Traumatyczne doświadczenia w dzieciństwie jako czynniki ryzyka zaburzeń psychicznych wieku rozwojowego i dorosłości

• Authors: Małgorzata Dąbkowska

Title variants

EN

Childhood traumatic events as a risk factor on psychiatric disorders in the age of child’s development and adulthood

• Languages of publication: EN PL

Abstracts

EN

Traumatic childhood-related experiences are a risk factor for several mental disorders during developmental age. Effects of traumatic events last until adulthood, promoting manifestation of symptoms of mental diseases. Among psychiatric patients, the incidence of such childhood-related events as sexual abuse, emotional abuse and physical violence is significantly higher than in general population. Traumatic experiences play a particular role in the pathogenesis of schizophrenia, expressed in the traumagenic theory of this disease. Unfavourable events associated with important losses play an important role in the development of depression. One of the most basic childhood-related losses is the loss of mother. In children, the source of traumatic experiences is often family dysfunction and parental mental disease. Threatening events in the family contribute to incorrect formation of personality, usually in the direction of borderline or dissocial personality. Catastrophic events during childhood are a risk factor for anxiety disorders. They may precede for many years or may be the direct triggering mechanism for anxiety symptoms in children. Stress associated with negative experiences inhibits normal intellectual development in children, contributing to worse verbal function and academic problems. Traumatic experiences may cause emotional disorders in children, e.g. nocturnal enuresis, neurorozwounderwear soiling or selective mutism. Childhood traumata may result in structural brain lesions. Children who experienced violence may present lesions in the limbic system – hippocampus, amygdala and septal area. Structural lesions resulting from traumatic experiences make these children more vulnerable to stress later in life, thus increasing the risk of mental disorders in adulthood.

PL

Traumatyczne doświadczenia w dzieciństwie są czynnikiem ryzyka wielu zaburzeń psychicznych wieku rozwojowego. Skutki traumatycznych zdarzeń trwają do wieku dorosłego, sprzyjając ujawnieniu się objawów chorób psychicznych. U pacjentów psychiatrycznych znacząco częściej notuje się w wywiadzie takie wydarzenia w dzieciństwie, jak wykorzystywanie seksualne, nadużycia emocjonalne i przemoc fizyczna. Traumatyczne doświadczenia odgrywają szczególną rolę w patogenezie schizofrenii, co podkreśla się w traumagenicznej teorii tej choroby. W depresji bardzo istotne są niekorzystne wydarzenia związane z ważnymi utratami. Jedną z najważniejszych utrat w dzieciństwie stanowi strata matki. U dzieci źródłem traumatycznych przeżyć są często dysfunkcyjna rodzina i zaburzenia psychiczne rodziców. Zagrażające wydarzenia w rodzinie sprzyjają nieprawidłowemu kształtowaniu się osobowości, najczęściej w kierunku typu osobowości granicznej lub dyssocjalnej. Katastroficzne wydarzania w dzieciństwie stanowią czynnik ryzyka zaburzeń lękowych. Mogą one wystąpić wiele lat przed lub być bezpośrednim mechanizmem spustowym objawów lękowych u dzieci. Stres związany z negatywnymi przeżyciami hamująco wpływa na rozwój intelektualny dzieci, przyczyniając się do obniżenia funkcji werbalnych i trudności w nauce. Traumatyczne przeżycia są przyczyną zaburzeń emocjonalnych u dzieci, takich jak moczenie nocne, zanieczyszczanie się czy mutyzm selektywny. W wyniku doznanych urazów w dzieciństwie obserwuje się zmiany strukturalne mózgu. U dzieci doświadczających przemocy stwierdzono zmiany w układzie limbicznym – w hipokampie, jądrach migdałowatych, w okolicach przegrody. Zmiany strukturalne mózgu powstałe pod wpływem traumatycznych przeżyć uwrażliwiają na stres w późniejszym okresie życia, narażając na ujawnienie się zaburzeń psychicznych w wieku dorosłym.

Keywords

EN

childhood; childhood trauma; dzieciństwo; early life stress; hypothalamic-pituitary-adrenocortical axis; oś podwzgórzowo-przysadkowo-nadnerczowa; pacjenci psychiatryczni; przemoc; psychiatric disorders; psychiatric patients; sexual abuse; traumatic events; traumatyczne wydarzenia; uraz w dzieciństwie; violence; wczesnodziecięcy stres; wykorzystywanie seksualne; zaburzenia psychiczne

Discipline

• MEDICINE: MEDICINE

• Journal: Psychiatria i Psychologia Kliniczna
• Year: 2006
• Volume: 6
• Issue: 4
• Pages: 203-210

Contributors

author

Małgorzata Dąbkowska

• Katedra i Klinika Psychiatrii Collegium Medicum im. L. Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu,

References

• 1. Fitzpatrick K.M., Boldizar J.P: The prevalence and consequences of exposure to violence among African-American youth. J. Am. Acad. Child Adolesc. Psychiatry 1993: 32: 424-430.
• 2. Teicher M.H., Glod C.A., Surrey J., Swett C. Jr: Early childhood abuse and limbic system ratings in adult psychiatric outpatients. J. Neuropsychiatry Clin. Neurosci. 1993; 5: 301-306.
• 3. Lipschitz D.S., Kaplan M.L., Sorkenn J.B. i wsp.: Prevalence and characteristics of physical and sexual abuse among psychiatric outpatients. Psychiatr. Serv. 1996; 47: 189-191.
• 4. Terr L.: What happens to early memories of trauma? A study of twenty children under age five at the time of documented traumatic events. J. Am. Acad. Child Adolesc. Psychiatry 1988; 27: 96-104.
• 5. Hampton T.: Effects of stress on children examined. JAMA 2006; 295: 1888.
• 6. Lyons D.M., Yang C., Sawyer-Glover A.M. i wsp.: Early life stress and inherited variation in monkey hippocampal volumes. Arch. Gen. Psychiatry 2001; 58: 1145-1151.
• 7. Pihoker C., Owens M.J., Kuhn C.M. i wsp.: Maternal separation in neonatal rats elicits activation of the hypothalamic-pituitary-adrenocortical axis: a putative role for corticotropin-releasing factor. Psychoneuroendocrinology 1993; 18: 485-493.
• 8. McEwen B.S.: Stressed or stressed out: what is the difference? J. Psychiatry Neurosci. 2005; 30: 315-318.
• 9. Watanabe Y., Gould E., McEwen B.S.: Stress induces atrophy of apical dendrites of hippocampal CA3 pyramidal neurons. Brain Res. 1992; 588: 341-345.
• 10. Perry B.D., Pollard R.: Homeostasis, stress, trauma, and adaptation. A neurodevelopmental view of childhood trauma. Child Adolesc. Psychiatr. Clin. N. Am. 1998; 7: 33-51.
• 11. Yehuda R., Schmeidler J., Wainberg M. i wsp.: Vulnerability to posttraumatic stress disorder in adult offspring of Holocaust survivors. Am. J. Psychiatry 1998; 155: 1163-1171.
• 12. Putnam F.W., Trickett P.K., Helmers K. i wsp.: Cortisol abnormalities in sexually abused girls. Proceedings of the 144th Annual Meeting of the American Psychiatric Association. American Psychiatric Association, Washington, DC 1991: 107.
• 13. Heim C., Newport D.J., Heit S. i wsp.: Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. JAMA 2000; 284: 592-597.
• 14. Walker E.F., Diforio D.: Schizophrenia: a neural diathe-sis-stress model. Psychol. Rev. 1997; 104: 667-685.
• 15. De Bellis M.D., Chrousos G.P, Dorn L.D. i wsp.: Hypothalamic-pituitary-adrenal axis dysregulation in sexually abused girls. J. Clin. Endocrinol. Metab. 1994; 78:249-255.
• 16. Teicher M.H., Ito Y., Glod C.A. i wsp.: Preliminary evidence for abnormal cortical development in physically and sexually abused children using EEG coherence and MRI. W: Yehuda R., McFarlane A.C. (red.): Psychobiology of Posttraumatic Stress Disorder. Ann. N.Y. Acad. Sci. 1997: 821: 160-175.
• 17. Green A.H., Voeller K., Gaines R., Kubie J.: Neurological impairment in maltreated children. Child Abuse Negl. 1981; 5: 129-134.
• 18. Goodman LA., Rosenberg S.D., Mueser K.T., Drake R.E.: Physical and sexual assault history in women with serious mental illness: prevalence, correlates, treatment, and future research directions. Schizophr. Bull. 1997; 23: 685-696.
• 19. Jacobson A., Richardson B.: Assault experiences of 100 psychiatric inpatients: evidence of the need for routine inquiry. Am. J. Psychiatry 1987; 144: 908-913.
• 20. Jacobson A.: Physical and sexual assault histories among psychiatric outpatients. Am. J. Psychiatry 1989; 146: 755-758.
• 21. Pfefferbaum B.J.: Aspects of exposure in childhood trauma: the stressor criterion. J. Trauma Dissociation 2005; 6:17-26.
• 22. Darves-Bornoz J.M., Lemperiere T, Degiovanni A., Gaillard P: Sexual victimization in women with schizophrenia and bipolar disorder. Soc. Psychiatry Psychiatr. Epidemiol. 1995; 30: 78-84.
• 23. Read J., van Os J., Morrison A.P., Ross C.A.: Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatr. Scand. 2005; 112: 330-350.
• 24. Myin-Germeys I., van Os J., Schwartz J.E. i wsp.: Emotional reactivity to daily life stress in psychosis. Arch. Gen. Psychiatry 2001; 58: 1137-1144.
• 25. Read J.: Child abuse and psychosis: a literature review and implications for professional practice. Professional Psychology: Research and Practice 1997; 28: 448-456.
• 26. Read J., Agar K., Barker-Collo S. i wsp.: Assessing suicidality in adults: integrating childhood trauma as a major risk factor. Professional Psychology: Research and Practice 2001; 32: 367-372.
• 27. Read J.: The Bio-bio-bio model of madness. The Psychologist (UK) 2005; 18: 596-597.
• 28. Muenzenmaier K., Meyer I., Struening E., Ferber J.: Childhood abuse and neglect among women outpatients with chronic mental illness. Hosp. Community Psychiatry 1993: 44: 666-670.
• 29. Velakoulis D., Pantelis C., McGorry P.D. i wsp.: Hippocampal volume in first-episode psychoses and chronic schizophrenia: a high-resolution magnetic resonance imaging study. Arch. Gen. Psychiatry 1999; 56: 133-141.
• 30. Jacobsen L.K., Giedd J.N., Castellanos F.X. i wsp.: Progressive reduction of temporal lobe structures in child-hood-onset schizophrenia. Am. J. Psychiatry 1998; 155: 678-685.
• 31. Chua S.E., Murray R.M.: The neurodevelopmental theory of schizophrenia: evidence concerning structure and neuropsychology. Ann. Med. 1996; 28: 547-555.
• 32. Russell A.J., Munro J.C., Jones PB. i wsp.: Schizophrenia and the myth of intellectual decline. Am. J. Psychiatry 1997; 154: 635-639.
• 33. Kremen WS., Buka S.L., Seidman L.J. i wsp.: IQ decline during childhood and adult psychotic symptoms in a community sample: a 19-year longitudinal study. Am. J. Psychiatry 1998; 155: 672-677.
• 34. Read J.: The problem of child sexual abuse. Science 2005; 309: 1182-1185.
• 35. Read J., Argyle N.: Hallucinations, delusions, and thought disorder among adult psychiatric inpatients with a history of child abuse. Psychiatr. Serv. 1999; 50: 1467-1472.
• 36. Tiet Q.Q., Bird H.R., Hoven C.W. i wsp.: Relationship between specific adverse life events and psychiatric disorders. J. Abnorm. Child Psychol. 2001; 29: 153-164.
• 37. Brown G.W, Harris T, Copeland J.R.: Depression and loss. Br. J. Psychiatry 1977; 130: 1-18.
• 38. Campbell E.A., Cope S.J., Teasdale J.D.: Social factors and affective disorder: an investigation of Brown and Harris’s model. Br. J. Psychiatry 1983; 143: 548-553.
• 39. Costello C.G.: Social factors associated with depression: a retrospective community study. Psychol. Med. 1982; 12: 329-339.
• 40. Goodyer I.M., Mitchell C.: Somatic emotional disorders in childhood and adolescence. J. Psychosom. Res. 1989; 33:681-688.
• 41. Goodyer I.M.: Life Experiences, Development and Childhood Psychopathology. John Wiley & Sons, Inc., Chichester 1991.
• 42. Tanskanen A., Hintikka J., Honkalampi K i wsp.: Impact of multiple traumatic experiences on the persistence of depressive symptoms - a population-based study. Nord. J. Psychiatry 2004; 58: 459-464.
• 43. Lipschitz D.S., Winegar R.K., Nicolaou A.L. i wsp.: Perceived abuse and neglect as risk factors for suicidal behavior in adolescent inpatients. J. Nerv. Ment. Dis. 1999; 187: 32-39.
• 44. Gmitrowicz A., Rabe-Jabłońska J.: Psychiatryczne uwarunkowania zachowań samobójczych u młodzieży. Wiadomości Psychiatryczne 1999; 2: 185-192.
• 45. Dube S.R., Anda R.F., Felitti VJ. i wsp.: Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study. JAMA 2001; 286: 3089-3096.
• 46. Kendler K.S., Myers J., Prescott CA.: The etiology of phobias: an evaluation of the stress-diathesis model. Arch. Gen. Psychiatry 2002; 59: 242-248.
• 47. Kendler K.S., Neale M.C., Kessler R.C. i wsp.: Childhood parental loss and adult psychopathology in women. Atwin study perspective. Arch. Gen. Psychiatry 1992; 49: 109-116.
• 48. Gittelman-Klein R., Klein D.F.: Separation anxiety in school refusal and its treatment with drugs. W: Hersov L., Berg I. (red.): Out of School: Modern Perspectives in Truancy and School Refusal. John Wiley & Sons, Inc., Chichester 1980: 321-341.
• 49. Cronk N.J., Slutske WS., Madden PA. i wsp.: Risk for separation anxiety disorder among girls: paternal absence, socioeconomic disadvantage, and genetic vulnerability. J. Abnorm. Psychol. 2004; 113: 237-247.
• 50. Poulton R., Milne B.J., Craske M.G., Menzies R.G.: A longitudinal study of the etiology of separation anxiety. Behav. Res. Ther. 2001; 39: 1395-1410.
• 51. Gibb B.E., Chelminski I., Zimmerman M.: Childhood emotional, physical, and sexual abuse, and diagnoses of depressive and anxiety disorders in adult psychiatric outpatients. Depress. Anxiety 2006 Oct 13.
• 52. Safren S.A., Gershuny B.S., Marzol P. i wsp.: History of childhood abuse in panic disorder, social phobia, and generalized anxiety disorder. J. Nerv. Ment. Dis. 2002; 190: 453-456.
• 53. Canino G.J., Bird H.R., Rubio-Stipec M. i wsp.: Children of parents with psychiatric disorder in the community. J. Am. Acad. Child Adolesc. Psychiatry 1990; 29: 398-406.
• 54. Florkowski A., Dietrich-Muszalska A.: Analiza rozpoznań psychiatrycznych u dzieci z objawami lęku. Psychiatr. Pol. 1995;29:175-180.
• 55. Gladstone G.L., Parker G.B., Malhi G.S.: Do bullied children become anxious and depressed adults? A cross-sectional investigation of the correlates of bullying and anxious depression. J. Nerv. Ment. Dis. 2006; 194: 201-208.
• 56. Startup M.: Schizotypy, dissociative experiences and childhood abuse: relationships among self-report measures. Br. J. Clin. Psychol. 1999; 38 (cz. 4): 333-344.
• 57. Hornstein N.L., Putnam F.W: Clinical phenomenology of child and adolescent dissociative disorders. J. Am. Acad. Child Adolesc. Psychiatry 1992; 31: 1077-1085.
• 58. Schafer I., Harfst T, Aderhold V i wsp.: Childhood trauma and dissociation in female patients with schizophrenia spectrum disorders: an exploratory study. J. Nerv. Ment. Dis. 2006; 194: 135-138.
• 59. Weinstein D., Staffelbach D., Biaggio M.: Attention-deficit hyperactivity disorder and posttraumatic stress disorder: differential diagnosis in childhood sexual abuse. Clin. Psychol. Rev. 2000; 20: 359-378.
• 60. Thapar A., Hervas A., McGuffin P: Childhood hyperactivity scores are highly heritable and show sibling competition effects: twin study evidence. Behav. Genet. 1995; 25: 537-544.
• 61. Stormont-Spurgin M., Zentall S.S.: Contributing factors in the manifestation of aggression in preschoolers with hyperactivity. J. Child Psychol. Psychiatry 1995; 36: 491-509.
• 62. McCormick L.H.: Depression in mothers of children with attention deficit hyperactivity disorder. Fam. Med. 1995; 27: 176-179.
• 63. Biederman J., Milberger S., Faraone S.V i wsp.: Family-environment risk factors for attention-deficit hyperactivity disorder. A test of Rutter’s indicators of adversity. Arch. Gen. Psychiatry 1995; 52: 464-470.
• 64. Silva R.R., Alpert M., Munoz D.M. i wsp.: Stress and vulnerability to posttraumatic stress disorder in children and adolescents. Am. J. Psychiatry 2000; 157: 1229-1235.
• 65. Delaney-Black V, Covington C., Ondersma S.J. i wsp.: Violence exposure, trauma, and IQ and/or reading deficits among urban children. Arch. Pediatr. Adolesc. Med. 2002; 156: 280-285.
• 66. Heffernan K., Cloitre M.: A comparison of posttraumatic stress disorder with and without borderline personality disorder among women with a history of childhood sexual abuse: etiological and clinical characteristics. J. Nerv. Ment. Dis. 2000; 188: 589-595.
• 67. Bandura A.: Social Foundations of Thought and Action: A Social Cognitive Theory. Prentice Hall, Englewood Cliffs, NJ 1986.
• 68. Dunn M.G., Tarter R.E., Mezzich A.C. i wsp.: Origins and consequences of child neglect in substance abuse families. Clin. Psychol. Rev. 2002; 22: 1063-1090.
• 69. Raine A.: Autonomic nervous system factors underlying disinhibited, antisocial, and violent behavior. Biosocial perspectives and treatment implications. Ann. N.Y. Acad. Sci. 1996; 794: 46-59.
• 70. af Klinteberg B., Andersson T, Magnusson D., Stattin H.: Hyperactive behavior in childhood as related to subsequent alcohol problems and violent offending: a longitudinal study of male subjects. Personality and Individual Differences 1993; 15: 381-388.
• 71. Siqueira L.M., Rolnitzky L.M., RickertVI.: Smoking cessation in adolescents: the role of nicotine dependence, stress, and coping methods. Arch. Pediatr. Adolesc. Med. 2001: 155: 489-495.
• 72. Schmidt U., Tiller J., Blanchard M. i wsp.: Is there a specific trauma precipitating anorexia nervosa? Psychol. Med. 1997; 27: 523-530.
• 73. Namysłowska I. (red.): Psychiatria dzieci i młodzieży. Wydawnictwo Lekarskie PZWL, Warszawa 2004.
• 74. Steiger H., Zanko M.: Sexual traumata among eating-disordered, psychiatric, and normal female groups: comparison of prevalences and defense styles. Journal of Interpersonal Violence 1990; 5: 74-86.
• 75. Welch S.L., Fairburn C.G.: Sexual abuse and bulimia nervosa: three integrated case control comparisons. Am. J. Psychiatry 1994; 151: 402-407.
• 76. Dallman M.F., Akana S.F., Strack A.M. i wsp.: Chronic stress-induced effects of corticosterone on brain: direct and indirect. Ann. N.Y. Acad. Sci. 2004; 1018: 141-150.
• 77. Pecoraro F., Reyes F., Gomez A. i wsp.: Chronic stress promotes palatable feeding, which reduces signs of stress: feed-forward and feedback effects of chronic stress. Endocrinology 2004; 145: 3754-3762.
• 78. Beversdorf D.Q., Manning S.E., Hillier A. i wsp.: Timing of prenatal stressors and autism. J. Autism Dev. Disord. 2005; 35: 471-478.
• 79. Wiers R.W., Sergeant J.A., Gunning W.B.: Psychological mechanisms of enhanced risk of addiction in children of alcoholics: a dual pathway? Acta Paediatr. Suppl. 1994; 404: 9-13.
• 80. Langeland W, Draijer N., van den Brink W.: Psychiatric comorbidity in treatment-seeking alcoholics: the role of childhood trauma and perceived parental dysfunction. Alcohol. Clin. Exp. Res. 2004; 28: 441-447.
• 81. De Bellis M.D.: Developmental traumatology: a contributory mechanism for alcohol and substance use disorders. Psychoneuroendocrinology 2002; 27: 155-170.
• 82. Dąbkowska M.: Wpływ traumatycznych przeżyć w dzieciństwie na przebieg choroby alkoholowej - doniesienie wstępne. Medical and Biological Sciences 2005; 19: 43-47.
• 83. van Goozen S.H., Fairchild G.: Neuroendocrine and neurotransmitter correlates in children with antisocial behavior. Horm. Behav. 2006; 50: 647-654.
• 84. Bentovim A.: Trauma Organised Systems. Physical and Sexual Abuse in Families. Karnac Books, London 1992.
• 85. Koenen K.C., Fu Q.J., Lyons M.J. i wsp.: Juvenile conduct disorder as a risk factor for trauma exposure and posttraumatic stress disorder. J. Trauma. Stress 2005; 18: 23-32.
• 86. Wolfe D.A., Nayak M.B.: Child abuse in peacetime. W: Green B.L., Friedman M.J., de Jong J.T.VM. i wsp. (red.): Trauma Interventions in War and Peace: Prevention, Practice and Policy. Kluwer Academic/Plenum Publishers, New York 2003: 75-104.
• 87. Ito Y., Teicher M.H., Glod C.A. i wsp.: Increased prevalence of electrophysiological abnormalities in children with psychological, physical, and sexual abuse. J. Neuropsychiatry Clin. Neurosci. 1993; 5: 401-408.
• 88. Black B., Uhde T.W: Psychiatric characteristics of children with selective mutism: a pilot study. J. Am. Acad. Child Adolesc. Psychiatry 1995; 34: 847-856.
• 89. Kołakowski A., Liwska M., Wolańczyk T.: Mutyzm wybiórczy u dzieci - przegląd piśmiennictwa. Psychiatr. Pol. 1996; 30: 233-246.
• 90. Read J., McGregor K., Coggan C., Thomas D.R.: Mental health services and sexual abuse: the need for staff training. J. Trauma Dissociation 2006; 7: 33-50.
• 91. McGregor K., Read J., Thomas D.: Therapy for child sexual abuse: women talk about helpful and unhelpful therapy experiences. Journal of Child Sexual Abuse 2006; 15: 35-59.
• 92. Soffe J., Read J., Freude N.: A survey of clinical psychologists’ views regarding service user involvement in mental health services. Journal of Mental Health2004; 13: 583-592.
• 93. Cohen J.A.: Treating traumatized children: current status and future directions. J. Trauma Dissociation 2005; 6: 109-121.

• Document Type: article