Childhood Trauma and Adult Mental Health

Experts understand that childhood trauma in the form of abuse, neglect, and other adverse childhood experiences (ACEs) can have a lasting negative effect on a person’s mental health.

In recent years, researchers have attempted to gain a better understanding of the nature of the relationship between childhood trauma and the development of mental health disorders during adolescence and adulthood.

One such study, which was conducted by two researchers from King’s College London and City College of New York, suggests that a person’s ability to process memories of past trauma may have a stronger effect on their emotional well-being than enduring the trauma itself.

What are ACEs?

The National Child Traumatic Stress Network (NCTSN) is an excellent resource for understanding the impact of childhood trauma on mental health. They define a traumatic childhood experience as “a frightening, dangerous, or violent event that poses a threat to a child’s life or bodily integrity.” Events that threaten the health and safety of a parent or other significant figure can also be traumatic.

Clinicians use the term adverse childhood experiences (ACEs) as an all-encompassing descriptor for the various forms of childhood trauma that may lead to various challenges later in life, including problems with both physical and mental health.

Examples of ACEs include the following:

• Enduring physical, sexual, and/or emotional abuse
• Being neglected by parents or other caregivers
• Bullying, which can include both in-person and online harassment
• Incurring a severe injury or developing a serious medical condition
• Losing a parent or other caregiver through death, divorce, or other type of permanent separation
• Living through a life-threatening natural disaster such as a tornado or hurricane
• Being present during a terrorist attack

In addition to those who are directly victimized, children may also be traumatized by witnessing horrific experiences that occur to someone else. For example, watching a friend being abused by their parents or living in a household where intimate partner violence is common can also fall under the definition of an adverse childhood experience.

The Scope of the Problem

Though we would like to think that all children have the opportunity to grow up in a healthy, nurturing environment, the harsh reality is that millions of people in the United States have a history of childhood trauma by the time they reach their 18^th birthday, and all of them are at increased risk of developing mental health problems.

• According to the U.S. Centers for Disease Control and Prevention (CDC), experts estimate that about 1 of every seven young people in the United States (or about 14.3% of the population under the age of 18) were either abused or neglected in the previous 12 months.
  • With a population of 73.1 million people under the age of 17 in the U.S., that means more than 10 million children and adolescents experience abuse and neglect each year

To underscore the prevalence of adverse childhood experiences in the U.S., the National Children’s Alliance (NCA) has reported the following:

• About 1 of every 40 infants (or 2.5% of newborns) experience abuse before their first birthday.
• 65% of abuse cases investigated by a Children’s Advocacy Center (CAC) involve sexual assault.
• About 1,750 children died as a result of abuse in 2020.

The NCA also noted that, when breaking down these statistics along gender lines, the data shows girls experience higher rates of overall victimization, while boys experience higher rates of abuse-related death.

Long-Term Effects of Childhood Trauma

A history of untreated childhood trauma – especially when that trauma occurred during childhood – can raise a person’s risk for several mental health disorders, including:

• Anxiety disorders
• Depressive disorders
• Borderline personality disorder
• Posttraumatic stress disorder (PTSD)
• Attention-deficit/hyperactivity disorder (ADHD)
• Bipolar disorder

The Child Welfare Information Gateway (which is part of the U.S. Department of Health and Human Services) has reported that childhood trauma can also increase the likelihood that a person will struggle with various cognitive, behavioral, and social challenges, such as:

• Substance abuse and addiction
• Unsafe sexual practices
• Learning problems
• Impaired executive functioning (which includes memory, self-control, and cognitive flexibility)
• Inability to form and maintain healthy relationships
• Criminal behaviors
• Incarceration
• Social withdrawal
• Suicidal thoughts and actions

The Impact of Traumatic Memories

As we mentioned at the top of this post – and as we detailed in the previous section – the connection between childhood trauma and later-life mental health challenges has been well established. However, researchers have been less successful at identifying mechanisms by which trauma transforms into mental health concerns.

The study from King’s College London and City College of New York that we mentioned in the opening of this post may improve our understanding of how this happens. This study, which was published July 5, 2023, by JAMA Psychiatry, was conducted by Andrea Danese, MD, PhD, and Cathy Spatz Widom, PhD.

Highlights From the Study

• It involved data from 1,196 subjects with “substantiated records of childhood physical and sexual abuse and/or neglect between 1967 and 1971.” During this period, subjects were age 12 or younger.
• The study also included a demographically matched group of subjects with no history of childhood abuse or neglect.
• Assessments occurred around age 29 and again around age 40. The age 29 assessment involved a self-report of childhood experiences. The age 40 assessment evaluated anxiety and depression.

Based on these assessments, Danese and Widom reached the following conclusions:

• Among the subjects with documented histories of childhood abuse, those who recalled these events at age 29 were more likely to experience anxiety and depression during the following 10 years than were those with no memory of abuse.
• Subjects with records of abuse who did not remember the abuse at age 29 assessment showed the same levels of anxiety and depression as subjects with no record of abuse

In other words, the strongest predictor of anxiety and depression at age 40 was the memory of the abuse, rather than the documented presence of abuse.

“Our study reveals that how a person perceives and remembers experiences of childhood abuse or neglect has greater implications on future emotional disorders than the experience itself,” Danese said in a July 5, 2023, Neuroscience News article.

“The findings also suggest that early interventions that help cope with memories of abuse and/or neglect may prevent emotional problems later on,” she added.

Treating Traumatic Memories

The good news about Danese’s and Widom’s findings is that treatment professionals already have effective ways of helping people overcome distress that results from traumatic memories.

For example, eye movement desensitization and reprocessing (EMDR) therapy, an evidence-based treatment for people who have PTSD, eases the psychological pain patients feel when they recall particularly disturbing memories.

EMDR was developed in the late 1980s and early 1990s by Francine Shapiro, PhD. Shapiro began to work on what she initially called eye movement desensitization (EMD) after realizing that negative emotions associated with her own traumatic memories seemed to subside when she moved her eyes from point to point while walking through a park.

Today, EMDR therapy is an eight-phase process that involves a collaborative effort between the therapist and the patient.

How EMDR Works

• The therapist and patient identify a specific traumatic memory to focus on.
• The patient engages in a procedure that involves rapid bilateral eye movements to ease the distress they feel when they recall the memory.
• Once this distress is eradicated, the therapist and patient work together to replace the negative emotion with a productive cognitive response to the memory.

It may take multiple EMDR sessions to accomplish this. Once the traumatic memory no longer causes emotional pain, the therapist and patient can select another memory and repeat the process.

EMDR therapy does not require a diagnosis of posttraumatic stress disorder. Treatment centers may incorporate EMDR into comprehensive, personalized treatment plans for people who have a wide range of mental health concerns, including:

• Generalized anxiety disorder
• Panic disorder
• Major depressive disorder
• Persistent depressive disorder
• Dissociative identity disorder
• Borderline personality disorder
• Antisocial personality disorder
• Body dysmorphic disorder
• Eating disorders
• Obsessive-compulsive disorder (OCD)

Given the information that Danese and Widom revealed in their study, EMDR and similar techniques may be beneficial not only to treat these mental illnesses, but also to prevent people with a history of ACEs from developing certain mental health concerns later in their lives.