Brain and Development affected after Child Abuse

The effect of child abuse on the brain and the impact of stress hormones on emotional and cognitive development

child-abuseMaltreatment, no matter whether it is abuse, neglect, abandonment or witnessing violent acts, can lead to enduring negative changes in the still developing brain of a child. Each time there is some sort of trauma, the brain suffers a particular change. So far, researchers have noted changes in the prefrontal cortex, the cerebellum and the limbic system (Wheeler T., 2006) It is important to point out that infancy and early childhood are times for rapid brain development and formation of dendritic connections. Of course, they continue to develop throughout adolescence and early adulthood, but are particularly vulnerable earlier in life (Kalat J, 2003).

Prefrontal cortexThe prefrontal cortex is the most anterior part of the frontal lobe of the brain and is involved in critical thinking and judgment, as well as any behavior that depends on context and requires decision making. Therefore, people with damaged prefrontal cortex often cannot modify their behavior and become inflexible in changing situations, which can make their reactions and behavior too impulsive and socially unacceptable (Kalat J., 2003). Damage to the prefrontal cortex can eventually result in many deficits, such as not being able to regulate motivation and efforts and having impaired short-term and long-term goal-directed behavior. In addition, damage and disruption of prefrontal cortex functions due to any type of abuse may lead to being unable to integrate positive emotions. Thus, the person is stuck in a negative stance of fear, anger and anxiety, and cannot engage in experiencing positive emotions. Needless to say, this may lead to developing depression, antisocial or borderline personality disorders (Wheeler T., 2006).

The cerebellum is a large structure in the hindbrain that is mainly known for controlling movement, achieving balance and coordination (Kalat J., 2003). However, it also plays a role in attention and emotions, as well as in regulating the limbic system (Wheeler T., 2006). Multiple studies involving brain imaging have shown that many people with psychiatric disturbances have abnormalities in the cerebellum (Wheeler T., 2006). This could be explained by the fact that in incidences of childhood abuse the cerebellum is extremely vulnerable to the stress hormones that are released in large amounts during stress, trauma or abuse. The brain changes that occur subsequently can lead to depression or hyperactivity, and inattention. Also, the cerebellum is considered to play a role in suppressing irritability. Therefore, abnormalities or damage to the cerebellum may cause chronic irritability and make the person seek external means, such as drugs, to deal the subjective discomfort (Wheeler T., 2006).

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The limbic system is the forebrain area next to the brainstem that includes a number of interdependent structures under the cerebral cortex, which deal with motivation and are critical in regulating emotions, sexual activity, eating, drinking, anxiety and aggression (Kalat J., 2003). The hippocampus and the amygdala are essential parts of the limbic system and are crucially important for controlling the emotional response to a particular situation. They also take part in memory formation and learning (Wheeler T., 2006). Prolonged and continuous exposure to stress hormones can cause serious damage to these parts of the limbic system and disrupt mood regulation, memory, and one’s way of interpreting the environment. Besides, damage to the limbic system can lead to epileptic seizures and abnormal EEGs that usually affect the temporal lobe of the left hemisphere. Usually, damage to the left hemisphere is associated with poor verbal development, but, more importantly, with aggression, self-destructive behavior and suicidality (Wheeler T., 2006).

Child abuse 03What is stress? Many things can be considered stressful for an individual, including insufficient nutrition, lack of rest, overstimulation, especially of the fear-related response system, as well as abuse, neglect or witnessing violence or death (Gunnar & Vazquez, 2001). The prolonged exposure to stress and the produced stress hormones in the body can be very serious and especially harmful to infants and young children (Gunnar & Vazquez, 2001). In fact, exposure to stress activates two body systems: the autonomic nervous system that prepares the body to react quickly to stimuli in the environment and the HPA-axis – the hypothalamus, pituitary and adrenal cortex.

The HPA-axis reacts more slowly, but is critically important in prolonged exposure to stressors (Kalat J., 2003). The activation of the hypothalamus stimulates the ‘master gland’ (the pituitary gland) to secrete adrenocorticotropic hormone (ACTH) that, in turn, stimulates the secretion of cortisol. Cortisol is generally regarded as ‘The’ stress hormone. It helps the body mobilize energy and respond to stress quickly, but has negative effects in the long run, since it enhances metabolism and elevates blood sugar levels (Kalat J., 2003). Other stress-related hormones are corticosteroids, corticotrophin release hormone (CRH), epinephrine and norepinephrine (Gunnar & Vazquez, 2001). Serotonin is also very important for the adequate coping with stress. Therefore, abnormal function of serotonin is associated with some depression and anxiety-related disorder, such as BPD.

Child abuse 02Research has shown that elevated stress hormone levels can cause malfunctions in the amygdala and hippocampus (Gunnar & Vazquez, 2001). Severe or merely constant exposure to stress may lead to the shriveling of certain dendrites in the hippocampus, which can cause its degeneration and malfunction (memory loss and inability to control the release of other stress hormones) (Gunnar & Vazquez, 2001). Shrunken hippocampus has been observed in autopsies of children who have experienced repeated abuse or in people who were suffering Post-traumatic Stress Disorder. In addition, disruption of the HPA-axis that is also related to exposure to stress in early age is associated with depression, inattention, and poor memory (Gunnar & Vazquez, 2001). The hippocampus is a particularly vulnerable brain structure, especially during infancy and childhood, when it is still developing (Gunnar & Vazquez, 2001).

Child abuse 04If too many stress hormones are being produced in the early stages of development, the developing brain may be permanently damaged, becoming incapable of initiating a normal stress response. It may either overproduce stress hormones, so that the person becomes hyper-vigilant, fearful and always on the alert, or it may underproduce stress hormones so that the person becomes “emotionally flat”, sad and depressed (Berger, 2005). A study of Cicchetti & Rogosch (2001) identified a lot of “atypical cortisol regulation patterns” that are obvious among children that have been maltreated. Studies like this are evidence for the correlation between child maltreatment and the disrupted function of certain brain structures that cause inflexibility in behavior, such as depression, chronic stress, anxiety, aggression and many others that can often be associated with a number of illnesses and disorders.

ChildAbuseTMany of the brain abnormalities that have been studied in abused and neglected children are located in the left hemisphere. Very often, in children, victims of abuse, there were fewer dendritic connections between different areas in the left hemisphere (Gunnar & Vazquez, 2001). Children that had showed such abnormal results demonstrated self-destructive or aggressive behavior, as well as certain disturbances in  thinking, emotional reactivity and physiology (higher blood pressure, heart rates, temperature, hypervigilance) (Gunnar & Vazquez, 2001). Since these could all be characteristics of a borderline personality patient, the results give food for thought as to the relation between abuse in childhood and the development of the disorder.

Studies of neglected children found that their cortex was about 20 percent smaller than that of a control group of subjects (children) who have not suffered neglect (Gunnar & Vazquez, 2001).

The negative effects of childhood abuse are real and alarming, perceived not only intuitively, but also through tangible scientific methods. Raising awareness, educating parents and engaging in careful preventative monitoring are not only the lawful obligations of doctors, teachers and helping professionals, but also the ethical obligation of any good citizen. Remember that you only need to suspect child abuse in order to call the National Child Abuse Hotline that receives anonymous calls 24/7 at 1-800-4-A-CHILD (1-800-422-4453). I believe we are all responsible for the welfare of our minors, who represent your future and the heritage we leave behind.

19 comments for “Brain and Development affected after Child Abuse

  1. Patricia
    December 14, 2009 at 3:32 am

    My husband and I adopted our daughter 9 years ago when she was 6. She comes from an abused back ground and I now find that her comprehension is very poor. What can I do to help her understand and analize.

    Many thanks

  2. ben
    October 21, 2011 at 8:22 am

    hey,

    i´m writing my exam and i find your article very interesting. can you please tell me the full reference for: Wheeler T, 2006.

    you helped me very much.
    ben

  3. Dima
    October 21, 2011 at 1:40 pm

    Hello Ben!
    If you are writing an APA style paper, Wheeler (2006) may not be your best option, since it was a brief presentation paper “Child Abuse and the Brain” by Tina Wheeler, MS in “Research Brief” from February 2006 intended for the Newfield School District. However, these sources might be more helpful in examining the neurobiology of child abuse:
    Teicher, M. H.(2000). Wounds that time won’t heal: The neurobiology of child abuse. Cerebrum, 4(2),50-67.
    Teicher, M. H.(2002). Scars that Won’t Heal: The Neurobiology of Child Abuse. Scientific American, 286 (3), 68-75.

    Good luck!

  4. ben
    November 1, 2011 at 2:21 pm

    hey dima,

    thanks!!! oh yeah, I like the papers of martin teicher. he´s one of my favorite trauma researchers. we translated his modified adverse experience scale on our university in konstanz. you helped me very much. take care, ben

  5. March 1, 2012 at 10:33 am

    Hello Dima
    Child Abuse should be stopped in world , It is cruelty to children
    Visit the Picture of Child Abuse In : http://www.nsun.us
    Thank you
    betty

  6. Amy
    March 13, 2012 at 8:33 pm

    Hello Dima,

    A group of us are doing a power point presentation on a visual that is powerful. We would like to use the picture you have at the begining of this article. We need this information about the visual for our power point:

    The source of the visual image. Where does it appear? Target audience? Who created the visual?

    If you could please let us know we would appreciate it.

    Thank you very much,

    Amy, Tina, & Sandy

  7. Amy
    March 14, 2012 at 11:28 am

    Hi Dima,

    I would like to use the picture of the little girl with the shawdow of a man yelling as a visual for a powerpoint I have to do for ENC1102. Could you please tell me where the picture is from?

    Thank you,
    Amy

  8. Dima
    March 14, 2012 at 12:26 pm

    Hello Amy (Tina & Sandy)!

    I wish I could help you with the source of the picture. It’s an image that had gone viral. It’s been used in newspaper articles and even by government agencies. However, people either don’t name a source, or cite Google as the source. After your request yesterday I did an extensive search again, but had no luck in finding the original source. However, I came across this book that uses the image for its cover (http://www.amazon.com/o/ASIN/1435706455). I’d imagine the author/publisher has obtained the right to use the image and would, therefore, know more. This may be your best bet of finding out the information that you need.
    I’m sorry I couldn’t help you.
    Good luck with your project and presentation.

  9. Kelsey
    November 9, 2012 at 12:33 pm

    i AM creating a poster to help prevent child abuse!

  10. Saba
    November 22, 2012 at 12:24 pm

    hi!
    i was wondering if i could use one of your pictures for my project. In our school we are focussing on a right you want to do and i chose children’s right’s about abuse. So i was wondering if i could use one of your pictures.
    thanks!

  11. Dima
    November 26, 2012 at 12:19 pm

    I cannot claim any rights over those pictures, so you don’t need my approval. Good luck with your project.!

  12. Saba
    November 26, 2012 at 12:39 pm

    thanks!

  13. Dave
    February 23, 2014 at 6:37 am

    I come from a Brocken family, I was abandoned/neglected as a child, didn’t get enough love or attention , managed to get by, but the behaviour I learned then has stayed with me, i am 50 now and have just started to have counseling. I now believe I have fewer dendritic connections in my brain. I am trying to find some reading to help me in my search ?

  14. KIMBA
    March 30, 2014 at 8:37 pm

    Hello

    Just found this website and forum today and it seems interesting.

    I am a very talented 45 year old artist (painter) with a range of styles but I am seriously held back from pursuing any dream because I have severe PTSD.
    I am also a sexual abuse survivor; It happened around 8 or 9 year old and that has shredded my ability to function. I go to work and then I go home where I feel safe. I live with depression due to my severe social anxiety.

    Long story short, I am interested in the concept of neurological changes in the brain of adolescent victims and the long term affects into adulthood.

    I take Meds but it’s definitely not the right match. I see a good psychiatrist but I still look for more input from forums like this one.

    I feel confident that the front part of my brain is not what it should be. My anxiety is thru the roof and I can literally feel a rush of what I believe are over reacting stress hormones in the back area of my brain. I have a Terrible Memory, Suffocating and Paralyzing Anxiety, Hyper-vigilant and whole range of other problems from years of untreated PTSD.

    I need help on finding specific ongoing experimental research studies of the brain; either by Meds or Electrical or Magnetic stimulation. I am interested in knowing what is the precise condition of my brain’s imbalances. I would love to see an actual scan of my brain.

    I know this is probably a lot to ask but I would greatly appreciate a little guidance.

    Thank you

  15. Loloma
    July 14, 2014 at 7:46 am

    Hello Dima,
    Thank you very much for this article. As a child I suffered extreme physical, sexual and emotion abuse at the hands of my parents. The same as my brothers and sisters. Three committed suicide and one drunk himself to death. I am now almost 65 and am still learning to deal with the affects of prolonged PTSD.
    I have a much better understanding of my own behaviour pattern, memory loss and difficulty being in a relationship. Having had two failed marriages behind me and the inability to settle anywhere. I would love to find happiness, but don’t know how.
    On the positive side I have three wonderful children and four grandchildren. Unfortunately their father also mistreated them as children, hence the pattern repeated itself. They seem to have let it go, although they have relationship problems as well, which is a great pity. It is sad to see that without intending to, I stuck with the type of person that my parents were.
    The depression and sadness remain with me, I have learned to live with it and work at living as normal a life as possible. I still work full time, as I find it the best form of escapism that I know.
    Once again thank you for the valuable information.

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