case study in psychology

case study in psychology

The Impact of Childhood Trauma on Adult Mental Health

1. Introduction

This section identifies the significance of the problem with regard to the study and also includes definitions and terms which will be used throughout the study. It also provides a brief explanation of the subsequent chapters to enable the reader to understand the flow and what will be discussed. Psychological literature is replete with theoretical formulations and research reviews of how adult emotional life is determined by earlier experiences. The evidence is now overwhelming that a child’s experience of the world is a major factor in the continuing development of his cognitive and social capacities. As the experience of the world for a child is primarily within the family, there is little doubt that the quality of family life the child may experience will have a profound effect on his subsequent life. Normal and especially abnormal child development occurs within a transactional process between the child and his environment. The key elements in that environment are the relationships with family and friends, cultural influences, and organized societal support and constraints. It is thus very difficult to specify the effects of any particular stressor in childhood as being harmful in a lasting way. A child’s interpretation of an event and its effects on him are heavily mediated by how other significant persons in his life react and by how it may fit into the overall sociocultural milieu. Commonly now it is marginalized groups such as immigrants, and refugees, and socially disadvantaged children who are the focus of concern around possible lasting psychopathological effects of early trauma. Highly stressful events such as divorce or death of a parent and events stemming from catastrophic social or natural events can have severe negative effects on children. Early trauma can be termed as any event that is experienced by a child as threatening to his life or bodily integrity, watching a loved one harmed, or even having a loved one scared by law or medical personnel. High trauma is created when the event is chronic and interpersonal such as abuse or neglect. The effects of childhood trauma are both acute and long-lasting.

2. The Definition and Types of Childhood Trauma

The types of events that can be considered to create trauma are endless, and they are specific to the individual and the culture. So, for example, a car accident may not have lasting negative effects on one person, but it may induce anxiety to travel in vehicles for another. However, it is easier to define some kinds of events as traumas, such as adverse childhood experiences, and these are extremely prevalent. The US Centers for Disease Control and Prevention identified 5 types of adverse childhood experiences: psychological, physical, or sexual abuse; exposure to an alcohol or drug abuser in the household; family mental illness; incarceration of a household member; and witnessing parental violence towards one another. A survey based on these categories, demonstrating a clear dose-response relationship between the number of adverse childhood experiences and poor physical and mental well-being in adult life, collected data from 17,000 patients and found that ACEs were relatively common. Two out of three participants had experienced at least 1 ACE, and a higher number of ACEs were associated with a higher risk of many diseases. This survey begins to shed light on the types of adverse childhood events that may produce mental health problems in adult life and a method of measuring them, but the concept of ACEs is still a long way from being a comprehensive typology of childhood trauma. Despite these issues, knowing what types of childhood trauma can have a bearing upon mental health in adult life is important for designing services for traumatized children and preventive and interventive services for adults with experience of childhood trauma. This may be a hard goal as we do not know what a specific traumatized 5-year-old child is going to grow up into, as we only have notions of maintaining mental health across the life course, and the trajectory of events and outcomes that links childhood trauma to adult mental health are complex and variable. But if services are to be designed with the aim to prevent adult mental health problems through addressing childhood trauma, some of these services have to be based on the specific type of trauma.

The attitude of the taking care of professions to the problem of recognizing psychological violence and physical and the lack of the tools for measuring the harm may be connected to the fact that these types of abuse are usually not perceived to be serious transgressions versus children. Additionally, generating a label for events that would be described as exceptional and untypical versus ongoing has posed many problems. All these issues have hampered the attempt to define what is meant by childhood trauma and constitute an impediment to research because there is no way to sample cases using agreed criteria. Despite these difficulties, there are a number of broad definitions of trauma. For example, Levav defines a traumatic occurrence as an event that an individual experiences as extremely threatening or harmful and that has lasting adverse effects on the individual’s functioning and mental, physical, or social health until the event is resolved by some means of treatment or not. The proposed WHO ICD-11 definition refers to an event that is stressful and harmful and causes lasting adverse effects on psychological development. This is about as far as there is consensus on the definition and scope of trauma, and using this as a foundation, we can consider the definition of an event being anything that happens to the specified individual.

3. The Link Between Childhood Trauma and Adult Mental Health

The complexity of diagnosing an adult mental health disorder is compounded by the diversity of symptoms experienced by different individuals. For example, a person with major depression may sleep excessively and gain significant weight, whereas another individual will suffer from insomnia and a decrease in appetite. The association of symptoms to a specific disorder is very difficult and garners much debate among mental health practitioners. Due to these difficulties, establishing a concrete diagnosis of a mental health disorder is challenging. The existence of an accurate and detailed childhood trauma history in the patient confines the diagnosis of adult psychopathology. This is due to the fact that it is widely acknowledged that childhood trauma is a contributory factor to developing mental health disorders. By limiting the traumatic event to a specific type or time period, it can be linked to presenting specific mental health disorders. For example, the experience of physical abuse has been shown to have significant correlation to developing a major depressive disorder and anxiety disorders. Sexual abuse has been linked to borderline personality disorder and somatoform/dissociative disorders. It is significant that the traumatic event can be linked to a disorder due to the fact that it is widely acknowledged that traumatic events which re-ignite the traumatic memory in the sufferer, for example further assault or a distressing anniversary, are powerful triggers for the onset of mental health disorders. This information is consistent with several major theories explaining the development of psychopathology and thus can be regarded as concrete evidence. Slightly off topic but worth mentioning is that childhood trauma is linked in adulthood to chronic physical conditions and is associated with a higher prevalence of health risk behaviors such as smoking, and can thus be linked to the decrease in life expectancy of mental health patients.

4. Case Studies: Examining the Effects of Childhood Trauma on Adult Mental Health

Case studies are used to gain a more detailed insight into individual cases and to question whether one factor can be linked to another. At the National Child Traumatic Stress Network’s 2004 conference, one symposium concentrated on the relationship between trauma in childhood and resulting adult health issues. Four studies were presented; they all support the theory that experiences in childhood are linked to both the development of health risk behavior and disease in adulthood, as well as the development of subsequent health problems. The four studies were based on different participant groups and explored differing mental health and physical health outcomes. An interesting research conducted in New Zealand aimed to establish a link between childhood behavior and adult disease. It was based on a sample of 1000 people studied from birth in the early 1970s. At the age of 3, parents were interviewed about their children’s behavior, and at age 32, participants were assessed for both physical and mental health. The main findings suggest that behavioral problems at age 5 and the presence of multiple behavioral problems were clearly linked to both physical disease and psychiatric disorder. Chronic behavior problems in childhood carry a definite risk to the child’s adult health. This study effectively links the issue of child behavior with adult health. It suggests that behavioral problems in childhood are a risk factor for the development of disease in adulthood. This is an issue often overlooked, and this study provides evidence that child behavior is an important area for health professionals to consider when dealing with the prevention of adult disease.

5. Conclusion and Recommendations

It is clear that childhood trauma has significant implications on adult mental health. Much research has been conducted to help us understand these effects. With an understanding of the connection between childhood trauma and adult mental health, it is important to consider ways in which we can alleviate undue suffering. Prevention and early intervention, recognition and effective management of childhood trauma are the keys to altering its course and reducing the impact of the trauma on subsequent adult mental health. By targeting those with a history of childhood trauma, more effective prevention and intervention strategies can be developed with the goal of reducing mental health disparities and promoting resilience. Understanding the connection between childhood trauma and adult mental health provides a framework for action, and will improve the lives of both current and future generations.