Neurobiology of Childhood Trauma – Lifelong Impact, by Dr. Drew W. Edwards.

Early life trauma can stem from physical, emotional or sexual abuse, neglect, loss of a loved one, bullying, witnessing violence, or from involvement in a serious accident, injury, natural disaster, terrorism or war. It can also result from growing up in a chronically dysfunctional home, where emotional neglect and indifference are the norm, and healthy attachments are never formed…and this is just the short list.

The list of acute responses to a traumatic event are long and often last into adulthood, creating a set-up for a life that is emotionally painful and difficult for the victim to achieve full potential:

  • Irritability hostility
  • Depressive Symptoms
  • Mood Swings, emotional instability
  • Anxiety (e.g., panic attacks, specific phobia, generalized anxiety)
  • Fear or traumatic reoccurrence
  • Grief reaction
  • Shame
  • Feeling vulnerable and fragile
  • Emotional detachment, unwilling to engage in discussion regarding emotions
  • Crying
  • Peritraumatic Disassociation: A form of psychological escape during or just after the event.
  • Adjustment Reaction Disorder (clinically significant depressive symptoms and/or intrusive anxiety symptoms in the wake of a distressing event. Symptoms usually resolve within 6 months.
  • Post-Traumatic Stress Disorder

The life trajectory of chronically traumatized persons will veer from the hopes and dreams they once possessed, as their life becomes increasingly and pathologically organized around the event(s), the aggressor(s) or alleviating the emotional pain that lingers like a frightening shadow.

Effects on Neurodevelopment

The fact that traumatic life experiences are predictive of mental illness and substance abuse is not surprising. What is surprising is the extent of neuroadaptive changes in the brains of traumatized children and teens.

Adverse Childhood Experience (ACE) Research

Two recent studies showed that experiencing childhood trauma is common among people undergoing addiction treatment as adults. Adverse Childhood Experience (ACE) is associated with post-traumatic stress disorder, substance use disorder, depression, anxiety, suicide, obesity, and compulsive sexual behavior.

ACE are “dose-dependent” The more ACEs one experiences, the greater the likelihood of psychopathology. Unless the child receives the appropriate professional intervention of adequate intensity and time, ACE’s always carry over to adulthood as some form psychopathology, latent or exposed.

Adverse childhood experiences are associated with numerous pathologies. Significantly, ACEs and traumatic stressors statistically increase one’s risk for mental illness, SUD and increase the symptom severity of both.

Brain Imaging Studies

Utilizing sophisticated brain imaging technology, researchers at the University of Texas were able to measure “preclinical” deficits in the neuronal signaling and “connectivity” in the midbrain region of adolescents who were traumatized as children. This neurocircuitry is the “hardwiring” that regulates how we process emotions and cope with stress. This finding is critical because young children do not have a frame of reference in which to process and categorize traumatic experiences. As they mature, these individuals are more likely to use drugs or alcohol to numb feelings of fear, powerlessness, depression—and to drown out painful memories. When this occurs, the deep wound of abuse, are inexorably tied to self-medication and addiction.

The significance of child maltreatment on brain development and function is important. A study lead by Penn Medicine researchers found that childhood trauma is linked to abnormal connectivity in the in adults with major depressive disorder (MDD), a common co-occurring illness.

Neurobiological Changes

Trauma leads to a cascade of biological changes and stress responses that precede acting out or substance abuse. These neuro-adaptations include:

  • Hypothalamic–pituitary–adrenal axis activity is activated by the Amygdala in response to a threat The HPA regulates cortisol and adrenalin levels pertinent to the perceived threat.
  • Adrenaline floods the body. The heart rate increase, as the Fight or Flight Response engages to the perception of threat, resulting in loss of behavioral control When the Sympathetic Nervous System is triggered, by the Amygdala, our fear response is not always rational, it is survival mode. The rational prefrontal cortex has been usurped by the Fight or Flight Response.
  • Reward Deficiency Syndrome. Over time, chronic stress and fear deplete the brain of essential neurotransmitters (dopamine, serotonin, norepinephrine). This increases vulnerability for Substance Use Disorder as a compensatory function to restore neurotransmitter homeostasis.
  • Repeated use of exogenous, psychoactive intoxicants further depletes neurotransmitter volume. As tolerance ensues, addiction is the result. The traumatized person now has two chronic, debilitating disorders.

Time Heals Treated Trauma

For children and teens, the emotional confusion, lack of understanding, personal boundaries, and the inability to express their emotions or describe the event is common and without professional intervention, almost always persists into adulthood. It is critical for those teens or adults impacted by childhood trauma to seek compassionate professional help to resolve the fear, depression, anger, shame, and self-medication and so be released from the personal prison that has been fashioned by the victim’s trauma.

 

References

  1. ACE Research Source: Iidaka T, Ozaki N, Matsumoto A, Nogawa J, Kinoshita Y, Suzuki T, et al. A variant C178T in the regulatory region of the serotonin receptor gene HTR3A modulates neural activation in the human amygdala. The Journal of neuroscience: the Official Journal of the Society for Neuroscience. 2005;25(27):6460–6.
  1. Liu R, Scopellti K, et al. Childhood maltreatment and non-suicidal self-injury: a systematic review and meta-analysis. Lancett Psychiatry. VOLUME 5, ISSUE 1, P51-64, JANUARY 01, 2018
  1. Afifi TO, Brownridge DA, Cox BJ, Sareen J (2006) Physical punishment, childhood abuse, and psychiatric disorders. Child Abuse Negl 30: 1093–1103

Blog was written by Dr. Drew Edwards for Sabino Recovery