Long Term Effects of Childhood Trauma

Molded From Youth

The first step of throwing clay on a pottery wheel is centering. Centering is fundamental in creating a functional piece, as it ensures even thickness and height throughout the artwork. Without proper centering, the shape of the clay piece will collapse. Once the clay is centered, the artist uses their fingers to manipulate the clay. Each squeeze, pull, and pinch transforms the soft material from a lifeless ball into a basic form. By the end of the process the clay becomes a fully functional ceramic piece but a successful final piece is entirely contingent upon proper centering.

Similar to how centering creates a foundation in pottery, childhood creates a foundation for adulthood. Just as an artist's fingers shape ceramics, subjective experiences shape individuals’ brains. For this reason, childhood trauma has a great impact on survivor’s lives. If trauma is left unresolved, it can manifest throughout one’s lifetime and result in neurological and physiological issues. Childhood trauma slowly infiltrates almost every aspect of a survivor's life, leading to several long-term effects on the brain and body. 

Prevalence

Before assessing the effects of trauma, it’s important to understand what experiences constitute trauma and the prevalence of these experiences among American youth. This article will address recurring interpersonal trauma specifically within the home. Interpersonal trauma includes psychological, physical, and sexual abuse as well as caregiver substance abuse, mental illness, violence towards mothers, and criminal behavior. Oftentimes, the prevalence of such experiences is underestimated. A common misconception of childhood trauma may be that it exclusively affects individuals from low socioeconomic status. The “The Adverse Childhood Experiences (ACE) Study” study is one of the most highly regarded trauma studies and found high prevalence for these experiences. Of the 13,494 American adults surveyed, many of which had a moderate-high socioeconomic background, 52% reported at least one adverse childhood experience [1]. Of all the categories, substance abuse was the most prevalent, with 25% of participants reporting a caretaker with substance abuse issues. 22% of participants had experienced sexual abuse: the second most common category [1]. Another study found that 14.2% of men and 32.3% of woman had experienced some form of sexual abuse as children [2]. In 2002, 896,000 children had experienced abuse or neglect [2]. The conclusion is clear: childhood trauma includes a variety of adverse experiences that many American children encounter.  

The Brain’s Role

The ramifications of childhood trauma begin internally, hindering both brain function and development. First, trauma takes a toll on the body's fear response一an automatic survival mechanism. When someone is in the presence of serious danger, their body’s fear response system takes over [2]. The fear response originates in two brain regions: the brainstem and limbic system. Some scientists refer to the brainstem as the “primal brain.” The brainstem is responsible for basic physiological processes, such as heart rate and breathing [3]. Meanwhile, the limbic system can be referred to as the “emotional brain” where arousal, memory, and pain are processed [3]. One of the most relevant functions of the limbic system is the ability to detect danger and elicit the feeling of fear [3]. When faced with a threat, the brainstem and limbic system work together to trigger the body's fear response, formally called the sympathetic nervous system (SNS) [4]. The activation of the SNS is synonymous with the activation of the “fight or flight” response, where the stress hormones cortisol and adrenaline are released into the bloodstream [4]. These hormones result in increased heart rate, breathing, and blood pressure [4], which prepare the body to react to the perceived threat. Once the individual no longer senses a threat, their body is brought back to homeostasis [4]. Traumatic experiences that occur within the home force individuals to habitually experience adversity, which leads to repeated activation of the SNS. Frequent activation of the SNS means the brain and body are constantly operating in survival mode and results in a dysregulation of the nervous system [4]. 

Children are especially vulnerable to the effects of trauma because their brains are undergoing rapid development. Research shows that brain mass triples within the first two years of life [5]. In addition, proper brain development relies heavily on a child’s environment [4]. Overactivation of the SNS, as a result of one’s traumatic experiences, leads to irregular brain development [2]. Specifically, stress caused by persistent SNS activation can result in loss of neurons, difficulty in the production of new neurons and a decrease in brain growth factors [2]. Furthermore, research has shown that the more neurons are used, the stronger the connections are between them. [3]. This means that if a child’s brain is constantly managing fear and anxiety the neural connections responsible for regulating those feelings will be strengthened [3]. At the same time, connections that develop skills like exploration are oftentimes neglected when children are exposed to traumatic experiences [3].  

Although the SNS is meant to be lifesaving, repeated activation of the SNS is harmful and inflicts toxic stress on the brain and body [6]. Toxic stress is consistent activation of the SNS, which results in the body’s inability to return to homeostasis even in the absence of the stressful situation that began activation  [7].  As a result, toxic stress disrupts everyday bodily regulation. For example, prolonged release of a stress hormone called cortisol in high amounts over time prevents human growth and inhibits immune and inflammatory responses: two physiological functions meant to heal the body or prevent illness [8]. Toxic stress also disrupts communication between two brain areas involved in decision making: the limbic system and prefrontal cortex [2]. These areas work together balancing decision making between logic and emotions [9]. The prefrontal cortex is involved in planning [9], allowing individuals to consider hypothetical scenarios before making a decision [9]. Toxic stress decreases functionality of the prefrontal cortex, [2] making it more difficult for individuals to think clearly when making decisions [9]. 

Neural activity has also been studied as it relates to childhood trauma. Positive experiences during childhood have been correlated with increased overall synaptic connections or connections between brain cells [5]. In contrast, early adverse experiences have been correlated with a reduction in these connections [5]. This is important because neural connections are what allow an individual to function day to day and are a sign of learning. Additionally, there is evidence indicating that childhood trauma impacts memory regulation and  the hippocampus, the region of the brain involved with memory formation. Consequently, memories are either overrepresented through nightmares or intrusive thoughts, or they are completely suppressed [10].  

Effects in Childhood

All of these biological disruptions translate into emotional and behavioral issues for children who have experienced trauma [11]. Survivors of childhood trauma often become hypervigilant and overly sensitive to any perceived potential threats [3]. This leads to an inability to properly identify a threat and results in extreme responses to generally non-threatening situations [3]. Two behavioral adaptations can be observed in children who have experienced trauma within the home: fighting or freezing [12]. An example of fighting would be a child attacking their instructors, or throwing tantrums in inappropriate settings. Children who freeze lack a reaction when in the presence of a perceived threat [13]. They tend to feel overwhelmed when frozen and both their brain and body are put on pause[13]. Constant arousal of the nervous system further manifests into physiological issues [14]. Symptoms can include sleep disturbances, headaches, and unexplained pain. As a way to cope and distract themselves, many children develop maladaptive behaviors, such as hair pulling, skin picking, or chronic rocking [14]. Further, trauma has been shown to be a risk factor for childhood asthma and obesity [15,16,17]. Data show that trauma has a considerable impact on academic achievement; children with traumatic history are more likely to be placed in special education programs and have lower grades, test scores, and attendance [11]. One study found that as exposure to trauma increases, so do academic hardships, attendance problems, and school behavior difficulties, even when controlling for race, gender and grade level [18]. If victims of childhood abuse are not identified or supported, the repercussions of their traumatic experiences follow them into adulthood [19]. 

Effects in Adulthood

Trauma continues to be detrimental to survivors through adulthood. Similar to childhood trauma, survivors are at risk for developing disorders in adulthood. Evidence has shown an increased risk of depression, anxiety disorders, and psychosis—a mental condition in which an individual’s thoughts and emotions are disconnected from reality [20]. In addition to these mental struggles, past research has shown that there is a positive correlation between childhood trauma and suicide [21]. This means, more adverse childhood experiences were linked to a higher risk of the individual attempting suicide [21].  In addition, adults who have undergone childhood trauma are more likely to develop substance abuse issues which can negatively impact their health. [22]. 

Trauma survivors may also face obstacles in regards to occupation, relationships, and physical health. Research has found a positive correlation between childhood trauma and impaired job performance, absenteeism, and serious financial problems, as well as unemployment and housing insecurity [23]. While trauma does not directly cause these occurrences, it impacts a person’s psychological well-being in ways that increase the likelihood of these struggles.

Adults who have faced childhood adversity often struggle with maintaining healthy romantic relationships. A child’s home shapes their perception of the world [24]. Children who endure abuse or neglect create expectations of others based on their dysfunctional family dynamic [24]. Many trauma victims find themselves with partners who exhibit the same patterns of behavior they had been exposed to during childhood [24]. Moreover, research shows that the greatest predictor of a woman becoming a victim to domestic violence is past experiences of enduring abuse [25] and women who have once been a victim of rape are eight times more likely to experience rape again [25]. Learned helplessness, a psychological adaptation to trauma, doubles down with familiarity to further explain this pattern of unhealthy relationships [25]. The psychological phenomenon of learned helplessness can be defined as one's belief that they have no control over what happens to them, and subsequently do not try to escape harmful situations [26]. Adults may gravitate towards unhealthy relationships because of their resemblance to their childhood, and stay in these relationships as a result of learned helplessness.

Physical health through adulthood is also greatly affected by trauma. “The Adverse Childhood Experiences (ACE) Study” has some of the most extensive research on how trauma influences long-term health. The ACE study uncovered a positive correlation between the number of adverse childhood experiences and the number of health risk factors for leading causes of death in adults [1]. Researchers found a positive correlation between the number of childhood exposures and the following disease conditions: ischemic heart disease, cancer, chronic bronchitis or emphysema, history of hepatitis or jaundice, skeletal fractures, and poor self-rated health [1]. This means as the number of exposures increased, the likelihood that one would develop these health conditions increased. Furthermore, child abuse has been positively correlated with respiratory problems, cardiovascular disease, Type 2 diabetes, Alzheimer’s disease, hypertension, obesity, and some forms of cancer [27]. 

Conclusion

Centering a ball of clay is the first and most critical step of creating a functional ceramic piece. Childhood, the first portion of an individual's life, has a similar role in shaping one’s lifetime. Every pull, proddle, and poke the artist inflicts on their piece changes its appearance. Similarly, life experiences form neural connections and functionality within the brain. This article explores the cascade effect trauma inflicts. In this instance, neurobiological and nervous system changes later present themselves through behavioral, mental health and physical health issues. The evidence provided in this article outlines the ways in which early life experiences mold an individual's biology and make an imprint for the rest of their life.

References:

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