Child Abuse and Adult Mental Disorders

Child Abuse and Long Term Mental/Physical Health 
 (Manning & Stickley, 2009; Cleverley & Boyle, 2010)

Child maltreatment causes suffering to children and families and can have long-term consequences. Maltreatment causes stress that is associated with disruption in early brain development.  Extreme stress can impair the development of the nervous and immune systems.

Consequently, as adults, maltreated children are at increased risk for behavioral, physical and mental health problems. Physical health problems include seizures, menarche occurring 2 years earlier, idiopathic bladder, bowel problems, fibromyalgia, fertility problems, sexual functioning and dental damage.  Long term mental health problems include depression, anxiety disorders, personality disorders, eating disorders (anorexia, bulimia, binging), substance abuse, phobias, post traumatic stress disorder, manic depression, and dissociation (Manning & Stickley, 2009).

There is growing evidence that suggests the possibility of a causal relationship between childhood abuse and psychosis in adulthood. Psychosis is an umbrella term used for number of conditions and experiences such as schizophrenia spectrum disorders, major depressive disorders, dissociative identity disorders (DID) and post-traumatic stress disorder (PTSD). Positive symptoms of psychosis are strongly associated with child abuse. It is estimated that lifetime prevalence of major depression among women with history of sexual abuse to be 28.5% and 46.6% of the men with history of sexual abuse met the criteria of at least one life time mental health disorder (Cleverley & Boyle, 2010).

Abuse teaches the child that others come first and the child exists to submit to others, self esteem is lowered, unassertive behaviours are learned, and health care practices and self care practices are not valued.  The child learns the problem rest with them.  The child may face social problems and problems in interpersonal relationships. Underachievement educationally and vocationally is common. 

Moroever, there is an economic impact, including costs of hospitalization, mental health treatment, child welfare, and longer-term health costs.

Neurobiology and Childhood Trauma  
(Kreidler & Kurzawa, 2009; McGuinness, 2010)

Childhood trauma can lead to irreversible damages to the brain that include neurotransmitter abnormalities, neuroendrocrine alterations, and changes in functional neuroanatomy. A general finding is that different systems are sensitized as a response to trauma and there is an increased release of norepinephrine and autonomic activity. Two brain structures, the amygdala and the hippocampus, appear to be specifically involved in early childhood brain responses to trauma.  The amygdala responds to repeated trauma in a way that prevents extinction of the fear response (Kreidler & Kurzawa, 2009). Significant stressors in childhood may have a dispro­portionately negative response, stimulating the HPA axis to re­lease corticotropin-releasing fac­tor and leading to chronically elevated systemic levels of corti­costeroids. These disruptions in HPA signal­ing cause sustained inflamma­tory processes, which may have a role in developing cancers, heart disease, and immune disorders (McGuinness, 2010).

Substance Abuse and Child Maltreatment  
(Health Canada, 2004)

Caregiver substance abuse is not considered maltreatment; it can compromise parenting capacity and quality. There is growing evidence that children being raised in homes where adult substance abuse exists are at a higher risk of maltreatment.  Maltreatment may occur as a result of depleted household budgets, parental abandonment for hours or days, reduced emotional and physical availability and cognitive capacity on the part of the caregiver, and exposure to criminal activity, harmful substances or potentially dangerous adults (Health Canada, 2004).

References

1. Cleverley, K., & Boyle, M. (2010). The individual as a moderating agent of the long-term impact of sexual abuse. Journal of Interpersonal Violence, 25(2), 274-290. doi:10.1177/0886260509334284.
2. Health Canada. (2004). Child Maltreatment: A public health issue. Retrieved December 12, 2010 from http://www.hc-sc.gc.ca/sr-sr/pubs/hpr-rpms/bull/2004-9-child-enfant/intro-eng.php#page12.
3. Kreidler, M., & Kurzawa, C. (2009). Trauma spectrum disorders: clinical imperatives. Journal of Psychosocial Nursing & Mental Health Services, 47(11), 26-33. doi:10.3928/02793695-20090930-02.
4. Manning, C., & Stickley, T. (2009). Childhood abuse and psychosis; a critical review of the literature.Journal of Research in Nursing, 14(6), 531-547. doi:10.1177/1744987109347045.
5. McGuinness, T. (2010). Childhood adversities and adult health. Journal of Psychosocial Nursing & Mental Health Services, 48(8), 15-6. doi:10.3928/02793695-20100701-04.