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This essay is going to be exploring how trauma during childhood can possibly cause mental health problems later in adult life. It is now widely accepted that distressing and traumatic events during childhood can cause mental health issues, and often very serious disorders. Such disorders include depression, post-traumatic stress disorder (PTSD), and borderline personality disorder. The NSPCC (2018) estimates that there are over half a million children in the UK being abused, meaning that this is a pressing issue. However, there is emerging arguments that possibly too much attention is being put on childhood trauma when there are other possible causes for adult mental health issues that are now being investigated.
Mental illness is becoming an increasingly more prevalent health issue, which is becoming a huge pressure the NHS is facing. The NHS ambulance service helped more than 30,000 more patients suffering from mental health issues in 2016-17 than 2014-15. The question of the essay is ‘Can childhood trauma cause mental illness in adulthood?’ this will be answered through my secondary research conducted on the topic from a range of reliable and dependable sources, such as Psychology Today, which is written by established psychiatrists, and other authentic journals such as the Journal of Affective Disorders and the American Journal of Psychiatry. These publications are aimed towards individuals of varying qualifications in the profession and so contain relevant and insightful information. These sources are fairly recent with some including both qualitative and quantitative data. Childhood trauma & mental health disorders
When a child experiences trauma it can shape their developing brain in many ways. It can alter the nucleus accumbens, which is the pleasure and reward centre of the brain, and the altering of this area can lead to an increased risk of substance abuse. Trauma can also overstimulate the amygdala which is where your fear responses are controlled, so when this area becomes highly triggered it can lead to children avoiding situations that normally aren’t distressing. The prefrontal cortex, which deals with the regulation of impulses and the ability to carry out basic functions such as decision-making, can also be inhibited. Trauma essentially remoulds children’s neuroplastic brains leaving them 3 times more likely to develop depression and 15 times more likely to commit suicide. The insula is part of the brain that helps control how much or little attention your body pays to sensory information. So, changes in the insula due to trauma could potentially heighten PTSD and its progress.
A study from the Stanford University School of Medicine and the Early Life Stress and Pediatric Anxiety Program found there are differences between male and female brains of young people who have experienced trauma and the symptoms of PTSD. They found that males who had experienced trauma had a larger insula volume and surface area than males who hadn’t experienced trauma and PTSD, and in females the insula was smaller in volume and surface area than those who hadn’t. In normal healthy individuals the insula becomes smaller with aging, so the smaller insula in females who exhibit PTSD symptoms would infer that the insula is aging prematurely because of the traumatic stress. If these issues aren’t dealt with in childhood, they can manifest themselves into serious mental health issues in adulthood such as depression, PTSD and borderline personality disorder. Depression is described as the prolonged constant feeling of despair over weeks or months and is connected to thoughts of self-harm and/or suicidal behaviour, including many other psychological, physical and social symptoms which can be found in Appendix A. PTSD is an anxiety disorder where individuals re-experience trauma in the form of flashbacks and nightmares. A full list of symptoms can be found in Appendix B. Finally, borderline personality disorder is the most commonly recognised personality disorder, and is categorised by individuals thinking, perceiving, feeling and relating to others differently. Its symptoms can range from emotional instability to disturbed thinking and impulsive behavior.
Babbel, S. (2011) describes how “at its core, any type of abuse of children constitutes exploitation of the child’s dependence on and attachment to the parent”, while referencing Finkelhor, D. (2008) who spoke about it as “interpersonal victimisation”. This term can be extended to children and adults and is any harm that is inflicted on an individual because of the acts of someone else that aren’t within societal norms. This definition sets child abuse apart from childhood trauma, as trauma can include accidents or illness which aren’t purposefully inflicted by another individual. Babbel, S. (2011) then goes on to describe how child abuse can turn into PTSD during childhood, which if untreated continues into adulthood. While sex plays a determining role as females are more likely to develop the condition than males, there are other important factors which can ascertain the probability of developing PTSD. The developmental state of the child is an important factor as it is theorised the younger the child is, the less intellectually developed they are, so they are less likely to be able to understand what is happening and perceive the level of threat.
However, when this abuse is continued it can cause developmental issues in the brain, as previously spoken about. The relationship with the abuser is also important as they are often individuals with power and influence over the child, and the level of care and support they receive is significant because if the abuser is the only source of support in their life it can be incredibly conflicting for the child. Finally, the child’s response to the abuse in the short-term is crucial as Babbel, S. (2011) states how an increased heart rate after suffering abuse is thought to increase the risk of developing PTSD later in life. Not all of these factors need to be in play, the trauma or abuse inflicted just has to surpass the victim’s tolerance and in turn make them too overwhelmed for their body cope, which is more likely in children because they do not have the coping mechanisms to deal with such trauma. If the child is unable to control these emotions, then symptoms of PTSD can arise which include nightmares, extreme emotional reactions and increased dependency mirroring that of a younger age. This can continue into adulthood, but the symptoms become less obvious. PTSD can sometimes mimic or be mistaken for other mental health disorders such as anxiety or depression. If these issues are not dealt with, they can lead to substance abuse, sleep issues or eating disorders.
A study conducted by Brodsky, B. et al (2001) explored the connection between childhood trauma and suicidal behaviour in adulthood by looking at individuals who suffered from borderline personality disorder, major depression and impulsivity issues. There is a strong correlation between childhood abuse and borderline personality disorder, so the study also aimed to look at the possibility that past trauma could influence development and psychological traits such as impulsivity. The study used patients who were diagnosed with major depressive episodes, and individuals who had and hadn’t been abused before the age of 15. From this they found that 58% of the patients had experienced physical or sexual abuse before the age of 15 and that those individuals were more likely to be women and/or African American or Hispanic.
The patients who suffered abuse were also more likely to have borderline personality disorder and scored higher in terms of impulsivity and aggression as well as having made at least 1 suicide attempt. This also corresponded with the likelihood of attempting suicide before the age of 17 which was 27% higher among the patients who had experienced child abuse then those who had not. These findings led Brodsky, B. et al (2001) to conclude that a history of childhood abuse is associated with high impulsivity and suicidal behaviour in adults with major depressive disorders. However, the possibility that abuse, an environmental factor, is the sole contributor to the influence of traits such as impulsivity, might not be the case. As studied by Higley, J. D. et al (1993), impulsivity may be an inherited trait. They studied a range of primates and found that it seemed to be a combination of genetics and environmental factors such as maternal deprivation that led to impulsive characteristics. Which leads to the idea that impulsivity is an inherited characteristic which can be worsened by environmental factors such as childhood abuse.
Chapman, D. et al (2003) details how adverse childhood experiences (ACEs) are connected to disorders such as PTSD, borderline personality disorder, dissociative symptoms and depression. ACEs are often just studied as one individual trauma, however there are many traumas that come under this title. Emotional, physical and sexual abuse, as well as having a “battered mother”, being in a household where substance abuse takes place or a criminal family member and living with a mentally ill individual are all classified as adverse childhood experiences. They conducted a study to evaluate the association between ACEs and depressive disorders, and so they sent out questionnaires to individuals that met the criteria for depressive disorders. The results of their study found that there are differences between males and females, although this was not the primary aim of the study. They found that there was a higher percentage of women (28.9%) compared to men (19.4%) who had a history of lifetime depressive disorders, and 7.3% more women than men reported recent depressive disorders. From this they discovered that women who had experienced ACEs had a 5 times greater chance of suffering from a depressive disorder than those who hadn’t experienced trauma.
The presence of mental health issues in a household was an interesting point of discovery. They theorised that if there was an individual who suffered from a mental illness in the household, genetic factors could possibly be responsible to the onset of depressive disorders later in adulthood. From their data they established that there was less of an influence from ACEs on patients who lived with a mentally ill household member, than those who didn’t. However, the household member in question may not have suffered from a similar condition and also may not have been a blood relative, so the relationship between genetics and depressive disorders could not be concluded from these results. The ACE that had the strongest relationship with depressive disorders was emotional abuse for both men and women, and this is corroborated by Roy, A. (1999) who also found that emotional abuse had a significant impact on children which then proceeded to become mental health issues later in adulthood. Although it is further explained by Chapman, D. et al (2003) that emotional abuse is often in conjunction with other forms of abuse.
There is a strong belief that overcoming childhood trauma can help with alleviating mental health issues, even though there is evidence that says otherwise. O’Connor, L. (2012) argues that there are other alternate causes for mental illnesses and that there may be too much attention being placed on childhood trauma. There was a study conducted by Jaroslav Flegr on how the parasite, Toxoplasma gondii, could be responsible for some cases of schizophrenia as it is thought to influence personality in those with susceptible genetics by causing dopamine imbalances. There are also mental illnesses which were previously thought to be caused by childhood abuse, but later research found otherwise, such as autism and maternal deprivation which was dubbed the “refrigerator mother”. Schizophrenia was also thought to be caused in the same manner. O’Connor, L. (2012) proclaims that blaming the parents for the child’s mental illness can have a detrimental effect on them and their families.
Mental illness can be partly inheritable, and some children are born more at risk of developing disorders due to their genetics. There is also an argument that with identical twins as they may have different experiences when in the uterus which can lead to the expression of different genes or epigenetic changes, which means the identical twins may not be completely identical and why one may develop a mental illness that the other does not even though they experienced the same childhood. O’Connor, L. (2012) also described how we are often led to believe those in authority, so when speaking to professionals there is commonly a focus on trauma which can cause individuals to probe old memories searching for an abuser or memory which would satisfy as a “cause” for their issue. While O’Connor, L. (2012) argues alternate causes of mental illness, there is still as acknowledgment that adverse experiences in childhood can have a detrimental impact on brain development.
All the data collected from these sources is valid as it accurately reflects the reality of society, for example Brodsky, B. et al. (2001) and Chapman, D. et al. (2003) conducted studies to examine the impact of childhood trauma and ACEs and their manifestation later in adulthood. These were done through questionnaires that were sent to patients who were either diagnosed with depressive disorders or met the criteria for major depressive episodes. From these studies, and the knowledge from Babbel, S. (2012) on PTSD, conclusions have been made about how trauma in childhood can cause mental health issues later in life. Babbel, S. (2011), Brodsky, B. et al (2001), Chapman, D. et al (2003) and O’Connor, L. (2012) all acknowledge the relationship between childhood abuse and mental illness later in life, and how there is a difference between men and women. Babbel, S. (2011) uses prior knowledge to reach that conclusion while Brodsky, B et al (2001) and Chapman, D. (2003) conducted studies. O’Connor, L. (2012) however argues some of the other possible causes of adult mental illness, and how possibly individuals are influenced to believe it was childhood trauma when in fact it could be a range of possibilities. Babbel, S. (2011) and Chapman, D. et al. (2003) both talk about how trauma as a child can result in PTSD, with the latter also agreeing with Brodsky, B. et al. (2001) that the trauma can also lead to borderline personality disorder. A hypothesis was also made by both O’Connor, L. (2012) and Chapman, D. et al. (2001) that there is a relationship between genetic make-ups, with the former providing a more detailed possibility.
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