The Impact and Long Term Effects of Childhood Trauma

By Heather Dye. Journal of Human Behavior in the Social Environment. 2018; Vol.28; No 3, 381–392

This article discusses the long-term consequences of early childhood trauma. Early childhood trauma can cause significant changes in the structure of the maturing brain as well as neurobiological and psychological changes that impact a child’s development. Childhood trauma is associated with physical, mental, and emotional symptoms that carry into their adult lives.

Trauma is defined as an experience that threatens injury and/or death and causes feelings of terror, fear, and helplessness (American Psychiatric Association). It can be a single event (acute) or multiple events over a period of time (chronic) as occurs in cases of child abuse or domestic violence. Examples of traumatic experiences include any type of physical or sexual abuse, domestic violence, accidents, disasters, war, etc. Adults who had traumatic experiences in childhood tend to have higher rates of physical and psychological problems such as ADHD, depression, anxiety, and personality disorders. Many qualify for a diagnosis of Post Traumatic Stress Syndrome (PTSD), which includes four symptom clusters. These PTSD clusters are (1) Heightened Arousal such as hyper alertness, hyperactivity, difficulty in emotional regulation; 2) Negative alterations in cognition and mood such as depression or anxiety; 3) Re-experiencing symptoms such as flashbacks or bad dreams; and 4) Avoidance of experiences that trigger the memories about the traumatic event.

Complex Trauma is the exposure to multiple or chronic and prolonged adverse traumatic events. These traumatic events interfere with normal cognitive and social-emotional development and often occur within the child’s caregiving system such as occurs with child maltreatment or domestic violence. Complex trauma can cause problems with dissociation, emotional regulation, interpersonal attachment, and behavior control issues. In later years, early complex trauma is associated with substance abuse, suicidality, and emotional and interpersonal dysregulation. Stressful life experiences can also contribute to an increase in chronic diseases such as hypertension and heart disease or obesity or diabetes (especially if the child learns to self-soothe by eating).

Exposure to trauma during the childhood years interrupts the developmental process and leaves the individual with lifelong medical and psychological deficiencies. It can lead to learned behaviors such as self-helplessness, exaggerated emotional distress, and problems with attachment. When a child experiences relationships that are uncaring, rejecting, or unsafe, then these experiences alter the child’s perception of self, trust in others, and perception of the world being an unsafe place.

These traumatic experiences cause neurobiological changes in the development of brain circuitry and hormonal systems that regulate stress. These changes can affect memory, impair information processing systems, and alter the hormone balance so the child has a higher level of stress hormones, which in turn cause hyper alertness and reactivity. The brain structures responsible for regulating intense emotions are deactivated, so the child has less control of their emotional reactions. Therefore, they may react to a normal situation as if they are under extreme threat.

Psychiatric problems are common among survivors of trauma. These problems may include substance abuse, depression, PTSD, mood disorders, anxiety disorders, self-injurious behaviors, aggression, criminal behaviors, attachment disorders, conduct disorders, and a higher risk of suicidal behaviors. Because of the developmental growth that is occurring in early childhood, children exposed to trauma may suffer from developmental delays in the areas of emotional regulation, social behaviors, and cognitive ability.

It can be very difficult to correctly diagnose PTSD because there are many dual diagnoses. Other diagnoses that reflect various symptoms of PTSD are Borderline Personality Disorder, Depressive Disorders, Anxiety Disorders, Bipolar Disorder, etc. When diagnosing young children who do not have the language to describe their traumatic experiences or the experience to understand that their traumatic experiences are not normal, it is difficult to tease out the symptoms of PTSD. Often children who have experienced trauma are diagnosed as having Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), or Separation Anxiety Disorder. Their symptoms may include hypervigilance, hyperarousal, aggression, anxiety or withdrawal, etc. Therefore it is important to understand that a child’s developmental stage, cognitive level, verbal skills, perception, and interpretation of any traumatic events will differ greatly from an adult’s.