By Charlene N. Rivera-Bonet, Waisman Science Writer
Early childhood maltreatment can have long lasting effects that follow a person into adulthood. Although the majority of kids who experience maltreatment do not go on to develop depression, a study by James Li, PhD, associate professor of psychology and Waisman Center investigator, found that individuals with early childhood trauma may experience difficulties in many areas of their lives even in the absence of a mood disorder.
Around 25% of kids that experience maltreatment early in life develop a mood disorder such as depression later in life. Those who don’t are labeled as resilient, or able to positively adapt to adversity. However, Li suggests that basing resilience solely on psychiatric outcomes may miss many other areas of an individual’s life that could be negatively affected. “You can’t just think of resilience as not having a psychopathology. It might be harmful to do that for the kids,” says Li.
From a public policy perspective, the authors point out, labeling individuals who experience maltreatment but are not diagnosed with mental disorders as resilient may lead policymakers to withhold much needed resources to individuals who may be experiencing other long-term consequences of abuse.
The new study from Li’s lab, published in Development and Psychopathology, looked at the 20-year trajectory of depression from adolescence into adulthood of individuals with and without early experiences of maltreatment including physical abuse or neglect, emotional abuse, sexual abuse, and supervisory neglect. Depression levels were classified as low, increasing, or declining.
To determine if the youth that did not develop depression had impairment in other domains of their lives, the researchers measured fundamental adaptive systems (FAS) including social/interpersonal, substance use, physical health, and socioeconomic domains.
Around 75% of individuals with early childhood maltreatment fell into the low depression category, which by the field’s standards would be identified as resilient. But the rest of the results may suggest otherwise.
Individuals with low depression that had experienced childhood maltreatment reported worse functioning in nearly every, but not all, FAS domains when compared to individuals with low depression and no childhood trauma. “In other words, it’s that trauma, early childhood trauma, that was really differentiating these outcomes among people,” Li says.
Overall, individuals in the low depression group that had experienced childhood maltreatment reported lower romantic satisfaction in relationships, higher intimate partner violence, more sexual violence victimization, more alcohol abuse or dependency, and worse general physical health. “Most people are not going to develop mental health problems, but they do develop so many other problems outside of mental health that have just as bad impacts on day to day life,” Li explains.
Trauma can affect the way brains develop. In particular, it affects the circuitry between the prefrontal cortex and the limbic system, involved in executive function and emotion regulation respectively. “For kids that have trauma histories, those connections are sort of weakened and not as strong. And that leads to greater difficulties with day to day functioning because it taps into their ability to make decisions and regulate emotions,” says Li. Some kids who experienced maltreatment, Li explains, may never develop post traumatic stress disorder (PTSD) or depression, but still have issues with executive function and decision making.
Kids who have experienced trauma in early life also develop more adaptive systems to deal with threat as they age, which may make them more hypervigilant and wary of making close connections with others.
Li’s research points out the need for two important interventions. The first is the need for maltreatment prevention. “We can give kids skills and we can give them tools, but we really ought to be protecting them in the first place,” Li says. This can look like developing parenting interventions that focus on teaching parents how to use more effective parenting skills, or how to regulate their own emotions.
Second, it highlights the need for tools and interventions for kids who have experienced abuse but do not present mental health issues. Although calling them resilient may sound like a compliment, it can be a harmful barrier for help.
“We’re saying don’t look at the mental disorder as a reason for giving kids interventions,” Li says. “If kids have experienced trauma, we should be making sure that they’re taught how to regulate their emotions, and coping skills. There’s a risk for developing those mental health outcomes, but there’s also a litany of negative effects that could happen down the line.”
This work was supported by a core grant to the Waisman Center from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and a seed grant from the University of Wisconsin-Madison Center for Human Genomics and Precision Medicine.
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