links

* Psychosocial dwarfism from FeralChildren.com * {{Growth disorder Child abuse Growth disorders Human height