Developmental psychology and the study of behaviour and emotion have tended to be
considered in parallel to the study of neurobiological processes. This review explores the
effects of child abuse and neglect on the brain, excluding nonaccidental injury that causes
gross physical trauma to the brain. It commences with a background summary of the nature,
context, and some deleterious effects of omission and commission within child maltreatment.
There is no post-maltreatment syndrome, outcomes varying with many factors including
nature, duration, and interpersonal context of the maltreatment as well as the nature of later
intervention. There then follows a section on environmental influences on brain development,
demonstrating the dependence of the orderly process of neurodevelopment on the
child's environment. Ontogenesis, or the development of the self through self-determination,
proceeds in the context of the nature–nurture interaction. As a prelude to reviewing the
neurobiology of child abuse and neglect, the next section is concerned with bridging the mind
and the brain. Here, neurobiological processes, including cellular, biochemical, and
neurophysiological processes, are examined alongside their behavioural, cognitive, and
emotional equivalents and vice versa. Child maltreatment is a potent source of stress and the
stress response is therefore discussed in some detail. Evidence is outlined for the buffering
effects of a secure attachment on the stress response. The section dealing with actual effects
on the brain of child abuse and neglect discusses manifestations of the stress response
including dysregulation of the hypothalamic-pituitary-adrenal axis, and parasympathetic
and catecholamine responses. Recent evidence about reduction in brain volume following
child abuse and neglect is also outlined. Some biochemical, functional, and structural
changes in the brain that are not reflections of the stress response are observed following
child maltreatment. The mechanisms bringing about these changes are less clearly
understood and may well be related to early and more chronic abuse and neglect affecting the
process of brain development. The behavioural and emotional concomitants of their
neurobiological manifestations are discussed. The importance of early intervention and
attention to the chronicity of environmental adversity may indicate the need for permanent
alternative caregivers, in order to preserve the development of the most vulnerable children.