Consequences of Child Abuse and Neglect The consequences of maltreatment can be devastating.
Synopsis Trauma in childhood is a grave psychosocial, medical, and public policy problem that has serious consequences for its victims and for society. Chronic interpersonal violence in children is common worldwide. Developmental traumatology, the systemic investigation of the psychiatric and psychobiological effects of chronic overwhelming stress on the developing child, provides a framework and principles when empirically examining the neurobiological effects of pediatric trauma.
This article focuses primarily on the peer-reviewed literature on the neurobiological sequelae of childhood trauma in children and adults with histories of childhood trauma.
We also review relevant studies of animal models of stress to help us better understand the psychobiological effects of trauma during development. Next, we review the neurobiology of trauma, its clinical applications and the biomarkers that may provide important tools for clinicians and researchers, both as predictors of posttraumatic stress symptoms and as useful tools to monitor treatment response.
Finally, we offer suggestions for future researchers. Childhood trauma, developmental traumatology, developmental psychopathology, posttraumatic stress symptoms, stress, biological stress systems, brain development, genes, polymorphisms, epigenetics, cortisol III.
Introduction Trauma in childhood has serious consequences for its victims and for society. For the purposes of this critical review, childhood trauma is defined according to the Diagnostic and Statistical Manual of Mental Disorders IV and V as exposure to actual or threatened death, serious injury, or sexual violence [ 12 ].
This includes experiences of direct trauma exposure, witnessing trauma or learning about trauma that happened to a close friend or relative. In children, motor vehicle accidents, bullying, terrorism, exposure to war, child maltreatment physical, sexual, and emotional abuse; neglect and exposure to domestic and community violence are common types of childhood traumas that result in distress, posttraumatic stress disorder PTSDand posttraumatic stress symptoms PTSS.
Childhood traumas, particularly those that are interpersonal, intentional, and chronic are associated with greater rates of PTSD [ 3 ], PTSS [ 45 ], depression [ 6 ] and anxiety [ 7 ], antisocial behaviors [ 8 ] and greater risk for alcohol and substance use disorders [ 9 - 12 ].
The traditional categorical cluster of symptoms that form the diagnosis of PTSD are each associated with differences in biological stress symptoms and brain structure and function; and are thought to individually contribute to delays in or deficits of multisystem developmental achievements in behavioral, cognitive and emotional regulation in traumatized children and lead to PTSS and co-morbidity [ 13 ].
Thus, we examine PTSD as a dimensional diagnosis encompassing a range of pathological reactions to severe stress, rather than as a dichotomous variable. Developmental traumatology, the systemic investigation of the psychiatric and psychobiological effects of chronic overwhelming stress on the developing child, provides the framework used in this critical review of the biological effects of pediatric trauma.
These three clusters are Criterion B: This makes both the psychotherapeutic and the psychopharmacological treatment of individuals with early trauma complex and challenging. For example, Cluster B reexperiencing and intrusive symptoms can best be conceptualized as a classically conditioned response that is mediated by the serotonin system and is similar in some ways to the recurrent intrusive thoughts experienced in obsessive compulsive disorder, where serotonin and norepinephrine transmitter deficits play an important role [ 16 ].
An external or internal conditioned stimulus e. However, other Criterion B symptoms, such as nightmares or night terrors, may involve the dysregulation of multiple neurotransmitter systems serotonin, norepinephrine, dopamine, choline, gamma-amino butyric acid GABA [ 17 ].
Criterion C symptoms represent both avoidant behaviors and negative alterations in cognitions. Avoidant behaviors can be thought of as ways to control painful and distressing reexperiencing of symptoms. These symptoms are likely associated with the dopamine system and overactivation of the opioid system and associated with anhedonia and numbing of responses [ 18 ].
In the DSM-IV the former Criterion D persistent symptoms of increased physiological arousal and reactivity is now Criterion E, and likely involves dysregulation of several biological stress systems [ 1319 ] as discussed in further detail below. These differences are likely the causes of the greater rates of psychopathology PTSD, depression, disruptive behaviors, suicidality, substance use disorders and of the common medical disorders cardiovascular disease, obesity, chronic pain syndromes, gastrointestinal disorders, immune dysregulation seen in child victims [ 20 ].
Throughout, we will associate the relationship to biological stress systems and common stress symptoms. Exposure to a traumatic event or series of chronic traumatic events e. Stress activation has behavioral and emotional effects that are similar to individual PTSS symptoms [ 24 ].
Cortisol levels become elevated through transmission of fear signals to neurons in the prefrontal cortex, hypothalamus, and hippocampus, and activity increases in the locus coeruleus and sympathetic nervous system. Subsequent changes in, catecholamine levels contribute to changes in heart rate, metabolic rate, blood pressure, and alertness [ 19 ].
This process also leads to the activation of other biological stress systems. In the review of the pertinent literature section, we will review the main biological stress response systems.
Experiencing trauma during development along with dysregulation of biological stress systems can adversely impact childhood brain development [ 13 ] and we will discuss brain imaging studies in children who experienced trauma and adults with trauma histories.
Recently, the field of neuroscience has become increasingly aware of gender as an important moderator of experience, so throughout, we review peer reviewed publications that highlight gender differences, if available.
Since longitudinal psychobiological research in pediatric trauma is a severely understudied area, most of our review will be based on cross-sectional studies. We will review the clinical applications of this knowledge and discuss how stress related biomarkers may provide important tools for clinicians and researchers to objectively examine predictors of PTSS and to monitor treatment response.
We then offer suggestions for future directions.
Trauma studies involving physical head trauma or medical illnesses were not included. Our criteria were that the articles be peer-reviewed and methodologically sound, with emphasis placed on the paucity of longitudinal studies in this field.Jun 05, · Childhood emotional and sexual abuse mark women’s brains in distinct patterns — with emotional abuse affecting regions involved in self-awareness and sexual abuse affecting areas involved in genital sensation, according to new research.
Cortical thickness is linked to brain development, with thicker regions generally. Impaired brain development. Child abuse and neglect have been shown, in some cases, to cause important regions of the brain to fail to form or grow properly, resulting in impaired development.
effects of maltreatment and household dysfunction during childhood, including: psychological, physical and sexual abuse; violence against the mother.
Effects of Child Sexual Abuse on Children. cognitive and psychological effects. Substance abuse, eating disorders and low self-esteem can occur as a result of child sexual abuse.
Because of the possible devastating effects of child sexual abuse, sexually abused children and their families need immediate professional evaluation and. PSYCHOLOGICAL EFFECTS ON CHILDREN AND ADOLESCENTS symptoms which are very similar to those of childhood sexual abuse, trauma influences brain development and .
typical brain development and the potential effects of abuse and neglect on that development. The information is designed to help professionals understand the emotional, mental, and behavioral impact of early abuse and neglect in children who come to the attention of the child welfare system.
By the time children are 2 years old, their. Psychological Effects of Abuse How child abuse and neglect damage the brain. By Josh Kendall, Globe Correspondent, 9/24/ The new neuroscientific findings have upended the deterministic view that brain development is essentially over by age 3.
Although the most rapid period of brain growth occurs during early childhood, the brain.