It is commonly accepted among behavioral health professionals that a strong connection between trauma in childhood and sometimes significant psychological problems exists. Certainly, not every child who experiences trauma develops any psychological problem. There are many reasons for this. However, a significant number of these children do develop psychological disorders that may last a lifetime.
Research suggests almost one million children yearly are directly affected by trauma of some kind (Barclay, 2014). This trauma comes from varied sources, including neglect, physical or sexual abuse, and witnessing violence toward others.
This trauma leads to stress responses in the children making them more likely to develop psychological problems either during childhood or later as adults. Anxiety and depression appear to be the most prevalent disorders in childhood with aggression following closely.
Even though researchers and treatment professionals know this progression from trauma to disorder, they don’t know the mechanism of the progression for certain. Understanding the mechanism could lead to new preventive efforts and more effective treatment options.
Current research could provide insight into this mechanism.
A study published in January, 2015, showed biological changes that occur because of adverse situations experienced in childhood may set the stage for future psychological disorders (Tyrka, et al., 2015). These same changes were said to possibly lead to faster aging in people so affected.
These researchers found telomere shortening and changes in mitochondrial DNA come about due to significant stress in childhood. Shorter telomeres, the nucleotide substances found at the ends of chromosomes, are a measure of aging. These nucleotides serve as buffers for the DNA inside chromosomes. Mitochondrial DNA (mtDNA) changes food into energy and has a strong role in growth of cells and death.
No other research has studied the relationship of mtDNA and psychosocial stress. However, there is clear evidence of stress and psychological disorders being related to inflammation and some health conditions. This current study may lead to greater understanding of cellular changes resulting from psychological factors and how they may lead to ill health and aging.
Trauma and Childhood Psychological Problems
According to the Centers for Disease Control and Prevention (2013), anywhere from 13-20% of children in the U.S. have a diagnosable mental disorder in any given year. The American Psychological Association (2015) reported about 15 million youth in the U.S. could be diagnosed with a psychological disorder.
What is the importance of research into causes of children’s psychological disorders? Besides the suffering resulting from psychological illness for both child and parents, an estimated $247 billion is spent yearly on these disorders. The cost in human suffering and economic areas is immense.
Not only that, but up to half of psychological disorders that last a lifetime begin by about age 14 (NAMI, 2010). Also, the time that elapses between onset of symptoms of these disorders and seeking of treatment may be decades. By that time, very serious disability likely has resulted from the years of psychological distress.
Suicide is often a choice young people make when facing serious psychological problems. It is the third leading cause of death in youth between the ages of 15 and 24 in the U.S. School failure is a frequent result of psychological problems in young people, also (NAMI, 2010). Nearly half of students of the age of 14 or older who have psychological problems drop out of school. Add to this 65% of males and 75% of females in juvenile detention are said to have at least one mental disorder.
As children with psychological disorders reach adulthood, their usage of health care services are higher than that of other adults. Untreated psychological disorders in childhood lead to a deteriorating spiral ending in poverty and illness in adulthood. The harm from these untreated childhood disorders is greater than that from any other illness.
It’s very easy to see why our children’s mental health issues are such a significant concern among parents and professionals alike. Any research that yields information helpful to preventing, diagnosing, or treating children’s mental health problems is very important.
The Inflammatory Response
What is inflammation? It’s a natural response by the body to any injury. It serves a protective function. Its function is to bring on the healing process by removing harmful pathogens and damaged cells.
Research is showing this same or a similar response occurs when a person experiences psychological distress and trauma (Miller and Cole, 2012). The major difference in this response is that this inflammation can be psychologically toxic.
Recent research (Miller and Cole, 2012) found people who experienced trauma in childhood and later became depressed also had an inflammatory response as measured by levels of interleukin-6, a marker for inflammation. And, people with early trauma who had high levels of this marker tended to experience depression six months later. Thus, high levels of interleukin-6 may forecast risk of depression.
This inflammatory response in people who experienced childhood trauma still was detected six months after the trauma, even if the depression brought on by the trauma lifted. This suggests inflammation of this type is chronic. The importance of this finding comes from inflammation being involved in serious health problems also. Thus, people with this type of inflammation due to childhood trauma may very well be more at risk of developing serious physical illnesses as well.
Genetic Changes Resulting From Trauma
In addition to inflammation, childhood trauma may bring on changes in how genes are expressed also. Researchers at Butler Hospital, a unit of Brown University, found that childhood trauma may bring on epigenetic changes in the human glucocorticoid receptor gene (Tyrka, et al., 2012). This gene is a regulator that may raise the risk of psychological disorders through the physiological stress response.
Epigenetics is the study of how genes are either allowed to ‘turn on’ and have an effect on the individual or are kept silent. The research mentioned above suggests that the glucocorticoid receptor gene may be locked in the ‘off’ position due to methylation of the gene. This apparently occurs as a result of the trauma experienced in childhood. Preventing this gene from expressing its effects appears to lead to increased sensitivity to stress and increasing reactivity to stress in adulthood. This increased sensitivity and reactivity to stress may then lead to psychological and physiological illnesses.
This kind of research may lead to an understanding of the relationship between childhood trauma and increased risk for psychological disorders. Understanding these epigenetic changes may help develop better treatment programs for childhood depression and anxiety. Better yet, preventive efforts can be developed and implemented to forestall the development of these psychological issues.
Effects of Childhood Trauma on Adults
It is generally accepted that childhood trauma can be the beginning of the pathway to adult psychological problems. As mentioned above, childhood trauma can bring on depression and anxiety in children which can become chronic and last a lifetime.
There are other possible consequences of childhood trauma for adults as well.
The possibility of developing significant chronic physical illness in adulthood increases in the presence of childhood trauma and its lasting effects. Genetic changes that come with childhood trauma lead to adults being more susceptible to stress and more likely to react negatively to stressful situations. This makes continuing stress greater than an adult’s ability to deal with it more possible.
A great deal of research has indicated chronic stress of this type significantly affects a person’s brain, endocrine system, and immune system (Kendall, 2009). Continued stress keeps the autonomic nervous system activated, resulting in serious physical illness such as high blood pressure, high blood sugar, and tense muscles. This activation over and over contributes to cardiovascular disease, diabetes, and autoimmune disorders.
Chronic diseases such as these are leading causes of death in the U.S., according to the Centers for Disease Control and Prevention (CDC, 2012). To this point, the way the mind can affect the body, especially the heart, isn’t well understood. But studies have shown emotional distress to be a known predictor of risk in cardiovascular deaths (Kendall, 2009). Emotional distress due to depression has been shown to be a predictor of early onset coronary heart disease. Depression is one of the most common outcomes of childhood trauma.
Recent research (Kelly-Irving, et al., 2013) strongly suggests a link between childhood trauma and higher risk of early death. In this study, women with one traumatic event before age 16 were 66% more likely to die prior to age 50 than those who suffered no trauma. With two or more traumatic childhood experiences, women were 80% more likely to die prematurely. Men with two or more childhood traumas were 57% more likely to die early.
A More Positive Note
The current research into genetic and inflammatory reactions to childhood trauma promises to set the stage for better prediction of who might be at risk of developing lifelong serious psychological and physiological illnesses. Not only will this allow professionals to intervene early and thus prevent long-term consequences, it may also pave the way for genetic intervention for treatment and preventative endeavors.
There has been recent research (Whitaker, et al., 2014) that shows a particular kind of treatment - mindfulness - to be effective in dealing with the long-term effects of childhood trauma in adults. Mindfulness is becoming aware of and accepting whatever is going on in adults’ lives at the moment. It is not learning to like what these situations or the person’s responses to them are, but rather to be curious about them and accept they are there.
Most adults spend a great deal of time focusing on what happened in the past, resenting and growing angry or disappointed or guilty about those events. Or they focus on the future, hoping for better times ahead.
Mindfulness encourages adults to simply accept and examine current responses to things in their lives. This includes feelings and thoughts. Doing this tends to decrease the stress responses related to events, both present and past. It may also increase resilience according to Whitaker (2014). Resilience helps people handle stressors more adequately.
Whitaker’s research (2014) showed a 50% reduction in the risk of having multiple health conditions when people developed high levels of mindfulness. Even in the face of having gone through multiple childhood traumas.
With the apparent increase in childhood trauma and increasing understanding of what it can bring both in childhood and later in adulthood, the need for research into the mechanisms by which trauma brings difficulties is greater than ever. The cost in human suffering and in economic terms is great.
Research such as has been discussed in this article puts professionals on the path to developing better treatment protocols for those children and adults who suffer the potentially long-term effects of trauma. It also points the way to early identification of those who are at risk for these lifelong problems. Knowing who is at risk allows for early interventions, also, thereby possibly preventing some of the later effects of trauma.
Early identification and treatment will allow those who experience childhood trauma to live better, more fulfilling, and more productive lives. This is good for individuals, families, and society at large.
American Psychological Association (2015). Children’s mental health. Retrieved from http://www.apa.org/pl/families/children-mental-health.aspx.
Barclay, R. (2014). Stress and trauma in childhood affect gene expression for life. Retrieved from http://www.healthline.com/health-news/childhood-stress-affects-genes-for-life-072914.
Centers for Disease Control and Prevention. (2013). Children’s mental health - new report. Retrieved from http://www.cdc.gov/Features/ChidlrensMentalHealth/.
Centers for Disease Control and Prevention. (2012). (Fact Sheet) Chronic disease prevention and health promotion. Retrieved from http://www.cdc.gov/chronicdisease/index.htm.
Kelly-Irving, M. et al. (2013). Childhood adversity as a risk for cancer: findings from the 1958 British birth cohort study. BMC Public Health, 13(1): 767.
Kendall, K. (2009). The psychoneuroimmunology of chronic disease: exploring the links between inflammation, stress, and illness. Washington, D.C.: American Psychological Association.
Miller, G. E. & Cole, S. W. (2012). Clustering of depression and inflammation in adolescents previously exposed to childhood adversity. Biological Psychiatry, 72(1): 34.
National Alliance on Mental Illness. (2010). Facts on children’s mental health in America. Retrieved from http://www.nami.org/
Tyrka, A. R., et al. (2015). Alterations of mitochrondrial DNA copy number and telomere length with early adversity and psychopathology. Biological Psychiatry. DOI: 10.1016/j.biopsych.2014.12.025.
Tyrka, A.R., et al. (2012). Childhood adversity and epigenetic modulation of the leukocyte glucocorticoid receptor: preliminary findings in healthy adults. PLoS ONE; 7(1):e30148 DOI: 10.1371/journal.pone.0030148.
Whitaker, R.C., et al. (2014). Adverse childhood experiences, dispositional mindfulness, and adult health. Preventive Medicine, 67:147. DOI: 10.1016/j.ypmed.2014.07.029.