Abuse and Neglect: Effects of Maltreatment on Brain Development Part 2

This information was taken directly from Child Welfare Information Gateway

Persistent Fear Response. Chronic stress or repeated traumas can result in a number of biological reactions, including a persistent fear state (Perry, 2006). Neurochemical systems are affected, which can cause a cascade of changes in attention, impulse control, sleep, and fine motor control (Perry, 2000a; 2000b). Chronic activation of certain parts of the brain involved in the fear response (such as the hypothalamic-pituitary-adrenal [HPA] axis) can “wear out” other parts of the brain such as the hippocampus, which is involved in cognition and memory (Perry, 2000b). The HPA axis may react to chronic fear or stress by producing excess cortisol—a hormone that may damage or destroy neurons in critical brain areas (Putnam, 2006). Chronic activation of the neuronal pathways involved in the fear response can create permanent memories that shape the child’s perception of and response to the environment. While this adaptation may be necessary for survival in a hostile world, it can become a way of life that is difficult to change, even if the environment improves.

Hyperarousal. When children are exposed to chronic, traumatic stress, their brains sensitize the pathways for the fear response and create memories that automatically trigger that response without conscious thought. This is called hyperarousal. These children have an altered baseline for arousal, and they tend to overreact to triggers that other children find nonthreatening (Child Trauma Academy, n.d.). These children may be highly sensitive to nonverbal cues, such as eye contact or a touch on the arm, and they may read these actions as threats. Consumed with a need to monitor nonverbal cues for threats, their brains are less able to interpret and respond to verbal cues, even when they are in a supposedly nonthreatening environment, like a classroom. While these children are often labeled as learning disabled, the reality is that their brains have developed so that they are constantly alert and are unable to achieve the relative calm necessary for learning (Child Trauma Academy, n.d.).

Dissociation. Infants or children who are the victims of repeated abuse may respond to that abuse—and later in life to other unpleasantness—by mentally and emotionally removing themselves from the situation. This coping mechanism of dissociation allows the child to pretend that what is happening is not real. Children who “zone out” or often seem overly detached may be experiencing dissociation. In some cases, it may be a form of self-hypnosis (Stien & Kendall, 2004). Dissociation is characterized by first attempting to bring caretakers to help, and if this is unsuccessful, becoming motionless (freezing) and compliant and, eventually, dissociating. Dissociation may be a reaction to childhood sexual abuse, as well as other kinds of active, physical abuse or trauma. Children who suffer from dissociation may retreat to the dissociative state when they encounter other stresses later in life.

This type of response may have implications for the child’s memory creation and retention. The brain may use dissociation to smother the memories of a parent’s abuse in order to preserve an attachment to the parent, resulting in amnesia for the abuse (Stien & Kendall, 2004). However, the implicit memories of the abuse remain, and the child may experience them in response to triggers or as flashbacks or nightmares. In its most extreme form, the child may develop multiple personalities, known as dissociative identity disorder.

Disrupted Attachment Process. At the foundation of much of our development is the concept of attachment, which refers to the emotional relationships we have with other people. An infant’s early attachment to his or her primary caregiver provides the foundation for future emotional relationships. It also provides the base for other learning, because babies and children learn best when they feel safe, calm, protected, and nurtured by their caregivers. If the attachment process is disrupted or never allowed to develop in a healthy manner, as can occur with abusive and neglectful caretakers, the child’s brain will be more focused on meeting the child’s day-to- day needs for survival rather than building the foundation for future growth (Applegate & Shapiro, 2005).

Disrupted attachment may lead to impairments in three major areas for the developing child (Cook et al., 2005):

Increased susceptibility to stress
Excessive help-seeking and dependency or excessive social isolation
Inability to regulate emotions

Young infants depend on positive interactions with caregivers to begin to develop appropriate emotional control and response (affect regulation) (Applegate & Shapiro, 2005). For instance, lots of appropriate face-to-face and other contact helps infants recognize and respond to emotional cues. Infants whose caregivers are neglectful or abusive may experience affect dysregulation— meaning that these children are not able to identify and respond appropriately to emotional cues (Applegate & Shapiro, 2005). Ongoing maltreatment may result in insecure or anxious attachment because the child is not able to derive a feeling of security and consistency from the caregiver. Children who have experienced insecure or anxious attachments may have more difficulties regulating their emotions and showing empathy for others’ feelings (Applegate & Shapiro, 2005). These children may have difficulties forming attachments later in life as well.

Impact of Abuse and Neglect on Adolescents

Adolescents who are abused or neglected were often maltreated at younger ages, as well. It can be difficult to isolate the effects of abuse and neglect during the adolescent years, because these youth often suffer from the cumulative effects of a lifetime of abuse and neglect.

Most teenagers who have not been victims of abuse or neglect find their teenage years to be exciting and challenging. Normal puberty and adolescence lead to the maturation of a physical body, but the brain lags behind in development, especially in the areas that allow teenagers to reason and think logically. Most teenagers act impulsively at times, using a lower area of their brain—their “gut reaction”—because their frontal lobe is not yet mature. Impulsive behavior, poor decisions, and increased risk-taking are all part of the normal teenage experience.

For teens who have been abused, neglected, or traumatized, this impulsive behavior may be even more apparent. Often, these youth have developed brains that focus on survival, at the expense of the more advanced thinking that happens in the brain’s cortex (Chamberlain, 2009). An underdeveloped cortex can lead to increased impulsive behavior, as well as difficulties with tasks that require higher-level thinking and feeling. These teens may show delays in school and in social skills as well (Chamberlain, 2009). They may be more drawn to taking risks, and they may have more opportunity to experiment with drugs and crime if they live in environments that put them at increased risk for these behaviors. Teenagers who lack stable relationships with caring adults who can provide guidance and model appropriate behavior may never have the opportunity to develop the relationship skills necessary for healthy adult relationships or for becoming good parents.

Long-Term Effects of Abuse and Neglect

Maltreatment during infancy and early childhood can have enduring repercussions into adolescence and adulthood. As mentioned earlier, the experiences of infancy and early childhood provide the organizing framework for the expression of children’s intelligence, emotions, and personalities.

When those experiences are primarily negative, children may develop emotional, behavioral, and learning problems that persist throughout their lifetime, especially in the absence of targeted interventions. The Adverse Childhood Experiences (ACE) study is a large-scale, long-term study that has documented the link between childhood abuse and neglect and later adverse experiences, such as physical and mental illness and high-risk behaviors (Centers for Disease Control and Prevention, n.d.).

Some of the specific long-term effects of abuse and neglect on the developing brain can include (Teicher, 2000):

Diminished growth in the left hemisphere, which may increase the risk for depression
Irritability in the limbic system, setting the stage for the emergence of panic disorder and posttraumatic stress disorder
Smaller growth in the hippocampus and limbic abnormalities, which can increase the risk for dissociative disorders and memory impairments
Impairment in the connection between the two brain hemispheres, which has been linked to symptoms of attention-deficit/ hyperactivity disorder

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Child Welfare Information Gateway. http://www.childwelfare.gov/pubs/issue_briefs/brain_development/

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Abuse and Neglect: Effects of Maltreatment on Brain Development Part 2

Contents

Emotional and Behavioral Impact

Impact of Abuse and Neglect on Adolescents

Long-Term Effects of Abuse and Neglect

Resource