Childhood Trauma

Childhood trauma  is often described as serious adverse childhood experiences. Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse. They may also witness abuse of a sibling or parent, or have a mentally ill parent. Childhood trauma has been correlated with later negative effects on health and psychological wellbeing. However, resilience is also a common outcome; many children who experience adverse childhood experiences do not develop mental or physical health issues. Childhood traumatic experiences leads to stress that increases an individual's allostatic load, negatively affecting the immune system, nervous system, and endocrine system. Exposure to chronic stress can triple or quadruple the risk to adverse medical outcomes. Childhood trauma is often linked to various health issues including depression, hypertension, autoimmune diseases, lung cancer, and premature mortality. The effects of childhood trauma on brain development can hinder emotional regulation and impair social skill development. Research indicates that children raised in traumatic or risky family environments often display excessive internalizing (e.g., social withdrawal, anxiety) or externalizing (e.g., aggressive behavior), and suicidal behavior. Recent research has found that physical and sexual abuse are associated with mood and anxiety disorders in adulthood, while emotional abuse is linked to personality disorders and schizophrenia later in life. Recent research suggests that mental health outcomes from childhood trauma may be better understood through a dimensional framework (internalizing and externalizing) as opposed to specific disorders. Neglect, abandonment, sexual abuse, emotional abuse, and physical abuse are all forms of psychological trauma that can have long-lasting effects on a child's mental health. These types of abuse disrupt a child's sense of safety and trust, which can lead to various mental disorders including post-traumatic stress disorder (PTSD), attachment issues, depression, and substance abuse. Sensitive and critical stages of child development can result in altered neurological functioning, adaptive to a malevolent environment but difficult for more benign environments. As an adult, feelings of anxiety, worry, shame, guilt, helplessness, hopelessness, grief, sadness, and anger that started with a trauma in childhood can persist. In addition, those who experience trauma as a child are more likely to face mental health challenges such as anxiety, depression, suicide and self harm, PTSD, substance misuse, and relationship complications. The effects of childhood trauma are not limited to emotional consequences; survivors of childhood trauma are also at higher risk of developing asthma, coronary heart disease, diabetes, or strokes. They are also more likely to develop a "heightened stress response," which can cause difficulties in emotional regulation, sleep difficulties, lower immune function, and increased risk of a number of physical illnesses throughout adulthood. Societal norms affect how children express emotional distress—some may be encouraged to "tough it out" rather than receive support. Women are more likely to experience sexual abuse, while men more often face physical abuse and neglect; however, stigma may prevent them from seeking help. Childhood trauma can leave epigenetic marks on a child's genes, which chemically modify gene expression by silencing or activating genes, or DNA methylation. This can alter fundamental biological processes and adversely affect health outcomes throughout life. Survivors of war trauma or childhood maltreatment are at increased risk for trauma-spectrum disorders such as PTSD. In addition, traumatic stress has been associated with alterations in the neuroendocrine and immune systems, enhancing the risk for physical diseases.  In particular, epigenetic alterations in genes regulating the hypothalamus–pituitary–adrenal axis as well as the immune system have been observed in survivors of childhood and adult trauma. Traumatic experiences might even affect psychological and biological parameters in the next generation. Parental trauma exposure is associated with greater risk for PTSD, as well as mood and anxiety disorders in offspring. Biological alterations associated with PTSD and/or other stress-related disorders have been observed in offspring of trauma survivors who have not themselves experienced trauma or psychiatric disorder. Research in animals has demonstrated that stress exposure can result in epigenetic changes in subject's offspring, potentially increasing vulnerability to psychiatric symptoms in offspring of trauma survivors. Enduring behavioral responses to stress and epigenetic alterations in adult offspring may be facilitated by changes in gametes, in utero environment, variations in early postnatal care, and/or other early life experiences that are influenced by parental exposure.  These changes could result in enduring changes to the stress response as well as physical health risk. The effects of parental trauma could be transmitted to the next generation by parental distress and the pre- and post-natal environment, as well as by epigenetic marks transmitted via the germline. While epigenetic research has a high potential of advancing our understanding of the consequences of trauma, the findings have to be interpreted with caution, as epigenetics only represent one piece of a complex puzzle of interacting biological and environmental factors. People can pass their epigenetic marks including de-myelinated neurons to their children. Exposure to childhood trauma, along with environmental stress, can also cause alterations in genes and gene expressions. A growing body of literature suggests that children's experiences of trauma and abuse within close relationships not only jeopardize their well-being in childhood, but can also have long-lasting consequences including emotion regulation issues, which can then be passed onto subsequent generations through child-parent interactions and learned behaviors. The social and economic costs of child abuse and neglect are difficult to calculate. Some costs are straightforward and directly related to maltreatment, such as hospital costs for medical treatment of injuries sustained due to physical abuse and foster care costs resulting from the removal of children when they are not safe with their families. Other costs, which are less directly tied to the incidence of abuse, include lower academic achievement, adult criminality, and lifelong mental health problems. Both direct and indirect costs impact society and the economy. For example, children who experience maltreatment are more likely to perform poorly in school, which can limit their future economic opportunities and increase likelihood of unemployment. The long-term psychological effects of abuse, such as depression, PTSD, and substance abuse can lead to increased healthcare costs and higher mortality rates. Exposure to maltreatment in childhood significantly predicts a variety of negative outcomes in adulthood. However, not all children who are exposed to a potentially traumatic event develop subsequent struggles with mental or physical health. Therefore, there are factors that reduce the impact of potentially traumatic events and protect an individual from developing mental health problems after exposure to a potentially traumatic event. These are called resiliency factors. Factors that affect resilience include cultural factors like socioeconomic status, such that having more resources at one's disposal usually equates to more resilience to trauma. Furthermore, the severity and duration of the potentially traumatic experience affect the likelihood of experiencing negative outcomes as a result of childhood trauma. One factor that does not affect resilience is gender, with both males and females being equally sensitive to risk and protective factors. Cognitive ability is also not a predictor of resilience. Attachment has been shown to be one of the most important factors to consider when it comes to evaluating the relative resilience of an individual. Children with secure attachments to an adult with effective coping strategies were most likely to endure adverse childhood experiences in an adaptive manner. Secure attachments throughout the lifespan (including in adolescence and adulthood) appear to be equally important in fostering and maintaining resilience. Secure attachment to one's peers throughout adolescence is a particularly strong predictor of resilience. Within the context of abuse, it is thought that these secure attachments decrease the extent to which children who are abused perceive others as being untrustworthy. In other words, while some children who are abused might begin to view other people as being unsafe and unable to be trusted, children who are able to develop and maintain healthy relationships are less likely to hold these views. Children who experience trauma but also experience healthy attachment with multiple groups of people (in essence, adults, peers, romantic partners, etc.) throughout childhood, adolescence, and adulthood are particularly resilient. Personality also affects the development (or lack of development) of adult psychopathology as a result of childhood abuse. Individuals who scored low in neuroticism exhibit fewer negative outcomes, such as psychopathology, criminal activity, and poor physical health, after exposure to a potentially traumatic event. Furthermore, individuals with higher scores on openness to experience, conscientiousness, and extraversion have been found to be more resilient to the effects of childhood trauma. e of the most common misconceptions about resilience is that individuals who show resilience are somehow special or extraordinary in some way. Successful adaptation, or resilience, is quite common among children. This is due in part to the naturally adaptive nature of childhood development. Therefore, resilience is enhanced by protecting against factors that might undermine a child's inborn resilience. Studies suggest that resiliency can be enhanced by providing children who have been exposed to trauma with environments in which they feel safe and are able to securely attach to a healthy adult. Therefore, interventions that promote strong parent-child bonds are particularly effective at buffering against the potential negative effects of trauma. Furthermore, researchers of resilience argue that successful adaptation is not merely a result, rather a developmental process that is ongoing throughout a person's lifetime. Thus, successful promotion of resilience must also be ongoing throughout a person's lifespan. Trauma affects all children differently (see stress in early childhood). Some children who experience trauma develop significant and long-lasting problems, while others may have minimal symptoms and recover more quickly. Studies have found that despite the broad impacts of trauma, children can and do recover with appropriate interventions. Trauma-informed care tailors to the unique needs of those with trauma and produce better outcomes than standard treatments. Early and sustained support can significantly improve long-term emotional and psychological well-being for children affected by trauma. Treatments are needed to halt childhood trauma. Thank you.