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Trauma in childhood is a grave psychosocial, medical, and public policy problem that has serious consequences for its victims and for society.
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Chronic interpersonal violence in children is common worldwide.
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Developmental traumatology, the systemic investigation of the psychiatric and psychobiological effects of chronic overwhelming stress on the developing child, provides a framework and principles when empirically examining the neurobiological effects of pediatric trauma.
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Despite the widespread
Child and Adolescent Psychiatric Clinics of North America
The Biological Effects of Childhood Trauma
Section snippets
Key points
Limbic-Hypothalamic-Pituitary-Adrenal Axis
The LHPA axis plays a central role in regulating the body’s response to stress and is the most studied biological stress system in animals and humans. Activation of the LHPA axis triggers the hypothalamus to secrete corticotropin-releasing hormone (CRH). This neuropeptide, also called corticotropin-releasing factor (CRF), is a key mediator of the stress response.26 The term CRH is used when describing its function in the neuroendocrine system and the term CRF is commonly used when describing
Clinical practice application
Understanding the biological effects of maltreatment provides important information that can be used in practice. The first approach is to ensure a safe environment for child and adolescent patients. It is unlikely that any treatment or buffering of the biological stress systems will occur if a child continues to live in an extremely adverse environment. As outlined in this issue, evidence-based interventions show promise in treating traumatized children. Similar interventions have shown not
Important tools for practice
Understanding the biological effects of maltreatment provides important tools that can be useful in practice. Besides self-report instruments to study changes in moods, emotions, and behaviors during psychotherapeutic and/or pharmacologic treatments, sleep can be objectively measured using biomarkers, such as actographs, which are noninvasive digital monitoring devices that can be worn on the wrist and measure daily activity, sleep awakenings, and sleep efficiency. Other biomarkers that can be
Future directions
The largest contributor to childhood trauma in the United States is family dysfunction; almost half of child-onset mental disorders and approximately a third of adult-onset mental disorders are preceded by child abuse and neglect and family dysfunction.251 Although the mental disorders found in maltreating parents and child victims are serious, they are amenable to prevention and treatment.
Given how detrimental childhood trauma is to an individual’s development, more efforts and social
Summary
This article outlines how childhood trauma has detrimental consequences on the biological stress systems and cognitive and brain development. Trauma in childhood is costly for its victims and for society. Resilience is not a common outcome of childhood trauma. In a longitudinal study of individuals who had experienced abuse and neglect during childhood, only 22% of those who had been abused or neglected achieved resiliency based on a comprehensive assessment of healthy adult functioning by the
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