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Childhood trauma

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Childhood trauma has profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being. Colloquially referred to as adverse childhood experiences (ACEs), childhood trauma ranges from sexual abuse to neglect to living in a household where a parent or sibling is treated violently or there is a parent with a mental illness. Kaiser Permanente and the Centers for Disease Control and Prevention's 1998 study on adverse childhood experiences determined that traumatic experiences during childhood are a root cause of many social, emotional, and cognitive impairments that lead to increased risk of unhealthy behaviors, risk of violence or re-victimization, chronic health conditions, low life potential and premature mortality. As the number of adverse experiences increases, the risk of problems from childhood through adulthood also rises.[1] Nearly 30 years of study following the initial study has confirmed this. Many states, health providers, and other groups now routinely screen parents and children for ACEs.

Health outcomes from childhood trauma

Main article: Stress in early childhood

Lasting Affects of Adverse Childhood Experiences Traumatic experiences during childhood causes stress that increases an individual’s allostatic load and thus affects the immune system, nervous system, and endocrine system.[2][3][4][5] Childhood trauma is often associated with adverse health outcomes including depression, hypertension, autoimmune diseases, lung cancer, and premature mortality[2][4][2][6][7] Effects of childhood trauma on brain development includes a negative impact on emotional regulation and impairment of development of social skills.[4] Research has shown that children raised in traumatic or risky family environments tend to have excessive internalizing (e.g., social withdrawal, anxiety) or externalizing (e.g., aggressive behavior), and suicidal behavior.[4][8] Recent research has found that physical and sexual abuse are associated with mood and anxiety disorders in adulthood, while personality disorders and schizophrenia are linked with emotional abuse as adults.[9][10]

Psychological impacts from childhood trauma

Main article: Psychological trauma

Childhood trauma can increase the risk of mental disorders including posttraumatic 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.

Socioeconomic costs of childhood trauma

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 as a result of physical abuse and foster care costs resulting from the removal of children when they cannot remain safely with their families. Other costs, 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.[11][12]

Transgenerational effects of childhood trauma

Main article: Transgenerational trauma

The effects of trauma can be transferred from one generation of childhood trauma survivors to subsequent generations of offsprings. This is known as transgenerational trauma or intergenerational trauma, and can manifest in parenting behaviors as well as epigenetically.[13][14][15] Exposure to childhood trauma, along with environmental stress, can also cause alterations in genes and gene expressions.[16][17][18] 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 that extend well into adulthood [19] (see life course approach). These long-lasting consequences can include emotion regulation issues, which can then be passed onto subsequent generations through child-parent interactions and learned behaviors.[20] (see also behavioral epigenetics, epigenetics, historical trauma, and cycle of violence)

Resilience and childhood trauma

Main article: Psychological resilience

Resilience is the process of adapting well to trauma, adversity, tragedy, threats, or significant sources of stress.[21] It strives on supportive, responsive relationships and capabilities that allow children to respond and adapt to adversity in healthy ways, turning toxic stress into tolerable stress.[22] Resilience can be impacted by a variety of risk or protective factors that either enhance or mitigate the risk of negative outcomes.[23] Establishing a secure attachment to caregivers has been identified as a significant protective factor that can buffer against the negative outcomes of childhood trauma.[24]

Recovering from childhood trauma

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.[25] Studies have found that despite the broad impacts of trauma, children can and do recover, and that trauma-informed care and interventions produce better outcomes than “treatment as usual”. Trauma-informed care is defined as offering services or support in a way that addresses the special needs of people who have experienced trauma.[26]

References

  1. ^ "The Adverse Childhood Experiences (ACE) Study". CDC.gov. Retrieved 2017-06-06.
  2. ^ a b c Brown, David W.; Anda, Robert F.; Felitti, Vincent J.; Edwards, Valerie J.; Malarcher, Ann Marie; Croft, Janet B.; Giles, Wayne H. (2010-01-19). "Adverse childhood experiences are associated with the risk of lung cancer: a prospective cohort study". BMC Public Health. 10: 20. doi:10.1186/1471-2458-10-20. ISSN 1471-2458. PMC 2826284. PMID 20085623.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  3. ^ Dube, Shanta R.; Fairweather, DeLisa; Pearson, William S.; Felitti, Vincent J.; Anda, Robert F.; Croft, Janet B. (2009-02-01). "Cumulative childhood stress and autoimmune diseases in adults". Psychosomatic Medicine. 71 (2): 243–250. doi:10.1097/PSY.0b013e3181907888. ISSN 1534-7796. PMC 3318917. PMID 19188532.
  4. ^ a b c d Taylor, Shelley E.; Lerner, Jennifer S.; Sage, Rebecca M.; Lehman, Barbara J.; Seeman, Teresa E. (2004-12-01). "Early environment, emotions, responses to stress, and health". Journal of Personality. 72 (6): 1365–1393. doi:10.1111/j.1467-6494.2004.00300.x. ISSN 0022-3506. PMID 15509286.
  5. ^ Motzer, Sandra Adams; Hertig, Vicky (2004-03-01). "Stress, stress response, and health". The Nursing Clinics of North America. 39 (1): 1–17. doi:10.1016/j.cnur.2003.11.001. ISSN 0029-6465. PMID 15062724.
  6. ^ Chapman, Daniel P.; Whitfield, Charles L.; Felitti, Vincent J.; Dube, Shanta R.; Edwards, Valerie J.; Anda, Robert F. (2004-10-15). "Adverse childhood experiences and the risk of depressive disorders in adulthood". Journal of Affective Disorders. 82 (2): 217–225. doi:10.1016/j.jad.2003.12.013. ISSN 0165-0327. PMID 15488250.
  7. ^ Murphy, MO; Cohn, DM; Loria, AS. "Developmental origins of cardiovascular disease: Impact of early life stress in humans and rodents". Neurosci Biobehav Rev. 74: 453–465. doi:10.1016/j.neubiorev.2016.07.018. PMC 5250589. PMID 27450581.
  8. ^ Aron, E. N., Aron, A., & Davies, K. M. (2005). "Adult shyness: The interaction of temperamental sensitivity and an adverse childhood environment." Personality and Social Psychology Bulletin, 31(2), 181-197.
  9. ^ Sachs-Ericsson, Natalie; Sheffler, Julia; Stanley, Ian; Piazza, Jennifer; Preacher, Kristopher (March 22, 2017). "When Emotional Pain Becomes Physical: Adverse Childhood Experiences, Pain, and the Role of Mood and Anxiety Disorders". Journal of Clinical Psychology. 73 (10): 1403–1428. doi:10.1002/jclp.22444.
  10. ^ Carr, Clara Passmann; Martins, Camilla Maria Severi; Stingel, Ana Maria; Lemgruber, Vera Braga; Juruena, Mario Francisco (December 2013). "The Role of Early Life Stress in Adult Psychiatric Disorders: A Systematic Review According to Childhood Trauma Subtypes". The Journal of Nervous and Mental Disease. 201 (12): 1007–1020. doi:10.1097/NMD.0000000000000049. ISSN 0022-3018.
  11. ^ "Social and Economic Consequences of Child Abuse and Neglect". Child Welfare Information Gateway. U.S. Department of Health and Human Services. Public Domain This article incorporates text from this source, which is in the public domain.
  12. ^ "The Estimated Annual Cost of Child Abuse and Neglect". Prevent Child Abuse America. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  13. ^ "Poor Parenting Can Be Passed From Generation to Generation". NBC News. Retrieved 2017-03-16.
  14. ^ "Childhood trauma compromises health via diverse pathways". www.blueknot.org.au. Retrieved 2017-03-16.
  15. ^ "Adverse Childhood Experiences (ACEs): Mental Illness of a Parent | Crow Wing Energized". crowwingenergized.org. Retrieved 2017-03-16.
  16. ^ Roth, Tania L. (2017-03-16). "Epigenetic mechanisms in the development of behavior: advances, challenges, and future promises of a new field". Development and Psychopathology. 25 (4): 1279–1291. doi:10.1017/S0954579413000618. ISSN 0954-5794. PMC 4080409. PMID 24342840.
  17. ^ Feder, Adriana; Nestler, Eric J.; Charney, Dennis S. (2017-03-16). "Psychobiology and molecular genetics of resilience". Nature Reviews. Neuroscience. 10 (6): 446–457. doi:10.1038/nrn2649. ISSN 1471-003X. PMC 2833107. PMID 19455174.
  18. ^ Tyrka, Audrey R., Lawrence H. Price, Carmen Marsit, Oakland C. Walters, and Linda L. Carpenter. "Childhood adversity and epigenetic modulation of the leukocyte glucocorticoid receptor: preliminary findings in healthy adults." PLoS ONE 7, no. 1 (2012): e30148.
  19. ^ Kaplan, Sandra J., David Pelcovitz, and Victor Labruna. "Child and adolescent abuse and neglect research: A review of the past 10 years. Part I: Physical and emotional abuse and neglect." Journal of the American Academy of Child & Adolescent Psychiatry 38, no. 10 (1999): 1214-1222.
  20. ^ "Maternal early-life trauma and affective parenting style: the mediating rol...: EBSCOhost". web.a.ebscohost.com. Retrieved 2017-10-04.
  21. ^ "The road to resilience". www.apa.org. Retrieved 2017-03-16.
  22. ^ "Resilience". Center on the Developing Child at Harvard University. Retrieved 2017-03-14.
  23. ^ "Resilience". Center on the Developing Child at Harvard University. Retrieved 2017-03-16.
  24. ^ Sciaraffa, Mary A.; Zeanah, Paula D.; Zeanah, Charles H. (2017-07-15). "Understanding and Promoting Resilience in the Context of Adverse Childhood Experiences". Early Childhood Education Journal: 1–11. doi:10.1007/s10643-017-0869-3. ISSN 1082-3301.
  25. ^ Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the Impact of Trauma. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/
  26. ^ Substance Abuse and Mental Health Services Administration. SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
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