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. 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 ...

(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 Cognitive skills are skills of the mind, as opposed to other types of skills such as motor skills, social skills or life skills. Some examples of cognitive skills are literacy, self-reflection, logical reasoning, abstract thinking, critical thin ...

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. Such children lack the basics of primary and ...

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 biochemistry, biochemical and physiology, physiological process by which an organism uses food and water to support its life. The intake of these substances provides organisms with nutrients (divided into Macronutrient, macro- ...

, they do not grow and develop normally compared to other children of their age. An environment of constant and extreme stress causes PSS. Stress-released hormones in the body such as

epinephrine Adrenaline, also known as epinephrine, is a hormone and medication which is involved in regulating visceral functions (e.g., respiration). It appears as a white microcrystalline granule. Adrenaline is normally produced by the adrenal glands a ...

and

norepinephrine Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic compound, organic chemical in the catecholamine family that functions in the brain and human body, body as a hormone, neurotransmitter and neuromodulator. The ...

engage what is known as the

fight-or-flight response The fight-or-flight or the fight-flight-freeze-or-fawn (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 describ ...

. 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 tract is the largest of the body's systems, after the cardiovascular system. ...

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 compounds into small water-soluble components so that they can be absorbed into the blood plasma. In certain organisms, these smaller substances are absorbed through the small intestine into th ...

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 Foster may refer to: People * Foster (surname) * Foster Brooks (1912–2001), American actor * Foster Moreau (born 1997), American football player * Foster Sarell (born 1998), American football player * John Foster Dulles (1888–1959), America ...

group home A group home, congregate living facility, care home (the latter especially in British English and Australian English), adult family home, etc., is a structured and supervised residence model that provides assisted living as well as medical car ...

increases growth rate and

socialization In sociology, socialization (also socialisation – see American and British English spelling differences#-ise, -ize (-isation, -ization), spelling differences) is the process of Internalisation (sociology), internalizing the Norm (social), norm ...

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 group 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

Günter Grass Günter Wilhelm Grass (; 16 October 1927 – 13 April 2015) was a German novelist, poet, playwright, illustrator, graphic artist, sculptor, and recipient of the 1999 Nobel Prize in Literature. He was born in the Free City of Danzig (now Gda ...

's 1959 novel ''

The Tin Drum ''The Tin Drum'' (, ) is a 1959 novel by Günter Grass, the first book of his Danzig Trilogy. It was adapted into a 1979 film, which won both the 1979 Palme d'Or and the Academy Award for Best Foreign Language Film in 1980. To "beat a ti ...

'' (''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 19th-century French literature, French Epic (genre), epic historical fiction, historical novel by Victor Hugo, first published on 31 March 1862, that is considered one of the greatest novels of the 19th century. '' ...

'' by Victor Hugo, eight-year old

Cosette Cosette () is a fictional character in the 1862 novel ''Les Misérables'' by Victor Hugo and in the many adaptations of the story for stage, film, and television. Her birth name, Euphrasie, is only mentioned briefly. As the orphaned child of an ...

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 One Flew Over the Cuckoo's Nest may refer to: * ''One Flew Over the Cuckoo's Nest'' (novel), a 1962 novel by Ken Kesey * ''One Flew Over the Cuckoo's Nest'' (play), a 1963 stage adaptation of the novel starring Kirk Douglas * ''One Flew Over the ...

'', Chief Bromden claims that one of Nurse Ratched's orderlies, Williams, a black man with

dwarfism Dwarfism is a condition of people and animals marked by unusually small size or short stature. In humans, it is sometimes defined as an adult height of less than , regardless of sex; the average adult height among people with dwarfism is . '' ...

, 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'', '' Christop ...

'' by

V.C. Andrews Cleo Virginia Andrews (June 6, 1923 – December 19, 1986), better known as V. C. Andrews or Virginia C. Andrews, was an American novelist. She was best known for her 1979 novel '' Flowers in the Attic'', which inspired two movie adaptations and ...

, 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