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  3. The Impact of Early Life Trauma on Health and Disease
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Book description

There is now ample evidence from the preclinical and clinical fields that early life trauma has both dramatic and long-lasting effects on neurobiological systems and functions that are involved in different forms of psychopathology as well as on health in general. To date, a comprehensive review of the recent research on the effects of early and later life trauma is lacking. This book fills an obvious gap in academic and clinical literature by providing reviews which summarize and synthesize these findings. Topics considered and discussed include the possible biological and neuropsychological effects of trauma at different epochs and their effect on health. This book will be essential reading for psychiatrists, clinical psychologists, mental health professionals, social workers, pediatricians and specialists in child development.

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' … 'The topic of this book is important and the information presented is timely and extensive …'

Source: The Journal of Psychological Medicine

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Contents

Page 1 of 2

Contents
  • Part 2 - Synopsis
    pp 88-92
  • View abstract

    Summary

    References to childhood trauma from Ambroise Tardieu's early work focused on physical abuse in the mid 1800s. This chapter outlines the history of child abuse and neglect in the medical and mental health fields. The literature, which refocused attention on the importance of childhood trauma and set the trajectory for a greater appreciation and acceptance of childhood adversity in health and mental health problems, was dominated by accounts of physical abuse. The focus on early sexual abuse gave way to a greater and broader investment in the role of various forms of childhood trauma, abuse and neglect in adverse effects on psychological and physical development, as well as on health and mental health functioning. The ability to accept such a proposition rests in part on accepting that one of the single most pathogenic factors in the causation of mental illness, and some physical health problems, is humans themselves.
  • Chapter 10 - Lateral asymmetries in infants’ regulatory and communicative gestures
    pp 103-111
  • View abstract

    Summary

    This chapter describes the prevalence of early childhood trauma in the general population of the USA using data from the National Comorbidity Study-Replication (NCS-R). It discusses some of the methodological issues around assessing the prevalence of childhood trauma, focusing on estimates of child maltreatment as a specific example. The chapter explains the risk factors for childhood trauma. The prevalence of exposure to any traumatic event, to any other injury or shocking experience and for most specific event types did not significantly differ by race. Factors associated with greater risk of childhood trauma occur at the individual, family, neighborhood, local, regional and national level; the bulk of research focuses on individual and family factors. Individual factors associated with risk of childhood trauma include demographic descriptors such as sex, age and race/ethnicity, as well as health and behavioral characteristics, including mental health, substance use, sexuality and prior traumatization.
  • Chapter 11 - Neurobiology of childhood trauma and adversity
    pp 112-122
  • View abstract

    Summary

    This chapter explains why the loss and recovery of trauma memory is considered to be controversial. It also explores the historical themes that maintain or exacerbate the controversy. Consensus papers have appeared in scientific journals, at times written jointly by clinical researchers and non-clinical cognitive researchers. The chapter emphasizes that extremity is obviously in the eye of the beholder and details a few of the historical sources of the zealotry. The acrimony that has fueled the debate on recovered memory has abated in most arenas, clearing the way for scientific research that has clearly established the reality of the phenomena of both false memory (FM) and accurate recovered memory. Further work will benefit from a clearer distinction between the study of phenomena (both recovered and FM) and their mechanisms (suggestion, repression, and dissociation), and direct and forthright debate about the nature and weight of types of evidence.
  • Chapter 12 - Theneurobiology of child neglect
    pp 123-132
  • View abstract

    Summary

    This chapter explores the effects of early adverse experiences by reporting on long-term outcomes of childhood trauma. It focuses on physical abuse by the child's parent. The chapter covers a more psychologically severe form of abuse: attacks by someone from whom the dependent child expects protection and caring. It compares the outcomes at 30 years of abused children with the non-abused children. Three protective factors interrupted the perpetuating abuse by the mothers: childhood emotional support from an alternative adult, psychotherapy for at least 6 months or a contemporary adult supportive and satisfying relationship. Abuse may involve a parent incompetent at caregiving, or too troubled to provide protective and sensitive childrearing. Its symptomatic effects vary with developmental age, but, invariably, abuse diminishes the more optimal possibilities of the child well into adulthood.
  • Part 3 - Synopsis
    pp 142-147
  • View abstract

    Summary

    This chapter focuses on the immediate outcomes of unresponsive early care during infancy, including the development of non-optimal physiological stress reactions and disorganized attachment behavior. It reviews the recent research pointing to interaction between caregiving environment and gene expression in the dopaminergic and serotonergic systems, as these effects relate to maladaptation in childhood and psychiatric morbidity in adulthood. Research using animal and human models has identified associations between characteristics of the early caregiving environment and infant physiological responsiveness to stressors. Disorganized attachment patterns in infancy have been associated with childhood onset of aggressive behavior problems and with psychopathology in young adulthood. Inadequate early care is an important risk factor in human development for multiple later psychopathologies. The chapter proposes that the risk for both physiological and behavioral dysregulation as a result of poor early care in infancy constitutes a hidden trauma.
  • Chapter 15 - Theneuroendocrine effects of early life trauma
    pp 157-165
  • View abstract

    Summary

    This chapter delineates the developmental trauma disorder (DTD) diagnosis proposed by the National Child Traumatic Stress DSM-V Taskforce. The numerous clinical expressions of the damage resulting from childhood interpersonal trauma are currently relegated to a whole variety of seemingly unrelated comorbidities, such as conduct disorder, attention-deficit hyperactivity disorder (ADHD) and separation anxiety. The chapter discusses the effects of childhood interpersonal trauma on brain activity, self-awareness and social functioning. Several large-sample studies have examined the causal relationship between childhood interpersonal trauma and DTD symptoms. These studies have documented the correlations of age of first trauma exposure, trauma severity and duration of exposure with DTD symptoms. Contemporary neuroscience research suggests that effective treatment needs to involve learning to modulate arousal, learning to tolerate feelings and sensations by increasing the capacity for interoception and learning that, after confrontation with physical helplessness, it is essential to engage in taking effective action.
  • Chapter 16 - Long-lasting effects of childhood abuse on neurobiology
    pp 166-177
  • View abstract

    Summary

    This chapter focuses on the sequelae in adulthood of traumatic victimization experienced in early childhood (that is, infancy, toddlerhood, and early school years). Adult survivors of early childhood traumatic victimization are at risk for post-traumatic stress disorder (PTSD), and for heightened anxiety, depression and suicidality, addiction, personality disorders, antisocial or violent behavior, serious mental illness and sexual disorders. Several methodological limitations suggest caution in interpreting the findings from studies on the effects of childhood traumatic victimization on adult functioning and health. The impact of psychological trauma and the etiology and course of post-traumatic disorders differ for males and females in several respects, such that gender may moderate the adverse effects of early life psychological trauma. Minority ethno-racial background is consistently associated with increased risk of childhood psychological trauma, including loss, domestic violence and sexual abuse.
  • Chapter 17 - Biological framework for traumatic dissociation related to early life trauma
    pp 178-188
  • View abstract

    Summary

    This chapter examines the relationship between traumatic stress in childhood and the leading causes of morbidity, mortality and disability in the USA: cardiovascular disease, chronic lung disease, chronic liver disease, depression and other forms of mental illness, obesity, smoking and alcohol and drug abuse. The essence of the Adverse Childhood Experiences (ACE) Study has been to match retrospectively, approximately a half century after the fact, an individual's current state of health and well-being against adverse events in childhood. The chapter illustrates with a sampling from the findings in the ACE Study, the long-lasting, strongly proportionate and often profound relationship between adverse childhood experiences and important categories of emotional state, health risks, disease burden, sexual behavior, disability, and healthcare costs. Biomedical disease in adults had a significant relationship to adverse life experiences in childhood in the ACE Study.

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