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  1. Home
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  3. The Impact of Early Life Trauma on Health and Disease
  • Cited by 118
Publisher:
Cambridge University Press
Online publication date:
May 2011
Print publication year:
2010
Online ISBN:
9780511777042
DOI:
https://doi.org/10.1017/CBO9780511777042
Subjects:
Psychiatry and Clinical Psychology, Medicine, Pediatrics and Child Health, Psychiatry
Information

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.

Reviews

' … '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 2 of 2

Contents
  • Chapter 19 - Assessing the effects of early and later childhood trauma in adults
    pp 207-216
  • View abstract

    Summary

    Trauma exerts approximately two-fold increased risk for various forms of psychopathology, including anxiety, major depression and behavior problems. Compelling evidence from a variety of studies suggests that an array of early life stressors, constitute a major risk factor for the development and persistence of both mood and anxiety disorders, as they are associated with increased rates of stress-related mental and physical disorders in adulthood. Accumulating evidence from laboratory animal studies on early life stress suggests persistent changes in the function of brain regions pivotal to the meditation of stress and emotion that are similar to the neurobiological alterations exhibited in patients suffering from depression or anxiety disorders. The juvenile stress model might serve as an animal model for developmental-stage-specific symptoms of mood and anxiety disorders, which could then promote the search for a valid diagnostic tool of these disorders in children and adolescents.
  • Chapter 21 - Scientific progress and methodological issues in the study of recovered and false memories of trauma
    pp 225-233
  • View abstract

    Summary

    This chapter examines whether differences in the lateralization of expressive and regulatory gestures may reflect different hemispheric activity. It evaluates the differential utilization and lateralization by infants of socioemotional expressive gestures and self-directed coping. Other directed gestures were common during the play and reunion and self directed behaviors were common during the still-face phases of the Face-to-Face Still-Face paradigm (FFSF). These findings suggest that during the FFSF infants showed greater right hemisphere activation and that the activation is associated with different kind of gestures related to episode. Overall differential distribution of self and other directed behaviors in relation to the different social contexts suggests that the regulatory capacities of the infant are highly tuned and sophisticated. Support for a lateralization of self and other directed behaviors to the right hemisphere was found, lending support to views of the specialization of the right hemisphere for both regulatory and communicative emotional processing.
  • Chapter 22 - Thepsychosocial consequences of organized violence on children
    pp 234-241
  • View abstract

    Summary

    This chapter presents new data suggesting that there are sensitive periods when particular brain regions may be most susceptible to the effects of abuse. New findings looking at the neurobiological correlates of exposure to other forms of adversity is considered including parental verbal abuse (PVA), peer verbal bullying (VB) and witnessing domestic violence (WDV). The effect of childhood trauma on the development of the left versus right hemisphere was investigated using electroencephalograph (EEG) coherence, which provides information regarding the nature of the brain's wiring and circuitry. Childhood maltreatment research has focused primarily on the effects of physical abuse (PA), sexual abuse (SA) or WDV. By comparison, PVA has received little attention as a specific form of abuse. Childhood adversity accounts for 50-75% of the population attributable risk for alcoholism, depression, suicidal behavior and drug abuse.
  • Part 5 - Synopsis
    pp 242-246
  • View abstract

    Summary

    Child neglect is the most chronic and prevalent form of child maltreatment. This chapter discusses the definitions, preclinical studies of maternal deprivation, the field of developmental traumatology, studies of neglected children and future directions. Child neglect may be more detrimental to the child's developing biological stress systems and brain than adversity experienced in adulthood, secondary to interactions between this lack of experience of expected environmental stimulation and brain maturation. Multiple neurotransmitter systems and neuroendocrine axes are activated during stress. The study of the effects of child neglect and childhood brain development is only in its infancy. Longitudinal investigations are a promising strategy to further understanding of the neurobiology of neglect and to help to identify the best predictors for the permanence and the therapeutic reversibility of the adverse effects associated with child neglect.
  • Chapter 23 - Therole of mentalizing in treating attachment trauma
    pp 247-256
  • View abstract

    Summary

    This chapter concentrates on three areas of model development. First, it presents data showing how differential impacts to specific neural regulatory systems are associated with variations by the type of early life stress (ELS) experienced. Second, the chapter describes how studies of the severity of ELS are providing a new basis for understanding trajectories towards risk versus resilience among foster children and other populations who experience ELS. Third, it also describes a growing body of evidence documenting the plasticity of these neural systems in response to psychosocial, family-based therapeutic interventions. The chapter focuses on the neurobiological systems involved in the reaction and the regulation of physiological responses to stressors. Much work remains to be done across the spectrum of risk and resilience following ELS in order to improve the identification of individuals in need of services and to specify the techniques most likely to improve outcomes.
  • Chapter 25 - Cognitive-behavioral treatments for post-traumatic stress disorder
    pp 268-277
  • View abstract

    Summary

    Early life stress (ELS) and abuse are the most commonly assessed environmental exposures in psychiatric genes and environment (GxE) interaction studies, partly because of the strength of evidence that ELS plays a role in risk for multiple psychiatric disorders. The research on GxE interactions is organized by the presumed underlying neurobiological systems and by the broader classification of psychiatric outcomes (mood/anxiety disorders and externalizing disorders). This chapter discusses the importance of clearly defining and measuring both the proposed environmental risk/resilience factors as well as the predicted diagnostic and behavioral outcomes. This allows investigators to conduct GxE studies that better inform the understanding of the role of ELS in predicting psychiatric risk/resilience. The chapter focuses on childhood physical, sexual and emotional abuse, which is currently among the most well-researched environmental risk variables in human psychopathology research.
  • Chapter 27 - Psychodynamic psychotherapy: adaptations for the treatment of patients with chronic complex post-traumatic stress disorder
    pp 286-294
  • View abstract

    Summary

    This chapter summarizes available findings on the neuroendocrine effects of exposure to trauma during early development, with a focus on a role for such alterations in the increased risk of mood and anxiety disorders in adulthood. The principal components of the stress system are the hypothalamic-pituitary-adrenal (HPA) axis, the locus ceruleus-norepinephrine (LC-NE) system and the extrahypothalamic corticotropin-releasing factor (CRF) systems. In addition, increased rates of major depression, post-traumatic stress disorder (PTSD) and attention-deficit hyperactivity disorder (ADHD) have been reported in maltreated children. The relationship between early adverse experiences and the development of adult psychopathology is likely mediated by alterations in neurobiological systems involved in the regulation of stress. Findings from the research would have important implications for the development of optimized treatment strategies that directly target different neurobiological pathways involved in depression and anxiety disorders in victims of early child maltreatment.
  • Part 6 - Synopsis
    pp 295-299
  • View abstract

    Summary

    Studies show that early childhood abuse has causative long-term effects on brain areas involved in memory and emotion, including the hippocampus, amygdala and medial prefrontal cortex. Brain circuits mediating the stress response including norepinephrine neurons, and the hypothalamic-pituitary-adrenal (HPA) axis also play a role. This chapter presents post-traumatic stress disorder (PTSD), and a working model for a neural circuitry. It discusses relevant findings from the neuroimaging and stress hormone literature concerning patients who have experienced childhood abuse. The chapter addresses the issue of causation in reference to epidemiological studies and neuropsychiatric investigations. There is considerable interest in alterations in memory function of patients with childhood abuse-related PTSD. The brain areas involved include the hippocampus, medial prefrontal cortex and amygdala, that are central to the neural circuitry of traumatic stress. Most functional neuroimaging studies to date have focused on specific cognitive tasks to examine brain functioning in various psychiatric disorders.
  • Epilogue
    pp 300-302
  • View abstract

    Summary

    Dissociation may involve the protective activation of altered states of consciousness related to acute changes in a variety of brain systems in response to immediate danger. Dissociation can produce a variety of somatoform conditions such as pseudoneurological conversion symptoms, pain disorders and somatization disorder. Individuals with repeated early life trauma such as dissociative identity disorder (DID) or borderline personality disorder (BPD) may show all of these symptoms, leading to a particularly complex and variable clinical picture. Critical anatomical structures for the post-encounter defensive behavior described include the amygdala, the ventral periaqueductal gray and the hypothalamus. Failure of corticolimbic inhibition or excessive corticolimbic inhibition may be one underlying mechanism that leads to altered temporal lobe and limbic system functioning. Typically, dissociative symptoms in neurological disorders have been reported to result from lesions in the limbic system, specifically the temporal lobe or the temporoparietal junction.

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