Early childhood trauma

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Early childhood trauma refers to various types of adversity and traumatic events experienced during the early years of a person's life. This is deemed the most critical developmental period in human life by psychologists. [1] A critical period refers to a sensitive time during the early years of childhood in which children may be more vulnerable to be affected by environmental stimulation. [1] These traumatic events can include serious sickness, natural disasters, family violence, sudden separation from a family member, being the victim of abuse, or suffering the loss of a loved one. [2] Traumatic experiences in early childhood can result in severe consequences throughout adulthood, for instance developing post-traumatic stress disorder, depression, or anxiety. [2] Negative childhood experiences can have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity. [3] However, not all children who are exposed to negative stimuli in early childhood will be affected severely in later life; some children come out unscathed after being faced with traumatic events, which is known as resilience. [4] Many factors can account for the invulnerability displayed by certain children in response to adverse social conditions: gender, vulnerability, social support systems, and innate character traits. [4] Much of the research in this area has referred to the Adverse Childhood Experiences Study (ACE) study. The ACE study found several protective factors against developing mental health disorders, including mother-child relations, parental health, and community support. [5] However, having adverse childhood experiences creates long-lasting impacts on psychosocial functioning, such as a heightened awareness of environmental threats, feelings of loneliness, and cognitive deficits. [5] Individuals with ACEs are more prone to developing severe symptoms than individuals in the same diagnostic category. [5]

Contents

Emotional Functioning

Research shows that even witnessing traumatic events can impact the physical development of a child’s brain — potentially leading to lifelong impairments in emotional functioning. In particular, they could diminish the structure and functioning of brain systems. Some children may forget the traumatic event all together, thought it can re-surface years later with severe symptoms or not surface at all. [3] Moreover, youth that grow up in emotionally dysfunctional environments typically don't have the opportunity to appropriately feel and express emotions, which can cause further distress accompanied by severe symptoms that persist into adulthood. [6] This can further cause a person difficulty in creating or maintaining relationships, or further frustration and anxiety. [3] Similarly, internalizing problems such as anxiety, depression, withdrawal, and somatic complaints are related to other forms of emotional dysregulation that can lead to difficulty with attention and cognitive control. [6] Additionally, whether children experienced neglectful behavior or abuse, they tend to show poor understanding of emotions, especially those whom were subject to high levels of anger or hostility by their caregivers. [7]

Researchers have also presented findings on the development of facial recognition of emotion in physically abused and neglected toddlers. [8] Their results outline that physically abused children have difficulty recognizing sadness and disgust, while neglected children have more difficulty discriminating differences between emotional expressions. However, both physically abused and neglected children tend to rate expressions of anger and sadness similarly to emotionally neutral expressions. Additionally, they describe how an appropriate level of exposure to emotional expressiveness supports good learning of emotion in children but increased exposure to anger and hostility or poor communication can lead to less than ideal learning of emotions. [8]

Moreover, results from recent neurological research suggests that childhood psychological trauma can influence the same physiological response systems as physical trauma can. [9] Neurologically, the initiation of emotion occurs as a product of the interaction between bottom-up and top-down processes. [9] Emotional regulation involves numerous brain regions and involves a broadly dispersed functional network with bidirectional links among many emotion-relevant regions in the brain. [6] For example, research has identified the amygdala, ventral striatum, thalamus, hypothalamus, and periaqueductal gray as key areas of activation during administration of emotional tasks. [10]

In a typically developing child, maturation of neural and neuroendocrine systems is related to decreased emotional lability and increased self-control. However, these processes also depend on the maturation of parasympathetic regulation in early childhood and developments in the hypothalamic-pituitary-adrenocortical (HPA) axis, which are shaped by positive early experiences and caregiver receptiveness. [6] Therefore, home environments that do not foster healthy maturation in brain systems may interfere with the development of language as a means to comprehend and communicate emotions effectively, and other cognitive processes regulated by the attentional system.

Depression

Depression can be displayed in persons that have experienced acute or chronic trauma, especially in their childhood. With the surfacing of relevant studies, evidence proposes that childhood trauma is a large risk factor in developing depressive disorders that can persist into adulthood. Also, these findings present that clinically depressed individuals reported being exposed to adversity/trauma during their early years of childhood. Types of adversity that were listed by clinically depressed individuals involved sexual, physical, and emotional abuse, neglect, separation from a parent, or mental illness in a parent. Specifically, the strongest correlation between the types of adversity and adulthood depression is sexual abuse and neglect, particularly in females. [11] Therefore, it is crucial in realizing how large of a factor environment surrounding a child plays in the development of depression.

As mentioned before, the Adverse Childhood Experiences Study is one of the largest studies that aspires to explore the relationship between childhood maltreatment and long term health outcomes. This study presented "findings showing that two-thirds of the participants reported at least one child adversity while one out of 5 participants reported having more than 3 child adversities, which was followed by a range of long term health consequences such as depression and major psychiatric disorders".

Post- Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder is differentiated from other psychiatric disorders by its need for a triggering stressor. [2] A few of the more common sources that can provoke PTSD are community violence (war), natural disasters, or serious illnesses. [2] The depth and severity of the trauma exposed to children were relative to high levels of psychopathology, especially anxiety and depressive disorders, as well as further impairments. [3] Also, new information was obtained in light of evidence, which suggests that a caretaker being sent to prison had the same effect of depth of PTSD on children as rape did. [3] [2] Additionally, a sudden separation from a loved one for any reason or receiving traumatic news about a loved one can also provoke severe PTSD in children. [2] Furthermore, specific reports from a research study indicated that adults who were diagnosed with PTSD had a history of exposure to countless trauma as children, had a history of anxiety, and were known to come from adverse social conditions. [3] For this disorder, the prevalence rate is higher in girls than boys. [2] Yet, reports of previous research showed that the risk of developing PTSD after being exposed to trauma in childhood was less than those who were exposed during adulthood. [2]

Resilience

Psychological resilience often refers to an individual's ability to utilize past experiences with stressors to successfully navigate new life challenges, and it is portrayed as the power to bounce back. Children who endured certain trauma in early life may develop the capacity to anticipate potential conflict or trauma before it occurs, and can plan to react accordingly, minimizing their stress as much as possible. [12] After being subject to traumatic experiences countless children can become resilient and even display more strength than before, known as invulnerability. [13] Reason being, there are factors to consider when contemplating on how certain children become resilient when faced with adverse social conditions. These factors include innate childhood qualities, specific character traits, social support systems, capability to make the best of what they're given, and ultimately the will to survive. [4]

Research on children’s emotional experience and competence suggests that children who have emotionally charged experiences tend to have a heightened awareness of emotional cues; thus, allowing for more effective processing of information. [7] Despite this evidence, some studies have showed that adults who were believed to be resilient after facing trauma in their childhood, also reported high levels of anxiety and depression; those deemed resilient can fall apart at any time if a certain vulnerability is triggered. [4] Some people are more apt to cope with stressful events than others. Not every child who has experienced early trauma will display psychological resilience, as each brain is wired differently; where some children may find future scenarios easier to navigate as a result, others may fall back on maladaptive coping mechanisms that make future stressors significantly more difficult. For example, someone who tended to dissociate during conflict as a child to protect themselves may find themselves relying on the same strategy during a mundane argument with their spouse ten years down the road -- this detachment will not work the same way, and it will not allow them to resolve the conflict at hand. This ingrained behavior is disruptive but can be amended by finding alternative ways to cope with tense situations.

If the early childhood trauma stems from a parent or guardian, or an individual the child has to encounter daily, the child may develop resilience through repeated exposure to mistreatment. This gives them a better picture of which strategies work, and which ones do not. This dynamic can complicate the lingering effects of the trauma; research shows that abused children need a secure, stable adult in their life to lean on for assistance. [14] Children with healthy parent-child relationships can go to their guardian for advice on how to navigate or overcome a negative experience, but when the parent or guardian is the source, the child may feel stranded. On the other hand, if they have an adult figure that validates their emotions and provides comfort, they will have an easier time building a support network, contributing to the development of their psychological resilience.

Related Research Articles

<span class="mw-page-title-main">Causes of mental disorders</span> Etiology of psychopathology

A mental disorder is an impairment of the mind disrupting normal thinking, feeling, mood, behavior, or social interactions, and accompanied by significant distress or dysfunction. The causes of mental disorders are very complex and vary depending on the particular disorder and the individual. Although the causes of most mental disorders are not fully understood, researchers have identified a variety of biological, psychological, and environmental factors that can contribute to the development or progression of mental disorders. Most mental disorders result in a combination of several different factors rather than just a single factor.

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

<span class="mw-page-title-main">Physical abuse</span> Medical condition

Physical abuse is any intentional act causing injury, trauma, bodily harm or other physical suffering to another person or animal by way of bodily contact. Physical abuse is a type of abuse that involves physical violence, such as hitting, kicking, pushing, biting, choking, throwing objects, and using weapons. Physical abuse also includes using restraints or confinement, such as tying someone up, locking them in a room, or restraining them with drugs or alcohol. Physical abuse can also include withholding basic needs, such as food, clothing, or medical care. In addition to the physical injuries caused by physical abuse, it can also lead to psychological trauma, such as fear, anxiety, depression, and post-traumatic stress disorder. Physical abuse can occur in any relationship, including those between family members, partners, and caregivers. It can also occur in institutional settings, such as nursing homes, schools, and prisons. Physical abuse can have long-term physical, psychological, and social consequences, and can even be fatal.

Psychological trauma is an emotional response caused by severe distressing events such as accidents, violence, sexual assault, terror, or sensory overload.

Complex post-traumatic stress disorder (CPTSD) is a stress-related mental disorder generally occurring in response to complex traumas, i.e. commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.

Emotion dysregulation is a range of emotional responses that do not lie within a desirable scope of emotive response, considering the stimuli.

Childhood trauma is often described as serious adverse childhood experiences (ACEs). 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, witnessing abuse of a sibling or parent, or having a mentally ill parent. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being such as unsocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Similarly, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.

Memory and trauma is the deleterious effects that physical or psychological trauma has on memory.

The effects of domestic violence on children have a tremendous impact on the well-being and developmental growth of children witnessing it. Children who witness domestic violence in the home often believe that they are to blame, live in a constant state of fear, and are 15 times more likely to be victims of child abuse. Close observation during an interaction can alert providers to the need for further investigation and intervention, such as dysfunctions in the physical, behavioral, emotional, and social areas of life, and can aid in early intervention and assistance for child victims.

Early childhood is a critical period in a child's life that includes ages from conception to five years old. Psychological stress is an inevitable part of life. Human beings can experience stress from an early age. Although stress is a factor for the average human being, it can be a positive or negative molding aspect in a young child's life.

Child neglect, often overlooked, is the most common form of child maltreatment. Most perpetrators of child abuse and neglect are the parents themselves. A total of 79.4% of the perpetrators of abused and neglected children are the parents of the victims, and of those 79.4% parents, 61% exclusively neglect their children. The physical, emotional, and cognitive developmental impacts from early childhood neglect can be detrimental, as the effects from the neglect can carry on into adulthood.

PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.

Neurological reparative therapy (NRT) is a new model of treatment synthesized from a compilation of literature and research on how to better the lives of individuals who have a wide range of mental, emotional, and behavioral disturbances – particularly children and adolescents. Although the term "neurological reparative therapy" is new, the foundation of this model is not.

<span class="mw-page-title-main">Transgenerational trauma</span> Psychological trauma

Transgenerational trauma is the psychological and physiological effects that the trauma experienced by people has on subsequent generations in that group. The primary modes of transmission are the uterine environment during pregnancy causing epigenetic changes in the developing embryo, and the shared family environment of the infant causing psychological, behavioral and social changes in the individual. The term intergenerational transmission refers to instances whereby the traumatic effects are passed down from the directly traumatized generation [F0] to their offspring [F1], and transgenerational transmission is when the offspring [F1] then pass the effects down to descendants who have not been exposed to the initial traumatic event - at least the grandchildren [F2] of the original sufferer for males, and their great-grandchildren [F3] for females.

The genetic influences of post-traumatic stress disorder (PTSD) are not understood well due to the limitations of any genetic study of mental illness; in that, it cannot be ethically induced in selected groups. Because of this, all studies must use naturally occurring groups with genetic similarities and differences, thus the amount of data is limited. Still, genetics play some role in the development of PTSD.

<span class="mw-page-title-main">Children in emergencies and conflicts</span>

Conflicts and emergencies around the world pose detrimental risks to the health, safety, and well-being of children. There are many different kinds of conflicts and emergencies, for example, violence, armed conflicts, war, natural disasters, etc. Approximately 13 million children are displaced by armed conflicts and violence around the world. Where violent conflicts are the norm, the lives of young children are significantly disrupted and their families have great difficulty in offering the sensitive and consistent care that young children need for their healthy development. One impact is the high rates of PTSD seen in children living with natural disasters or chronic conflict.

Adverse childhood experiences (ACEs) include childhood emotional, physical, or sexual abuse and household dysfunction during childhood. The categories are verbal abuse, physical abuse, contact sexual abuse, a battered mother, household substance abuse, household mental illness, incarcerated household members, and parental separation or divorce. The experiences chosen were based upon prior research that has shown to them to have significant negative health or social implications, and for which substantial efforts are being made in the public and private sector to reduce their frequency of occurrence. Scientific evidence is mounting that such adverse childhood experiences (ACEs) have a profound long-term effect on health. Research shows that exposure to abuse and to serious forms of family dysfunction in the childhood family environment are likely to activate the stress response, thus potentially disrupting the developing nervous, immune, and metabolic systems of children. ACEs are associated with lifelong physical and mental health problems that emerge in adolescence and persist into adulthood, including cardiovascular disease, chronic obstructive pulmonary disease, autoimmune diseases, substance abuse, and depression.

Out-of-home placements are an alternative form of care when children must be removed from their homes. Children who are placed out of the home differ in the types and severity of maltreatment experienced compared to children who remain in the home. One-half to two-thirds of youth have experienced a traumatic event leading to increased awareness and growing literature on the impact of trauma on youth. The most common reasons for out-of-home placements are due to physical or sexual abuse, violence, and neglect. Youth who are at risk in their own homes for abuse, neglect, or maltreatment, as well as youth with severe emotional and behavior issues, are placed out of the home with extended family and friends, foster care, or in residential facilities. Out-of-home placements aim to provide children with safety and stability. This temporary, safe environment allows youth to have their physical, mental, moral, and social needs met. However, these youth are in a vulnerable position for experiencing repeated abuse and neglect.

Being exposed to traumatic events such as war, violence, disasters, loss, injury or illness can cause trauma. Additionally, the most common diagnostic instruments such as the ICD-11 and the DSM-5 expand on this definition of trauma to include perceived threat to death, injury, or sexual violence to self or a loved one. Even after the situation has passed, the experience can bring up a sense of vulnerability, hopelessness, anger and fear.

The influence of childhood trauma on the development of psychopathy in adulthood remains an active research question. According to Hervey M. Cleckley, a psychopathic person is someone who is able to imitate a normal functioning person, while masking or concealing their lack of internal personality structure. This results in an internal disorder with recurrent deliberate and detrimental conduct. Despite presenting themselves as serious, bright, and charming, psychopathic people are unable to experience true emotions. Robert Hare's two factor model and Christopher Patrick's triarchic model have both been developed to better understand psychopathology; however, whether the root cause is primarily environmental or primarily genetic is still in question.

References

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