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Long-Term Impact of Childhood Trauma

Summary and Comment |
July 9, 2007

Long-Term Impact of Childhood Trauma

  1. M. Katherine Shear, MD

Even if they lack current psychopathology, adults who had experienced trauma during childhood evidence greater reactivity.

  1. M. Katherine Shear, MD

Studies of adult psychiatric patients indicate that childhood adversity can have longstanding psychobiologic effects. However, these studies have confounded the effects of early trauma with those of current axis I psychopathology. To disentangle the confounding, researchers studied stress reactions among subjects (police cadets) without current axis I disorders. Twenty-five cadets had experienced childhood trauma (a life-threatening event occurring before age 14), and 64 had not.

Investigators performed an emotion-modulated startle experiment with different levels of threat regarding a forthcoming finger shock. They measured physiologic activation (eyeblink response to startle, skin conductance, and heart rate) and self-reported psychological reactions (positive and negative affect). Within-participant results showed that sense of safety decreased as threat grew. Compared with the no-trauma group, the childhood-trauma group had fewer positive emotions, more negative emotions, greater eyeblink response, and greater skin conductance. Negative emotions and eyeblink were more responsive to increases in threat level among childhood-trauma participants than among no-trauma participants.

Comment

These results among adults without axis I pathology support the validity of the authors’ hypothesis — prolonged psychophysiologic changes that confer risks for mood and anxiety disorders were seen nearly 2 decades after the participants experienced trauma. These results, although from a study of police cadets and not necessarily generalizable to other populations, are consistent with a growing body of evidence from both human and animal studies supporting lifelong effects of important childhood experiences. The findings suggest that monitoring of childhood trauma has implications for preventive intervention. When evaluating patients, clinicians might consider a childhood history of trauma as having similar importance to a prior history of an axis I disorder.

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