Childhood trauma: Difference between revisions

Traumatic experiences during childhood causes stress that increases an individual's [[Allostatic load#cite note-1|allostatic load]] and thus affects the [[immune system]], [[nervous system]], and [[endocrine system]].<ref name="Brown et al 2010">{{cite journal | vauthors = Brown DW, Anda RF, Felitti VJ, Edwards VJ, Malarcher AM, Croft JB, Giles WH | title = Adverse childhood experiences are associated with the risk of lung cancer: a prospective cohort study | journal = BMC Public Health | volume = 10 | pages = 20 | date = January 2010 | pmid = 20085623 | pmc = 2826284 | doi = 10.1186/1471-2458-10-20 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Dube SR, Fairweather D, Pearson WS, Felitti VJ, Anda RF, Croft JB | title = Cumulative childhood stress and autoimmune diseases in adults | journal = Psychosomatic Medicine | volume = 71 | issue = 2 | pages = 243–50 | date = February 2009 | pmid = 19188532 | pmc = 3318917 | doi = 10.1097/PSY.0b013e3181907888 }}</ref><ref name="Taylor et al 2004">{{cite journal | vauthors = Taylor SE, Lerner JS, Sage RM, Lehman BJ, Seeman TE | title = Early environment, emotions, responses to stress, and health | journal = Journal of Personality | volume = 72 | issue = 6 | pages = 1365–93 | date = December 2004 | pmid = 15509286 | doi = 10.1111/j.1467-6494.2004.00300.x | citeseerx = 10.1.1.324.5195 }}</ref><ref name=":14">{{cite journal | vauthors = Motzer SA, Hertig V | title = Stress, stress response, and health | journal = The Nursing Clinics of North America | volume = 39 | issue = 1 | pages = 1–17 | date = March 2004 | pmid = 15062724 | doi = 10.1016/j.cnur.2003.11.001 }}</ref> Exposure to chronic stress triples or quadruples the vulnerability to adverse medical outcomes.<ref>{{Cite journal|last1=Miller|first1=Gregory E.|last2=Chen|first2=Edith|last3=Zhou|first3=Eric S.|date=2007|title=If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans|url=https://pubmed.ncbi.nlm.nih.gov/17201569|journal=Psychological Bulletin|volume=133|issue=1|pages=25–45|doi=10.1037/0033-2909.133.1.25|issn=0033-2909|pmid=17201569}}</ref> Childhood trauma is often associated with adverse health outcomes including [[Depression (mood)|depression]], [[hypertension]], [[autoimmune disease]]s, [[lung cancer]], and premature mortality.<ref name="Brown et al 2010"/><ref name="Taylor et al 2004"/><ref>{{cite journal | vauthors = Chapman DP, Whitfield CL, Felitti VJ, Dube SR, Edwards VJ, Anda RF | title = Adverse childhood experiences and the risk of depressive disorders in adulthood | journal = Journal of Affective Disorders | volume = 82 | issue = 2 | pages = 217–25 | date = October 2004 | pmid = 15488250 | doi = 10.1016/j.jad.2003.12.013 | s2cid = 20750042 }}</ref><ref>{{cite journal | vauthors = Murphy MO, Cohn DM, Loria AS | title = Developmental origins of cardiovascular disease: Impact of early life stress in humans and rodents | journal = Neuroscience and Biobehavioral Reviews | volume = 74 | issue = Pt B | pages = 453–465 | date = March 2017 | pmid = 27450581 | pmc = 5250589 | doi = 10.1016/j.neubiorev.2016.07.018 }}</ref>

Effects of childhood trauma on [[Neural development#Overview of brain development|brain development]] includes a negative impact on [[Emotional self-regulation|emotional regulation]] and impairment of development of [[social skills]].<ref name="Taylor et al 2004" /> 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.<ref name="Taylor et al 2004" /><ref name="Aron_2005">{{cite journal | vauthors = Aron EN, Aron A, Davies KM | title = Adult shyness: the interaction of temperamental sensitivity and an adverse childhood environment | journal = Personality & Social Psychology Bulletin | volume = 31 | issue = 2 | pages = 181–97 | date = February 2005 | pmid = 15619591 | doi = 10.1177/0146167204271419 | s2cid = 1679620 }}</ref><ref>{{cite journal | vauthors = Norman RE, Byambaa M, De R, Butchart A, Scott J, Vos T | title = The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis | journal = PLOS Medicine | volume = 9 | issue = 11 | pages = e1001349 | date = 2012 | pmid = 23209385 | pmc = 3507962 | doi = 10.1371/journal.pmed.1001349 | doi-access = free }}</ref> Recent research has found that physical and sexual abuse are associated with [[Mood disorder|mood]] and [[anxiety disorder]]s in adulthood, while [[personality disorder]]s and [[schizophrenia]] are linked with emotional abuse as adults.<ref>{{cite journal | vauthors = Sachs-Ericsson NJ, Sheffler JL, Stanley IH, Piazza JR, Preacher KJ | title = When Emotional Pain Becomes Physical: Adverse Childhood Experiences, Pain, and the Role of Mood and Anxiety Disorders | journal = Journal of Clinical Psychology | volume = 73 | issue = 10 | pages = 1403–1428 | date = October 2017 | pmid = 28328011 | pmc = 6098699 | doi = 10.1002/jclp.22444 }}</ref><ref>{{cite journal | vauthors = Carr CP, Martins CM, Stingel AM, Lemgruber VB, Juruena MF | title = The role of early life stress in adult psychiatric disorders: a systematic review according to childhood trauma subtypes | journal = The Journal of Nervous and Mental Disease | volume = 201 | issue = 12 | pages = 1007–20 | date = December 2013 | pmid = 24284634 | doi = 10.1097/NMD.0000000000000049 | s2cid = 205878806 }}</ref> In addition, research has proposed that mental health outcomes from childhood trauma may be better understood through a dimensional framework (internalizing and externalizing) as opposed to specific disorders.<ref>{{Cite journal|last1=Curran|first1=Emma|last2=Adamson|first2=Gary|last3=Rosato|first3=Michael|last4=De Cock|first4=Paul|last5=Leavey|first5=Gerard|date=2018-05-03|title=Profiles of childhood trauma and psychopathology: US National Epidemiologic Survey|url=https://pure.ulster.ac.uk/en/publications/851a2032-16ff-4371-95d5-173e69d0c4d7|journal=Social Psychiatry and Psychiatric Epidemiology|volume=53|issue=11|pages=1207–1219|doi=10.1007/s00127-018-1525-y|pmid=29725700|s2cid=20881161|issn=0933-7954}}</ref>

As an adult feelings of anxiety, worry, shame, guilt, helplessness, hopelessness, grief, sadness and anger that started with a trauma in childhood can continue. In addition, those who endure trauma as a child are more likely to encounter anxiety, depression, suicide and self harm, PTSD, drug and alcohol misuse and relationship difficulties.<ref name=":8">{{cite web|title=Effects of Childhood Trauma on Adults|url=http://www.istss.org/public-resources/what-is-childhood-trauma/effects-of-childhood-trauma.aspx|access-date=February 17, 2019|website=International Society for Traumatic Stress Studies}}</ref> The effects of childhood trauma don't end with just emotional repercussions. Survivors of childhood trauma are also at higher risk of developing asthma, coronary heart disease, diabetes or having a stroke. They are also more likely to develop a "heightened stress response" which can make it difficult for them to regulate their emotions, lead to sleep difficulties, lower immune function, and increase the risk of a number of physical illnesses throughout adulthood.<ref name=":8" />

These changes could result in enduring alterations of the stress response as well as the physical health risk.<ref name="Ramo-Fernández et al 2015" /> Furthermore, the effects of parental trauma could be transmitted to the next generation by parental distress and the pre- and postnatal environment, as well as by epigenetic marks transmitted via the germline.<ref name=":0" /> 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.<ref name="Ramo-Fernández et al 2015"/>