Every child faces adversity to a varying degree. The line between general adversity and trauma, however, is distinct, and many children have truly traumatic experiences with considerable repercussions. In a recently reviewed report from 2014, compiled by the U.S. Department of Health and Human Services, a national estimate set the number of substantiated cases of child maltreatment at 702,000, with 1,546 of those cases involving the death of the victim (U.S. Department of Health & Human Services 2016). The number of yearly cases fluctuates slightly but prevalence remains staggering, with yearly incidence in certain states having grown as much as 130.5% in the last several years, while other states have had a moderate decrease in yearly incidence. It is also important to keep in mind that many of the cases deemed unsubstantial may very well be cases of maltreatment. The reality of maltreatment can be subjective in terms of the victim’s perception of the perpetrator’s actions towards them (Gracia, 1995). Thus, the consequences of seemingly meager maltreatment cannot be generalized. Furthermore, the number of serious cases of abuse that remain completely unreported is likely high, although that’s difficult to ascertain for obvious reasons.
In the past, researchers have placed minimal emphasis on the study of sustained trauma in adults that have experienced childhood maltreatment, believing that children were too oblivious to be affected by early-life traumatic experiences (Zeanah & Zeanah, 2009). Over the last couple of decades, research concerning the mental health of young children has increased rapidly. Now, the long-term effects of childhood trauma are thoroughly documented and it appears that these early life experiences influence virtually every aspect of the developing child’s health (Buss, Warren & Horton, 2015). Due to the rapid developmental changes that occur during childhood, children are especially susceptible to trauma, with resounding effects that can span generations, let alone the rest of the child’s life (American Academy of Pediatrics 2012). It was shown that stress as the result of maltreatment can have cascading effects, wherein very frequent stress during childhood (‘toxic stress’) primes the child for life-long physiological agitation in the face of adversity, influencing many facets of both their mental and physical health. Exposure to maltreatment may even influence the methylation (attachment of methyl groups) of DNA, specifically methylation that decreases the expression of the BDNF (Brain-Derived-Neurotropic-Factor) gene in the prefrontal cortex; witnessed during a study on rats (Roth et al., 2009). The BDNF promotes the growth of new neurons and synapses, and sustains existing neurons. In this study, the change in BDNF expression that was observed persisted in the subsequent generation.
The following overview of the long-term effects of childhood adversity will be split into three categories: physical health, mental health and personality; the content will focus on categorized symptoms in adulthood that the individual is more likely to exhibit as a result of the maltreatment. The effects are usually multi-faceted therefore there will likely be considerable overlap throughout the categories. In order to be aware of the full range of effects associated with childhood adversity, and provide a bit of clarity, it is useful to examine past research in the form of these three categories.
Children who have experienced physical abuse are more likely to develop heart disease in adulthood (Springer et al., 2007; Dong et al., 2004; Shaw & Krause 2002;). Springer et al. (2007) also found that there was a higher incidence of hypertension among the physically abused. This study made an effort to eliminate the potentially confounding variable of family background; the effects still persisted. Goodwin et al. (2003) discovered a link between childhood physical abuse and chronic stomach problems, including ulcers. Even the development of autoimmune diseases (Dube et al., 2009), and lung cancer (Brown et al., 2010) were shown to be associated with early childhood trauma. In a 30-year longitudinal study (Widom et al., 2012) – that investigated the physical health of adults that had been abused or neglected as children – previously maltreated adults showed an increased risk for diabetes, lung disease, and problems with vision. They also generally had poor nutrition.
Adverse childhood experiences increase the likelihood of future drug abuse, including cigarette smoking and overindulgence in alcohol (Children’s Bureau, 2013), with serious adversity drastically increasing the likelihood of intravenous drug use during adulthood. Strine et al. (2012) also present the association between alcohol dependence and childhood trauma. In this study, women were shown to be more likely than men to develop this trauma induced dependence.
Countless studies have demonstrated the concrete link between psychological disorders and childhood trauma. Childhood adversity has been shown to influence the development of anxiety disorders, eating disorders, dissociative disorder, PTSD, stress-induced depression, substance abuse as a result of psychological distress, in addition to other psychological disorders (Buss, Warren & Horton, 2015; Goodman et al., 2012; Read & Bentall, 2012; DeYoung, Kenardy & Cobham, 2011; Kessler et al., 2010; Crusto et al., 2010; Heim et al., 2008; Springer et al., 2007). Moreover, there is a predictive relationship between childhood trauma and psychotic disorders. Adults who have experienced adversity in their youth are significantly more likely to develop a psychotic disorder (Varese et al., 2012). This vulnerability to psychosis is rooted in developmental disruptions that result from childhood trauma, in conjunction with maladaptive behaviors and the absence of social support (Read et al., 2014). Victims of serious childhood trauma are characterized by abnormal neural structures including but not limited to an excessively stimulated hypothalamic-adrenal-pituitary axis, and disrupted dopaminergic and serotonergic systems (Read et al., 2014). In all psychotic disorders there appears an element of heightened stress sensitivity that was touched on previously. This disadvantage biases the victim’s behavior towards the maladaptive, and if these behaviors aren’t corrected, their cumulative effects may result in serious illness (Nurius et al., 2015; American Academy of Pediatrics 2012).
When evaluating personality, the Big Five has been very useful for hierarchically categorizing subsuming personality traits (facets) within broader personality domains (DeYoung, Peterson & Quilty, 2007). The Big Five is composed of five main domains: openness/intellect, conscientiousness, extraversion, agreeableness, and neuroticism. Each of these domains is made up of more specific traits, and after evaluating an individual using a Big-Five inventory, the presence or absence of these traits determines whether the individual’s personality can be marked by high or low levels of the corresponding domain (ex. “high neuroticism”, or “low neuroticism”).
Personality can be defined as a set of characteristics that determine how a person is likely to react in a given situation. It is a rather vague and all encompassing term for a person’s patterns of thought, and behavior. Personality is a complex trait, greatly influenced by genetics (Serretti et al., 2007; Pilia et al., 2006) in terms of neurophysiological changes that make a child more likely to adopt certain behaviors, as well as environmental (Torgersen & Janson 2002) stressors that coerce the child towards an appropriate or maladaptive developmental course. There is evidence to suggest personality continues to change in adulthood (Roberts & Mroczek 2008), therefore, a child that has experienced maltreatment has the potential to remedy maladaptive behaviors that they reactively adopted in the face of adversity.
There have been relatively few studies examining the relationship between childhood trauma and personality from a Big Five perspective. The association between childhood trauma and maladaptive personality traits has been established (Carvalho et al., 2015), but it requires further study. The presence of depression (as well as its severity) was found to be significantly associated with domains of the Big-Five, specifically higher neuroticism, and lower extraversion and conscientiousness (Koorevaar et al. 2013). Those individuals that were higher in openness were also shown to have an earlier onset of depression. In addition, there is evidence for a strong relation between anxiety disorders and personality (Brandes & Bienvenu, 2006).
Personality traits such as an internal locus of control have been shown to dramatically increase resilience to adversity (Gunby, 2002). Locus of control refers to the origin of a person’s influence within their environment. An internal locus is adaptive, and is generally characterized by a feeling of control and influence, while an external locus is maladaptive and is characterized by feelings of helplessness (sense of being controlled by external forces). The adoption of adaptive personality traits is critical for combating the cascading effects of trauma. A nurturing environment can effectively insulate a child from future anguish resulting from unaddressed patterns of maladaptive behavior (Turner et al. 2012).
A dysfunctional family dynamic makes a child more likely to be exposed to traumatic events. A child that has been traumatized and is in poor socio-demographic standing is at greater risk of developing a serious illness (Briggs-Gowan et al., 2011). The relationship between the child and their guardian is of major importance: poor parenting only aggravates the effects of trauma (Turner et al. 2012). Furthermore, the way that the parent responds to stress has been shown to influence the coping mechanism that the child adopts, and if the parent tends to respond in a maladaptive fashion, the child is likely to be less resilient to adversity. Finkelhor & Browne (1985) introduced a model consisting of four trauma-causing factors (specifically in sexual abuse, although they occur in other forms of abuse). The factors relate to a feeling of powerlessness (external locus of control) as well as betrayal (neglect/lack of support). This distorted outlook is the primary downfall of a traumatized child, and it needs to be remedied. Further research is required on the topic.
By: Arseni Sitartchouk