Child abuse is now considered a major public health problem, so in recent decades there has been a rapid process for trying to understand the effects of exposure to traumatic experiences in childhood psychopathology (1), but how does trauma neurobiology develop?
In recent years, clinical research has focused on explaining the impact of on-time traumatic incidents and exposure to neglect and chronic violence; for example, several studies have shown that isolated traumatic incidents tend to produce conditional responses to traumatic memories.
- Meanwhile.
- Chronic abuse or recurrent exposure to traumatic events.
- Such as exposure to repeated medical or surgical procedures.
- Has extensive effects on neurobiological development (1).
- Apparently.
- Several facts contribute to the extent of psychological damage caused by trauma:.
We know that traumatic experiences can alter brain structures and compromise emotional, cognitive and bodily functions, weakening the patient, however, the neurobiology of trauma is still poorly understood by specialists and available educational resources are scarce, despite its prevalence ( 2).
In 2013, the American Psychiatric Association reviewed the criteria for diagnosing post-traumatic stress disorder (PTSD) in the Diagnostic Manual for Mental Disorders, so the disorder was included in a new category of the manual: trauma and stress disorders.
Traumatic events can compromise emotional, cognitive and bodily functions, causing debilitating symptoms for patients (3, 4) and a diagnosis of PTSD (2). In this way, trauma can occur:
When a major stress factor occurs, the hippocampus (involved in memory processing) and amygdala (involved in the processing of emotions) are flooded with stress hormones (3). The individual cannot treat traumatic experience as a finite event (although the threat no longer exists) and memory remains active in the brain (2).
This is why PTSD symptoms can appear long after trauma, in fact, in 25% of cases, these symptoms occur late (5).
Neurobiological changes in normal trauma-induced development include areas involved in the regulation of homeostasis. These are (6, 7):
The systems dealing with threats are sympathetic and parasympathetic nervous systems, which originate in the brain trunk, so early exposure to extreme threats and inadequate care significantly affects the child and, in the long term, the body’s ability to modulate sympathetic and parasympathetic. nervous system in response to stress (16).
Some studies report that children suffering from post-traumatic stress disorder and who have been abused have significantly higher levels of dopamine and norepinephrine than those who have not been abused (18, 19).
Children who have suffered trauma have less variability in heart rate than healthy individuals (20).
In general (and unlike cortisol studies in adults with PTSD), traumatized children have significantly higher levels of cortisol than control groups, who have never experienced trauma (21).
Research shows that adults who were still affected by trauma and who had PTSD had increased activation of the right amygdala when the trauma was remembered, this activation was accompanied by less activation of the speech center (22).
People who have suffered trauma and developed PTSD may experience a decrease in hippocampus volume in their neurobiology, so Davidson and his collaborators concluded that the impact of hippocampus participation in psychopathology may be more evident in the treatment of emotional information. Children injured in the hippocampus are more likely to show emotional behavior in inappropriate contexts (23).
Other areas affected by trauma include
The inability to self-regulate is characteristic of children who have suffered chronic trauma, their lack of self-regulation processes generates self-definition problems, so these problems are reflected in (8, 9):
Some features of traumatized children include:
Children who have been exposed to violence tend to
Other studies have shown that traumatized children are vulnerable to various physical illnesses. As adults, they are 10% to 15% more likely to develop cancer, heart disease, and diabetes.
During adolescence, they participate in destructive acts against themselves, and others are also about 300% more likely to consume violent and aggressive substances, self-harm and behavior against people other than those who have not experienced trauma (16).
Many trauma-affected children tend to communicate what happened to them without words, positioning themselves in front of the world as if it were a place full of dangers and activating survival-focused neurobiological systems, even when they are safe, so while children cannot speak of their traumatic experiences, trauma is likely to be expressed as an incarnation of what happened to them.
Therefore, the task of therapy with traumatized children is to help them develop a sense of physical domination, stimulating awareness of who they are and what has happened to them, in this way they will be able to understand what is happening to them in the present. and stop recreating the traumatic past emotionally, behaviorally and biologically (1).