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[edit]

Lasting effects of Adverse Childhood Experiences
Lasting effects 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][9] 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.[10][11]

Psychological impact[edit]

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.

Epigenetics[edit]

Child abuse can leave tracks, not only physically and emotionally, but also in the form of epigenetic marks on a child's genes. Although these epigenetic marks do not cause mutations in the DNA itself, the chemical modifications-including DNA methylation-change gene expression by silencing (or activating) genes. This can alter fundamental biological processes and adversely affect health outcomes throughout life. A 2013 study found that people who had experienced childhood trauma had different neuropathology than people with PTSD from trauma experienced after childhood.[12] Another recent study in rhesus macaques showed that DNA methylation changes related to early-life adversity persisted into adulthood.[13]

Socioeconomic costs of childhood trauma[edit]

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.[14][15]

Transgenerational effects[edit]

We can pass our epigenetic marks including de-myelinated neurons to our children. 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.[16][17][18] Exposure to childhood trauma, along with environmental stress, can also cause alterations in genes and gene expressions.[19][20][21] 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.[22] These long-lasting consequences can include emotion regulation issues, which can then be passed onto subsequent generations through child-parent interactions and learned behaviors.[23] (see also behavioral epigenetics, epigenetics, historical trauma, and cycle of violence)

Resilience[edit]

Resilience is the process of adapting well to trauma, adversity, tragedy, threats, or significant sources of stress.[24] 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.[25] Resilience can be impacted by a variety of risk or protective factors that either enhance or mitigate the risk of negative outcomes.[26] Establishing a secure attachment to caregivers has been identified as a significant protective factor that can buffer against the negative outcomes of childhood trauma.[27]

Prognosis[edit]

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.[28] 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.[29]

Types[edit]

Medical trauma[edit]

Medical Trauma, sometimes called "pediatric medical traumatic stress" refers to a set of psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures, and invasive or frightening treatment experiences. Medical trauma may occur as a response to a single or multiple medical events.[30]

Separation trauma[edit]

Separation trauma[31] is a disruption in an attachment relationship that disrupts neurological development and can lead to death.[32][33] Chronic separation from a caregiver can be extremely traumatic to a child.[34][35]

References[edit]

  1. ^ "The Adverse Childhood Experiences (ACE) Study". Centers for Diesase Control. Retrieved 6 June 2017.
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