Video Presentation extra credit

Video Presentation

Final Literature Review

The effects of childhood trauma in adolescence and adulthood

Abstract

The impacts of childhood trauma on cognitive function, self-reflection, psychological disorders and recurrence of victimization were studied for individuals during adolescence and adulthood in order to understand the long-term influences on these individuals. Various studies were gathered for each category and combined to establish general trends and associations. The majority of individuals who experienced childhood trauma also experienced impaired cognitive function, poorer self-esteem, psychological disorders and/or more severe symptoms, as well as an increased risk of recurrence within their family. The findings demonstrate a lack of programs and treatment available for childhood trauma victims to avoid complications during adolescence and adulthood.

1. Introduction

All professionals involved in the treatment of individuals with psychological disorders as well as childhood trauma would be able to gather further insight as to the importance of treatment and early intervention of these victims. Childhood trauma and its long-term effects on victims are constantly overlooked and lack research. It is also unclear if individuals being treated for psychological disorders are also being seen for coping with the trauma experienced. Understanding the effects of childhood trauma in adolescence and adulthood allows for early intervention and treatment programs to be developed in order to decrease the number of individuals developing psychological disorders and the number of children experiencing traumatic events. This information can be gathered to answer the following research question: What psychological disorders are associated with adolescents and adults who have experienced childhood trauma and what cognitive limitations are they more likely to experience?

1.1  Methods

Research for this article was conducted through the University of Nevada, Reno Knowledge Center database. Key words for the search included childhood trauma, psychological disorders, mental disorders, adolescence, and social behavior. A total of 10 articles were gathered and all articles used were found no later than March 3, 2017 using three different criteria. The criteria consisted of observational studies on brain activity, social behavior, and factors contributing to psychological disorders, peer-reviewed journal articles published within the last 10 years, and comparisons with individuals who did not experience childhood trauma with variations in age of participants.

The first section consists of impaired cognitive function due to childhood trauma exposure. Understanding prevalence of psychological disorders and re-victimization requires understanding how the brain is influenced by the trauma, which is why cognitive function is discussed first. The second section focuses more on self-reflection and understanding how individuals with childhood trauma exposure view themselves and how this influences their mental health in adolescence and adulthood. The third section delves into the psychological disorders associated with childhood trauma along with the increased severity of symptoms. The final section is regarding recurrence of childhood trauma among individuals and generations. In order to understand why psychological disorders are common among individuals with childhood trauma exposure and the lifelong impacts, readers will need to understand cognitive function as it connects to every section.

2. Outcomes of childhood trauma exposure

            2.1. Impaired cognitive function and reactions
            Regarding storage and responses of memories, a series of interviews took place with individuals who survived the Holocaust and the genocide in Rwanda in 1994 by Kaplan (2006). Kaplan studied the interviews for indicators of how these individuals processed the traumatic event(s) as well as how they address the recurring memories through images and objects. The concept of space creating was present among the individuals interviewed, explaining how individuals who have experienced childhood trauma are able to get through the event(s). Space creating is when an individual creates a space or individual in their mind that captures their life before the traumatic experience (Kaplan, 2006). Those interviewed used space creating in order to mentally remove themselves from the terrifying surroundings and produce an exciting or positive experience.
            A pilot study of 47 healthy adults assessed how different types of childhood trauma exposure influence memory in adulthood by conducting several memory tests. Randomly selected participants from a population were assessed for current and past medical and psychological concerns, eliminating the possibility of other influencing factors (Majer, Nater, Lin, Capuron, & Reeves, 2010). The study found a correlation between childhood trauma exposure and altered memory in adulthood, with type of memory related to type of childhood trauma exposure. Participants who experienced higher rates of physical neglect had longer delays during the Pattern Recognition Memory task, which assesses long-term memory (Majer, et al., 2010). Participants with higher rates of emotional abuse produced more errors during the Spatial Working Memory task, demonstrating poorer working memory (Majer et al., 2010).
            Psychological disorders are known to be associated with cognitive function, and in this case, the cognitive ability for improvement is impacted due to childhood trauma exposure. In regards to improvement rates of psychological disorders with individuals who have experience childhood trauma, Aas et al. (2016) conducted a study including 96 participants with first-episode psychosis gathered from several in and out patient hospitals along with 264 healthy individuals. All participants were assessed within the first year of treatment as well as one year after treatment. Individuals with childhood trauma exposure who were also being treated for first-episode psychosis presented poorer functioning and more severe clinical symptoms at the start of their treatment as well as one year after the treatment (Aas et al., 2016). More individuals reported experiencing childhood trauma in the psychosis group as well. The study found depression to be the most strongly associated with childhood trauma along with suicide attempts, which delayed improvements (Aas et al., 2016).
            2.2. Altered self-reflection

On the subject of physical and mental health, Tanaka, Wekerle, Schmuck, & Paglia-Boak (2011), studied self-compassion as influenced by childhood maltreatment. Participants consisted of adolescents between the ages of 16-20 receiving child protection services and were randomly selected. Child maltreatment was studied using the Childhood Trauma Questionnaire upon starting the study and were then assessed on mental health, substance use, suicide attempt, as well as self-compassion after two years (Tanaka et al., 2011). Participants with higher rates of emotional abuse and neglect, and physical abuse also demonstrated lower self-compassion. Emotional abuse presented the most significant association with low self-compassion. The study found adolescents with lower self-compassion were at an increased risk for psychological disorders, substance use, and serious suicide attempts (Tanaka et al., 2015). Measuring self-compassion is an important tool to better understand the impact of childhood trauma on adolescence.

Model-of-self is influenced by cognitive distortion in a poor manner due to childhood trauma exposure. Browne and Winkelman (2007) researched if adult attachment and cognitive distortion influence psychological adjustment. 219 participants were recruited from undergraduate psychology courses in Australia and were questioned on the type of childhood trauma experienced as well as the prevalence of trauma symptoms from the past 6 months. The study resulted in low levels of childhood trauma but emotional abuse and neglect occurred the most (Browne & Winkelman, 2007). Model-of-self reflected cognitive distortion, which was highly related to trauma symptoms. In other words, model-of-self is related to cognitive distortion but not trauma symptoms. Model-of-self is a cognitive creation negatively influenced by exposure to childhood trauma and is thus maintained by negative experiences, surroundings and exposures (Browne & Winkelman, 2007). This model-of-self persists into adulthood because it has been established since childhood, even if the environment has changed.

            2.3. Prevalence and severity of psychological disorders among victims

A study conducted by Ballard et al. (2015), delves into the latent classes of childhood trauma exposure before age 13 as well as using this information to predict negative behavior development in adolescence and young adulthood. 1,815 randomly selected first graders of elementary schools in an urban Detroit community completed comprehensive psychiatric assessments as well as upon entering young adulthood. One latent class of childhood trauma exposure, consisting primarily of women who were sexually assaulted, demonstrated higher rates of psychiatric issues in young adulthood (Ballard et al., 2015). A second latent class, predominantly male, had experienced violence and resulted in increased rates of post-traumatic stress disorder as well as antisocial personality disorder. The last class made up 84% of the participants and had low rates of childhood trauma exposure (Ballard et al., 2015). Different classes of childhood trauma exposure are indicators of specific psychiatric and behavioral outcomes, evident during adolescence and young adulthood.

Individuals with bipolar disorder are often found to have childhood trauma exposure. Watson el al. (2014) ran a randomized placebo-controlled study of mifepristone treatment in bipolar depression in colleges in England and New Zealand. 115 participants were randomly selected from outpatient clinics between ages 18-65, stable with medication for at least 4 weeks, and able to adequately understand English. Those abusing substances, pregnant, or suffer from a significant mental illness affecting safety were excluded from the trial. Participants with bipolar I and bipolar II disorder scored higher for childhood trauma exposure than the healthy control group. The trial concludes emotional neglect to be the most influential for individuals diagnosed with bipolar I and II disorder (Watson et al., 2014). Although the trail was relatively small, decreasing the reliability of the findings, Etain et al. (2013), also researched the influence of childhood trauma exposure on bipolar disorder. The study including 587 patients with bipolar disorder from France and Norway. Participants completed the Childhood Trauma Questionnaire and those who scored higher on the CTQ experienced earlier onset of bipolar disorder, suicide attempts, and increased depressive episodes (Etain et al., 2013). Etain et al. (2013), found consistent associations between childhood trauma and severe symptoms of bipolar disorder.
            The study conducted by Aas et al. (2016), did not necessarily have results indicating increased chances of experience psychotic episodes for individuals who experienced childhood trauma, but rather those with psychosis experienced much more severe characteristics during and after their first year of treatment. The study demonstrates various how influences of childhood trauma exposure can increase the severity of psychosis, a large portion probably due to the cognitive development (Aas et al., 2016).

2.4. Recurrence of victimization among individuals and generations
            Regarding environmental influences on psychological disorders, Catalan et al. (2017), researched the rate of childhood trauma depending on parental rearing styles with individuals with borderline personality disorder, first episode psychosis, and healthy individuals. The relationship between childhood trauma, parental rearing style, and presence of psychological disorder symptoms was also studied. A relationship between childhood trauma and affectionless parenting style is present, along with a correlation between participants with trauma exposure and poorest parenting style (Catalan et al., 2017). Participants who experienced emotional trauma demonstrated high levels of emotional expression and excessive overprotection in hopes of avoiding recurrence with their children. Overall, women with higher rates of childhood trauma are more likely to portray psychotic symptoms, and are therefore have poorer parenting styles. Children who are raised with more optimal rearing styles have a lower chance of experiencing psychotic symptoms in adulthood (Catalan et al., 2017). The environment these individuals are surrounded by affect the severity of any possible psychological disorders, it is not just the traumatic event.
            A study conducted by Wearick-Silva et al. (2014) includes 41 mothers of sexually abused children and 82 mothers of non-sexually abused children, all completing a questionnaire on childhood trauma, specifically for sexual abuse, to predict the likelihood of having a sexually abused child.  The participants were from Brazil and the mothers of sexually abused children scored higher on this questionnaire, indicating women who sexually abused as children are more likely to have children who will also experience sexual abuse (Wearick-Silva et al., 2014). Recurrence of childhood sexual abuse among subsequent generations can result from maternal psychopathology and/or distress, inconsistent maternal care, and negative family and romantic relationships (Wearick-Silva et al., 2014).

3. Discussion

Based on gathered research covering various life aspects influenced by childhood trauma exposure, these individuals tend to be cognitively impacted for the duration of their life. The research does not go to say these individuals cannot learn how to manage cognitive limitations or psychological disorders, but the research does clearly demonstrate the strong association with childhood trauma exposure. The gathered research can be grouped into four major themes: cognitive function, self-reflection, prevalence and severity of psychological disorders, and recurrence of victimization.

Research regarding cognitive function demonstrates an important cognitive function is altered or impacted by childhood trauma exposure and that is memory. The way in which the brain chooses to store experiences, emotions, and information is different for many of the individuals in adolescence and adulthood who experience childhood trauma by either making it difficult to retrieve the memories or by completely altering the memory itself. This may be a coping mechanism or a way to prevent the individual from re-experiencing the trauma. There is also research-providing information on how self-reflection and esteem is impacted. The research presents the idea that many who experience childhood trauma have lower self-esteems and a poorer model-of-self, meaning the trauma experienced influenced them enough to begin believing in the verbal and physical abuse endured as having occurred for a reason. Through this research, it can be suggested these individuals are less likely to take care of themselves mentally, emotionally, physically, and in many other forms, which could contribute to the increased risk of developing a psychological disorder in adolescence and adulthood.

What is of particular interest is the research is beginning to make connections between types of psychological disorders and types of childhood trauma. Multiple articles have presented a high rate of individuals being treated for bipolar disorder having experienced childhood trauma. Often times these individuals have more severe cases of bipolar disorder and slower progression rates. While there are some mixed results regarding prevalence of psychological disorders among individuals with childhood trauma exposure, the research does demonstrate the severity of symptoms is higher for this demographic. Research gathered regarding recurrence of childhood trauma demonstrate a strong indication that individuals who experienced childhood trauma are more likely to experience another form of trauma in adulthood as well as more likely to have children who will experience childhood trauma. Family characteristics are difficult to break from, especially when all four themes presented are interrelated. All four themes influence and feed from one another, making it difficult for the impacted individuals to re-establish themselves and truly recover from the traumatic experience.

Cognitive function decreases in individuals with childhood trauma exposure and are more likely to return to a non-existent world throughout adulthood. Psychological disorders are a strong possibility due to the changes and variations in cognitive development and function. On top of being at a higher risk for developing psychological disorders, there is also a likelihood of experiencing more severe symptoms if a psychological disorder develops. Childhood trauma exposure does not end with childhood, it continues to influence the relationships established in adulthood with friends and family. Without getting the appropriate assistance, there is a high chance that impacted individuals will have children who will experience similar trauma. The impacts of childhood trauma are becoming clearer but more research is required for properly understand how these individuals are impacted as well as how to assist them.

4. Conclusion

            Based on the gathered research regarding psychological disorders and cognitive function in individuals with childhood trauma exposure, it can be concluded that a large portion of this population will develop a psychological disorder by the time they enter adulthood. It can also be concluded that cognitive function is often altered by traumatic exposure in childhood, which carries into adolescence and adulthood. Psychological disorders are more prevalent in individuals who have experienced childhood trauma and often they experience more severe symptoms of the disorder. This could be a result of the combination of decreased self-esteem, altered cognitive function and the environment as all aspects build from one another and have the opportunity to inhibit progress. Recognizing the connection between types of psychological disorders and types of childhood trauma is important for understanding cognitive development as well as treatment for individuals exposed to childhood trauma.

While there is research demonstrating the increased rates of psychological disorders within this community, more research is required in order to study treatment methods and to discover whether individuals being treated for psychological disorders are also being treated for the childhood trauma. Research demonstrating an association between specific psychological disorders and types of childhood trauma is also necessary to obtain a deeper understanding of the impact of childhood trauma in adolescence and adulthood and would provide great insight on appropriately treat for these patients. Further research is also required to better understand the extent to which memory is impacted as well as to uncover and other possible cognitive functions impaired by childhood trauma.

Final Presentation

Final Presentation

Introduction

1. Introduction

All professionals involved in the treatment of individuals with psychological disorders as well as childhood trauma would be able to gather further insight as to the importance of treatment and early intervention of these victims. Childhood trauma and its long-term effects on victims are constantly overlooked and lack research. It is also unclear if individuals being treated for psychological disorders are also being seen for coping with the trauma experienced. Understanding the effects of childhood trauma in adolescence and adulthood allows for early intervention and treatment programs to be developed in order to decrease the number of individuals developing psychological disorders and the number of children experiencing traumatic events. This information can be gathered to answer the following research question: What psychological disorders are associated with adolescents and adults who have experienced childhood trauma and what cognitive limitations are they more likely to experience?

Writing Center Visit #2

Conclusion

4. Conclusion

Based on the gathered research regarding psychological disorders and cognitive function in individuals with childhood trauma exposure, it can be concluded that a large portion of this population will develop a psychological disorder by the time they enter adulthood. It can also be concluded that cognitive function is often altered by traumatic exposure in childhood which carries into adolescence and adulthood. Psychological disorders are more prevalent in individuals who have experienced childhood trauma and often they experience more severe symptoms of the disorder. This could be a result of the combination of decreased self-esteem, altered cognitive function, and the environment as all aspects build from one another and have the opportunity to prevent progress. Recognizing the small and developing connection between types of psychological disorders and types of childhood trauma is important for understanding cognitive development as well as treatment for individuals exposed to childhood trauma.

While there is research demonstrating the increased rates of psychological disorders within this population, more research is required in order to study treatment methods and to discover whether individuals being treated for psychological disorders are also being treated for the childhood trauma. Research regarding an association between specific psychological disorders and specific types of childhood trauma is also necessary to obtain a deeper understanding of the impact of childhood trauma in adolescence and adulthood and would provide great insight on how to appropriately treat these patients. Further research is also required in order to further understand the extent to which memory is impacted as well as to uncover and other possible cognitive functions impaired by childhood trauma.

Ch. 7 Annotations

Berridge, Virginia. Public Health: A Very Short Introduction. Oxford University Press, 
             Oxford, 2016.

The final chapter provides an overview of the changes in public health from the 19^th century to present along with concerns for the future of public health and public health interventions. For Berridge, the purpose of this chapter is to promote reflection, to encourage learning and growing from previous experiences in order to properly handle current public health issues. Berridge does this by addressing various concerns and approaches and referring to examples of previous experiences, both successful and unsuccessful. By providing supporting examples, Berridge is able to present a concrete perspective and opinion on the current status of public health. It is important to note the usage of subheadings as doing so allows the reader to easily identify the different areas being influenced by public health efforts as well as to identify the various types of concerns and tactics being addressed.

            One thing I found interesting was being able to see a quick time lapse of the changes public health underwent throughout the centuries and comparing it to where public health currently stands. This is interesting because in looking through changes quickly after having read into detail allows for a better appreciation of public health efforts as well as a clearer understanding of the fluid definition of public health. Another interesting point from this chapter is that Berridge provided hints towards the possibility of public health entering a cycle with the reemergence of certain diseases because certain tactics have been stopped. This makes Berridge’s point about reflection that much more important because public health could be addressing the same issues that had already once been resolved. Overall, the clarity of organization and the use of concrete information makes it possible for Berridge to assert and opinion regarding current public health efforts and how to approach them successfully. 

Ch. 6 Annotations

Berridge, Virginia. Public Health: A Very Short Introduction. Oxford University Press, Oxford,

2016.

Berridge discusses the changes occurring from the 19^th century through the 20^th century regarding politics, establishments, and changing social concerns and needs on the global level. Chapter 6 differs from the rest by focusing on public health issues on a global level rather than looking at national and local efforts to address public health concerns. Throughout the chapter Berridge discusses the importance of recognizing how much more was able to get accomplished when programs and interventions were initiated internationally and by organizations such as the League of Nations. It is mentioned how effective strategies implemented by individual countries were adopted and implemented internationally within developing countries. Developing countries faced the biggest issues when looked at on a global level because their idea of public health was different than that of developed countries, this was another key point made by Berridge.

            The overall purpose of this chapter was to shine light on the changes public health underwent on an international level to understand that changes to do not only occur with smaller organizations and services. It is because of colonization that research began on certain diseases and strategies were initiated to prevent pandemics. International public health also faced criticism during the 19^th century for being motivated by protecting European settlers and military troops in foreign lands rather than improving the health of indigenous individuals. This was interesting but not very surprising as it was normal for the time period to be concerned with oneself along with racial superiority. It was interesting to discover how much supervision there has been over marketing, implementation, and other aspects influencing public health efforts by the League of Nations as well as how much effort was actually put in to help the developing countries. 

Ch. 5 Annotations

Discussion Section

Discussion Section

3. Discussion

Based on the gathered research covering various aspects of life influenced by childhood trauma exposure, it is clear individuals who have experienced childhood trauma are cognitively impacted for the duration of their life. It does not go to say these individuals cannot learn how to manage any cognitive limitations or psychological disorders, but the research does clearly demonstrate the strong association with childhood trauma exposure. The gathered research can be grouped into four major themes: cognitive function, self-reflection, prevalence and severity of psychological disorders, and recurrence of victimization.

The research regarding cognitive function demonstrates an important cognitive function is altered or impacted by childhood trauma exposure and that is memory. The way in which the brain chooses to store experiences, emotions, and information is different for many of the individuals in adolescence and adulthood who experience childhood trauma by either making it difficult to retrieve the memories or by completely altering the memory itself. This may be a coping mechanism or a way to prevent the individual from re-experiencing the trauma. There is also research providing information on how self-reflection and esteem is impacted by childhood trauma exposure. The research presents the idea that many of those who experienced childhood trauma have lower self-esteems and a poorer model-of-self, meaning the trauma experienced influenced them enough to begin believing in the verbal and physical abuse endured as having occurred for a reason. Through this research, it can be suggested that these individuals are less likely to take care of themselves mentally, emotionally, physically, and in many other forms, which could contribute to the increased risk of developing a psychological disorder in adolescence and adulthood.

What is of particular interest is the research is beginning to make connections between types of psychological disorders and types of childhood trauma. Multiple articles have presented a high rate of individuals being treated for bipolar disorder are known to have experienced childhood trauma. Often times these individuals had more severe cases of bipolar disorder and it took longer for these individuals to demonstrate progress. While there are some mixed research findings regarding prevalence rates of psychological disorders among individuals with childhood trauma exposure, the research does demonstrate the severity of symptoms is higher for this demographic. Research gathered regarding recurrence of childhood trauma demonstrate a strong indication that individuals who experienced childhood trauma are not only more likely to experience another form of trauma in adulthood but are also more likely to have children who will experience childhood trauma. Typical characteristics within a family are difficult to break from, especially when all four themes presented in the results section are interrelated. All four themes influence and feed from one another, making it difficult for the impacted individuals to re-establish themselves and truly recover from the traumatic experience.

Childhood trauma exposure influences various aspects of an individual’s life over the course of several life stages, but has not been thoroughly researched. Cognitive function decreases in individuals with childhood trauma exposure and are more likely to return to a non-existent world throughout adulthood. Psychological disorders are a strong possibility due to the changes and variations in cognitive development and function. On top of being at a higher risk for developing psychological disorders, there is also a likelihood of experiencing more severe symptoms if a psychological disorder develops. Childhood trauma exposure does not end with childhood, it continues to influence the relationships established in adulthood with friends and family. Without getting the appropriate assistance, there is a high chance that impacted individuals will have children that will experience similar trauma in their young age. The impacts of childhood trauma are beginning to become clearer but more research is required if properly understand how these individuals are impacted as well as how to assist them is to be discovered.

Ch 4 Annotations

Berridge, Virginia. Public Health: A Very Short Introduction. Oxford University Press, Oxford,

2016.

In the chapter Sanitation to Education: 1800-1900s, Berridge discusses various social and economic changes that occurred during the 19^th century and how this information altered what was considered to be public health efforts. Focusing on the changes in Britain during this time is important because Berridge wants to ensure readers obtain a clear understanding of the beginning of modern public health. Berridge believes public health is one of the key aspects of countries modernizing because individuals were beginning to consider the impacts of urbanization on communities of all statuses. Explaining the transition from the wealthy individual to the poor and their surroundings is what allowed for the discovery of various diseases along with their sources and cures.

            It is important to note Britain experienced demographic, health and epidemiologic transitions as the health of individuals increased due to improved living conditions and resources. During the 1800s there were multiple instances when the government and local organizations experienced resistance from the wealthy and these individuals needed to be educated on the benefits of interventions. What seemed to scare the communities the most was the rapid change from not understanding why certain diseases were prevalent to being able to identify the source as well as cures for these diseases, making it difficult to be widely accepted. Educating the public is still a public health tactic to get communities to cooperate and even then there may continue to be resistance. The British government finally took some of the responsibility off of local organizations when cholera took over Europe which is great, but their intervention was simply motivated by keeping those who can turn a profit alive.

            Nearing the end of the 19^th century there were multiple improvements that have laid the basis for what public health currently consists of. Research and specifically the study of organisms grew tremendously, providing credible information for intervention programs as well as educating the public. Genetics, environments, method of transition and many other aspects of disease were being researched and people were living longer and better. Understanding the vast improvement of living conditions and concern for individuals establishes a groundwork for current public health strategies.

Ch 3 Annotations

Berridge, Virginia. Public Health: A Very Short Introduction. Oxford University Press, Oxford,

2016.

Berridge places an importance on understanding how public health was developed as a result of the beginning of modernization, and the concern for military and economic needs. The purpose of this chapter is to understand that concern for the health of communities began with some of the earliest civilizations while the needs and concerns of the communities is what has changed over the years. The work of Hippocrates is what initiated widespread recognition for what public health consists of. Focusing on the individual eventually led to also observing the environment and attempting to make changes to both, acknowledging a correlation between environment and illness. It is important to note how countries modeled their public health tactics after other countries, as well as the increase in disease due to the agricultural shift and traveling that grew into the 18^th century.

            Understanding the economic, social, and political history of the 18^th century is what allows readers to better understand the evolution of public health and the various motives for interventions. This also helps understand what it is so difficult to define public health as well as to better grasp how and why public health has so many branches. By providing background information on what provoked the government to begin getting involved with health concerns, Berridge is displaying the hardships of public health development. This is a hurdle that public health officials continue to experience as there are often times when local organizations are left to tackle issues alone or with little support. It is not until the economy or military is threatened that the government decides to take action, as seen when the bubonic plague took over European countries. The devastating results of the bubonic plague provoked other countries to begin intervention programs for things such as STDs.

            With this beginning concern for the health of individuals came the increasing desire for research to gather statistics on disease rates. Being able to identify the disease also became important as well as attempting to find a cure. Berridge directs the readers to focus on the motives of government involvement as well as the history of the time certain diseases were spreading in order to better understand the various changes to the definition of public health.

Methods Section

Methods Section

Title

1.1 Methods

Research for this article was conducted through the University of Nevada, Reno Knowledge Center database. Key words for the search included childhood trauma, psychological disorders, mental disorders, adolescence, and social behavior. A total of 10 articles were gathered and all articles used were found no later than March 3, 2017 using the following criteria:

• Observational studies on brain activity, social behavior, and factors contributing to psychological disorders
• Peer-reviewed journal articles published within the last 10 years
• Comparisons with individuals who didn’t experience childhood trauma with variations in age of participants

The first section consists of impaired cognitive function due to childhood trauma exposure. Understanding prevalence of psychological disorders and re-victimization requires understanding how the brain is influenced by the trauma, which is why cognitive function is discussed first. The second section focuses more on self-reflection and understanding how individuals with childhood trauma exposure view themselves and how this influences their mental health in adolescence and adulthood. The third section delves into the psychological disorders associated with childhood trauma along with the increased severity of symptoms. The final section is regarding recurrence of childhood trauma among individuals and generations. In order to understand why psychological disorders are common among individuals with childhood trauma exposure and the lifelong impacts, readers will need to understand cognitive function as it connects to every section.

Ch.2 Annotations

Ch.1 Annotations

Results Section

●       Research question: What psychological disorders are associated with adolescents and adults who have experienced childhood trauma and what cognitive limitations are they more likely to experience?

The first section consists of impaired cognitive function due to childhood trauma exposure. Understanding prevalence of psychological disorders and re-victimization requires understanding how the brain is influenced by the trauma, which is why cognitive function is discussed first. The second section focuses more on self-reflection and understanding how individuals with childhood trauma exposure view themselves and how this influences their mental health in adolescence and adulthood. The third section delves into the psychological disorders associated with childhood trauma along with the increased severity of symptoms. The final section is regarding recurrence of childhood trauma among individuals and generations. In order to understand why psychological disorders are common among individuals with childhood trauma exposure and the lifelong impacts, readers will need to understand cognitive function as it connects to every section.

2. Outcomes of childhood trauma exposure

            2.1. Impaired cognitive function and reactions
            Regarding storage and responses of memories, a series of interviews took place with individuals who survived the Holocaust and the genocide in Rwanda in 1994 by Kaplan (2006). Kaplan studied the interviews for indicators of how these individuals processed the traumatic event(s) as well as how they address the recurring memories through images and objects. The concept of space creating was present among the individuals interviewed, explaining how individuals who have experienced childhood trauma are able to get through the event(s). Space creating is when an individual creates a space or individual in their mind that captures their life before the traumatic experience (Kaplan, 2006). Those interviewed used space creating in order to mentally remove themselves from the terrifying surroundings and produce an exciting or positive experience.
            A pilot study of 47 healthy adults assessed how different types of childhood trauma exposure influence memory in adulthood by conducting several memory tests. Randomly selected participants from a population were assessed for current and past medical and psychological concerns, eliminating the possibility of other influencing factors (Majer, Nater, Lin, Capuron, & Reeves, 2010). The study found a correlation between childhood trauma exposure and altered memory in adulthood, with type of memory related to type of childhood trauma exposure. Participants who experienced higher rates of physical neglect had longer delays during the Pattern Recognition Memory task, which assesses long-term memory (Majer, et al., 2010). Participants with higher rates of emotional abuse produced more errors during the Spatial Working Memory task, demonstrating poorer working memory (Majer et al., 2010).
            Psychological disorders are known to be associated with cognitive function, and in this case, the cognitive ability for improvement is impacted due to childhood trauma exposure. In regards to improvement rates of psychological disorders with individuals who have experience childhood trauma, Aas et al. (2016) conducted a study including 96 participants with first-episode psychosis gathered from several in and out patient hospitals along with 264 healthy individuals. All participants were assessed within the first year of treatment as well as one year after treatment. Individuals with childhood trauma exposure who were also being treated for first-episode psychosis presented poorer functioning and more severe clinical symptoms at the start of their treatment as well as one year after the treatment (Aas et al., 2016). More individuals reported experiencing childhood trauma in the psychosis group as well. The study found depression to be the most strongly associated with childhood trauma along with suicide attempts, which delayed improvements (Aas et al., 2016).

            2.2. Altered self-reflection

On the subject of physical and mental health, Tanaka, Wekerle, Schmuck, & Paglia-Boak (2011), studied self-compassion as influenced by childhood maltreatment. Participants consisted of adolescents between the ages of 16-20 receiving child protection services and were randomly selected. Child maltreatment was studied using the Childhood Trauma Questionnaire upon starting the study and were then assessed on mental health, substance use, suicide attempt, as well as self-compassion after two years (Tanaka et al., 2011). Participants with higher rates of emotional abuse and neglect, and physical abuse also demonstrated lower self-compassion. Emotional abuse presented the most significant association with low self-compassion. The study found adolescents with lower self-compassion were at an increased risk for psychological disorders, substance use, and serious suicide attempts (Tanaka et al., 2015). Measuring self-compassion is an important tool to better understand the impact of childhood trauma on adolescence.

Model-of-self is influenced by cognitive distortion in a poor manner due to childhood trauma exposure. Browne and Winkelman (2007) researched if adult attachment and cognitive distortion influence psychological adjustment. 219 participants were recruited from undergraduate psychology courses in Australia and were questioned on the type of childhood trauma experienced as well as the prevalence of trauma symptoms from the past 6 months. The study resulted in low levels of childhood trauma but emotional abuse and neglect occurred the most (Browne & Winkelman, 2007). Model-of-self reflected cognitive distortion, which was highly related to trauma symptoms. In other words, model-of-self is related to cognitive distortion but not trauma symptoms. Model-of-self is a cognitive creation negatively influenced by exposure to childhood trauma and is thus maintained by negative experiences, surroundings and exposures (Browne & Winkelman, 2007). This model-of-self persists into adulthood because it has been established since childhood, even if the environment has changed.

            2.3. Prevalence and severity of psychological disorders among victims

A study conducted by Ballard et al. (2015), delves into the latent classes of childhood trauma exposure before age 13 as well as using this information to predict negative behavior development in adolescence and young adulthood. 1,815 randomly selected first graders of elementary schools in an urban Detroit community completed comprehensive psychiatric assessments as well as upon entering young adulthood. One latent class of childhood trauma exposure, consisting primarily of women who were sexually assaulted, demonstrated higher rates of psychiatric issues in young adulthood (Ballard et al., 2015). A second latent class, predominantly male, had experienced violence and resulted in increased rates of post-traumatic stress disorder as well as antisocial personality disorder. The last class made up 84% of the participants and had low rates of childhood trauma exposure (Ballard et al., 2015). Different classes of childhood trauma exposure are indicators of specific psychiatric and behavioral outcomes, evident during adolescence and young adulthood.

Individuals with bipolar disorder are often found to have childhood trauma exposure. Watson el al. (2014) ran a randomized placebo-controlled study of mifepristone treatment in bipolar depression in colleges in England and New Zealand. 115 participants were randomly selected from outpatient clinics between ages 18-65, stable with medication for at least 4 weeks, and able to adequately understand English. Those abusing substances, pregnant, or suffer from a significant mental illness affecting safety were excluded from the trial. Participants with bipolar I and bipolar II disorder scored higher for childhood trauma exposure than the healthy control group. The trial concludes emotional neglect to be the most influential for individuals diagnosed with bipolar I and II disorder (Watson et al., 2014). Although the trail was relatively small, decreasing the reliability of the findings, Etain et al. (2013), also researched the influence of childhood trauma exposure on bipolar disorder. The study including 587 patients with bipolar disorder from France and Norway. Participants completed the Childhood Trauma Questionnaire and those who scored higher on the CTQ experienced earlier onset of bipolar disorder, suicide attempts, and increased depressive episodes (Etain et al., 2013). Etain et al. (2013), found consistent associations between childhood trauma and severe symptoms of bipolar disorder.
            The study conducted by Aas et al. (2016), did not necessarily have results indicating increased chances of experience psychotic episodes for individuals who experienced childhood trauma, but rather those with psychosis experienced much more severe characteristics during and after their first year of treatment. The study demonstrates various how influences of childhood trauma exposure can increase the severity of psychosis, a large portion probably due to the cognitive development (Aas et al., 2016).
           

2.4. Recurrence of victimization among individuals and generations
            Regarding environmental influences on psychological disorders, Catalan et al. (2017), researched the rate of childhood trauma depending on parental rearing styles with individuals with borderline personality disorder, first episode psychosis, and healthy individuals. The relationship between childhood trauma, parental rearing style, and presence of psychological disorder symptoms was also studied. A relationship between childhood trauma and affectionless parenting style is present, along with a correlation between participants with trauma exposure and poorest parenting style (Catalan et al., 2017). Participants who experienced emotional trauma demonstrated high levels of emotional expression and excessive overprotection in hopes of avoiding recurrence with their children. Overall, women with higher rates of childhood trauma are more likely to portray psychotic symptoms, and are therefore have poorer parenting styles. Children who are raised with more optimal rearing styles have a lower chance of experiencing psychotic symptoms in adulthood (Catalan et al., 2017). The environment these individuals are surrounded by affect the severity of any possible psychological disorders, it is not just the traumatic event.
            A study conducted by Wearick-Silva et al. (2014) includes 41 mothers of sexually abused children and 82 mothers of non-sexually abused children, all completing a questionnaire on childhood trauma, specifically for sexual abuse, to predict the likelihood of having a sexually abused child.  The participants were from Brazil and the mothers of sexually abused children scored higher on this questionnaire, indicating women who sexually abused as children are more likely to have children who will also experience sexual abuse (Wearick-Silva et al., 2014). Recurrence of childhood sexual abuse among subsequent generations can result from maternal psychopathology and/or distress, inconsistent maternal care, and negative family and romantic relationships (Wearick-Silva et al., 2014).

3. Discussion

Childhood trauma exposure influences various aspects of an individual’s life over the course of several life stages, but has not been thoroughly researched. Cognitive function decreases in individuals with childhood trauma exposure and are more likely to return to a non-existent world throughout adulthood. Psychological disorders are a strong possibility due to the changes and variations in cognitive development and function. On top of being at a higher risk for developing psychological disorders, there is also a likelihood of experiencing more severe symptoms. Childhood trauma exposure does not end with childhood, it continues to influence the relationships established in adulthood with friends and family. Without getting the appropriate assistance, there is a high chance that impacted individuals will have children that will experience similar trauma in their young age. The impacts of childhood trauma are beginning to become clearer but more research is required if properly understand how these individuals are impacted as well as how to assist them is to be discovered.

References

Aas, M., Andreassen, O. A., Aminoff, S. R., Færden, A., Romm, K. L., Nesvåg, R., Melle, I.

(2016). A history of childhood trauma is associated with slower improvement rates: Findings from a one-year follow-up study of patients with a first-episode psychosis. BMC Psychiatry, 16(1). doi:10.1186/s12888-016-0827-4

Ballard, E. D., Eck, K. V., Musci, R. J., Hart, S. R., Storr, C. L., Breslau, N., & Wilcox, H.

C.(2015). Latent classes of childhood trauma exposure predict the development of behavioral health outcomes in adolescence and young adulthood. Psychological Medicine, 45(15), 3305-3316. doi:10.1017/s0033291715001300

Browne, C., & Winkelman, C. (2007). The Effect of Childhood Trauma on Later Psychological

Adjustment. Journal of Interpersonal Violence, 22(6), 684-697. doi:10.1177/0886260507300207

Catalan, A., Angosto, V., Díaz, A., Valverde, C., Artaza, M. G., Sesma, E., . . . Gonzalez-Torres,

M. A. (2017). Relation between psychotic symptoms, parental care and childhood trauma in severe mental disorders. Psychiatry Research, 251, 78-84. doi:10.1016/j.psychres.2017.02.017

Etain, B., Aas, M., Andreassen, O. A., Lorentzen, S., Dieset, I., Gard, S., . . . Henry, C. (2013).

Childhood Trauma Is Associated With Severe Clinical Characteristics of Bipolar Disorders. The Journal of Clinical Psychiatry, 74(10), 991-998. doi:10.4088/jcp.13m08353

Kaplan, S. (2006). Children in genocide Extreme traumatization and the 'affect propeller'

International Journal of Psychoanalysis, 87(3), 725-746. doi:10.1516/9c86-h1rg-k3ff-drah

Majer, M., Nater, U. M., Lin, J. S., Capuron, L., & Reeves, W. C. (2010). Association of

childhood trauma with cognitive function in healthy adults: a pilot study. BMC Neurology, 10(1). doi:10.1186/1471-2377-10-61

Tanaka, M., Wekerle, C., Schmuck, M. L., & Paglia-Boak, A. (2011). The linkages among

childhood maltreatment, adolescent mental health, and self-compassion in child welfare adolescents. Child Abuse & Neglect, 35(10), 887-898. doi:10.1016/j.chiabu.2011.07.003

Watson, S., Gallagher, P., Dougall, D., Porter, R., Moncrieff, J., Ferrier, I. N., & Young, A. H.

(2014). Childhood trauma in bipolar disorder. Australian & New Zealand Journal of Psychiatry, 48(6), 564-570. doi:10.1177/0004867413516681

Wearick-Silva, L. E., Tractenberg, S. G., Levandowski, M. L., Viola, T. W., Pires, J. M., &

Grassi-Oliveira, R. (2014). Mothers who were sexually abused during childhood are more likely to have a child victim of sexual violence. Trends in Psychiatry and Psychotherapy, 36(2), 119-122. doi:10.1590/2237-6089-2013-0054

Writing Center Visit

Synthesis Proposal

Categories

• Self
• Kaplan (2006)
• Tanaka (2011)
• Catalan (2017)
• Cognitive function
• Majer (2010)
• Kaplan (2006)
• Aas (2016)
• Psychological disorders
• Ballard (2015)
• Watson (2013)
• Etain (2013)
• Aas (2016)
• Catalan (2017)
• Re-occurrence
• Wearick-Silva (2014)
• Catalan (2017)

Order

1. Cognitive function

My research question directly involves how cognitive function is effected by having experienced trauma in childhood. By starting the results section with cognitive function, it will allow for better understanding of how self-reflection and psychological disorders are altered.

1.1 Space Creating (Kaplan)

Interviews were used to figure out the way brains function in those who have experienced childhood trauma (specifically genocide). The concept of space creating is important because it describes a specific action for these individuals. The article also touches on how this influences memory and response in adulthood which will set the stage for the next section.

~2 paragraphs

1.2 Memory (Majer)

This article found how childhood trauma impacts memory in adulthood. An important cognitive function is being altered by this experience which has been introduced by the previous subheading.

~1-2 paragraphs

1.3 Slower progression rate (Aas)

Now that readers are aware with cognitive function being an issue in individuals who experienced childhood trauma, I can bring up how cognitive function is connected to psychological disorders. In doing this I will not only demonstrate the connection, I will also be setting the stage for when psychological disorders are discussed. This article mentions how individuals who have experienced CT are more likely to have a slowed progression rate with psychotic episodes.

~2 paragraphs

2. Self

Knowing that childhood trauma impacts cognitive development, the reader can have a better understanding of why these individuals have a poorer view of themselves when compared to others. Understanding that these individuals know they are being affected by their experiences and understanding how is crucial to understanding why they are being impacted in this manner. Understanding how they view themselves also provides an insight to any possible psychological disorders.

2.1 Poorer model-of-self (Tanaka)

This article reviewed questionnaires given to teens who had experienced childhood trauma to see what kind of self-esteem they have as well as to understand how they view themselves.
~2 paragraphs

2.2 Influenced responses to objects and memories (Kaplan)

This article explains how it was commonly found that the individuals interviewed responded to certain situations in a poor manner because of a memory about their traumatic experience and many times they are not able to make that connection on their own because they tend to block out those memories. It isn't until they are asked about specific memories that they are able to make the connections to their reactions and many times the situations they are reacting to in response to their experiences are fairly innocent, such as pregnancy. Understaning the cognitive aspect of the reactions and knowing the event and reactions allows for others to help work on this as well as to understand why they are reacting in this particular manner.
~2-3 paragraphs

2.3 Catalan (maybe)

3. Psychological disorders

3.1 Classes of childhood trauma as predictors (Ballard)
Classes of childhood traumatic experiences predict specific psychiatric and behavioral outcomes in adolescence and young adulthood. The long-term effects of childhood traumas are primarily concentrated in victims of sexual and non-sexual violence
~2 paragraphs

3.2 Bipolar disorder (Watson and Etain)

Both article deal with the severity of clinical symptoms along with the associations found between certain psychological disorders and certain types of childhood trauma.
~4 paragraphs

3.3 Severity of symptoms (Aas)

This article did not necessarily find that those who had experienced childhood trauma are more likely to experience psychotic episodes, but rather that those who had experienced much more severe characteristics during their first year. This article demonstrates that the various influences of childhood trauma can increase the severity of their psychological disorders, a large portion probably due to the cognitive development.
~1-2 paragraphs

3.4 Environmental influences (Catalan)

This article can be used in this section because it discusses how different parenting styles influence the psychological symptoms experienced in adulthood. The environment these individuals are surrounded by impact the severity of any possible psychological disorders, it is not just the traumatic event.
~2 paragrpahs

4. Re-occurrence

Re-occurrence should be last because I think the initial event should be explained first along with the consequences/impacts as the individual ages.  I want the paper to follow aging/life stages and then mention things that could occur somewhere in between.

4.1 Environmental influences on psychotic symptoms (Catalan)

This article looks at how different parenting styles along with childhood trauma influences the type and severity of psychotic symptoms in adulthood. I can use this article to point out how individuals who experienced childhood trauma may reflect the same parenting style with their possible children, leading to re-occurrence.

~1-2 paragraphs

4.2 Sexual abuse re-occurrence (Wearick-Silva)

This article looks at the chances of sexual abuse having occurred in mothers of children who had been sexually abused. This article directly looks into the chances of re-occurrence within families and generations. This article also connects with the Catalan article about environmental influences.

~2-3 paragraphs

In class work 2/22

Research Journal 3

What is your research question? Have you decided to change it at all? And, if you have, how do I know that the way in which this question is formulated is appropriate to conduct a literature review with a systematic approach? 

Current Research Question: What psychological and mental disorders are associated with adolescents and adults who have experienced childhood trauma and what cognitive limitations are they more likely to experience?
Old Research Question: How does having experienced trauma during childhood influence the development of the brain with age and what differences can be seen in the processing and reaction to specific tasks and situations? Are individuals who have experienced childhood trauma more likely to develop social or emotional disorders and if so what disorders are most likely to occur?

How do I know that the remit of the method itself is selecting the research, rather than just you on a whim? + 1 thing you found interesting + how you imagine using the source 

Article #1 (interviews; secondary source) 

Kaplan, S. (2006). Children in genocide Extreme traumatization and the 'affect propeller' International Journal of Psychoanalysis, 87(3), 725-746. doi:10.1516/9c86-h1rg-k3ff-drah

This article is directly relevant to my topic and my research question because individuals that had experienced childhood trauma were interviewed. Then, these interviews were used to gather information on the way these individuals processed and stored these memories which impacts the way they respond to their actual environment and thus the cognitive processing of these reactions. In this article Kaplan describes a concept called space creating which is a technique many individuals as a coping method for dealing with the trauma both during and after. The concept of space creating can be used in the results section of my research paper because I am interested in finding how childhood trauma influences cognitive function and influences mental disorders and this article explains how space creating allowed for these individuals to essentially see and "live" in an imaginary world. This imaginary world, place, or person can continue to serve as an escape from reality even later in adulthood which can trigger bad memories from the trauma or even cause the individual to be unable to recall such event information.

Article #2 (research study)

Majer, M., Nater, U. M., Lin, J. S., Capuron, L., & Reeves, W. C. (2010). Association of childhood trauma with cognitive function in healthy adults: a pilot study. BMC Neurology, 10(1). doi:10.1186/1471-2377-10-61

This article is directly relevant to my research topic and question because it discusses how their study found that adults who had experienced childhood trauma had slightly altered brain development over the years possibly due to the levels of certain hormones in their bodies. The article also found that these individuals had worse memories than individuals who had not experienced trauma after having them perform several memory tests. Since this article discusses how trauma impacts the physical development of the brain and because it found an association between memory issues and childhood trauma, I think I would be able to use this in my research paper because it demonstrates less cognitive ability and a higher risk for mental disorders in adulthood for individuals who experienced childhood trauma. I also like that the article mentioned that although none of their subjects had been diagnosed with a psychological disorder, they still found evidence of anxiety and depression during their tests. This to me shows that even if individuals who experienced trauma early in life are not diagnosed with a disorder, they will still experience symptoms that can alter their behavior and cognitive function. 

Article #3 (participatory action research)

Ballard, E. D., Eck, K. V., Musci, R. J., Hart, S. R., Storr, C. L., Breslau, N., & Wilcox, H. C.(2015). Latent classes of childhood trauma exposure predict the development of behavioral health outcomes in adolescence and young adulthood. Psychological Medicine, 45(15), 3305-3316. doi:10.1017/s0033291715001300

This article directly relates to my research topic because it is a study that interviewed and questioned individuals that had experienced different types of childhood trauma once they had entered young adulthood to see how the trauma influenced their psychological health. This study found many similarities of symptoms and signs of diagnosis within the group of individuals that had experienced the same form of childhood trauma. Those who experienced sexual trauma had similar characteristics and risks, those who experienced abuse had similar psychological characteristics and risks, etc. I will be able to use this article in my research paper to explain how individuals that experienced childhood trauma are not only more likely to experience symptoms and diagnosis of multiple psychological disorders, but there are specific psychological disorders associated or common to the type of childhood trauma. What I like about this article is that it was able to find some associations between a disorder like PTSD and a childhood trauma such as sexual abuse. This article helps me answer my research question directly and I think it helps lead me in a productive way.

Article #4 (longitudinal study research)

Tanaka, M., Wekerle, C., Schmuck, M. L., & Paglia-Boak, A. (2011). The linkages among childhood maltreatment, adolescent mental health, and self-compassion in child welfare adolescents. Child Abuse & Neglect, 35(10), 887-898. doi:10.1016/j.chiabu.2011.07.003

This article directly relates to my research topic and helps me answer my research question because it is a study that looks into the impacts of childhood trauma on self-reflection as well as self-dysfunction, which can lead to psychological disorders in adulthood. This article does specifically focus on individuals that had experienced childhood trauma whose family had also been in the welfare system at the time which does mean the results could be a bit more specific but I think it will still be able to contribute a good portion to my paper because many individuals that experienced childhood trauma have come from low SES families. In this article it is discussed how these specific individuals are more likely to have a psychological disorder in adulthood as a result of the low self-esteem and self-confidence of the individual as a result of the trauma. This article explains how 1/4 to 1/2 of the individuals found in psychiatric homes and diagnosed with psychological disorders had experienced childhood trauma and for me this is what I am looking for. The reason I chose this topic is because I think the relationship between childhood trauma and psychological disorders in adulthood gets ignored.

Article #5 (research; interview-based, qualitative)

Browne, C., & Winkelman, C. (2007). The Effect of Childhood Trauma on Later Psychological Adjustment. Journal of Interpersonal Violence, 22(6), 684-697. doi:10.1177/0886260507300207

This article relates directly to my research topic and research question as well as the previous article. This is the second article I have found that has found an association between childhood trauma and a poor mode-of-self. This article is similar to the previous one in that young adults were given questionnaires on their childhood trauma and how they view themselves. The article found that individuals who experienced trauma in childhood missed a large portion of development in terms of being able to form attachments with others and deal with their thoughts and emotions properly. Due to this missed development, these individuals are more likely to have a poor mode-of-self which leads to psychological disorders. Combined with the previous article, I will be able to use both in my paper to help answer my research question which involves explaining what cognitive functions are impacted and whether these individuals are more likely to develop psychological disorders.

Anything else interesting happen? 

I definitely feel I am on a much better track now that my research question is a little more focused. The more I look for articles the more difficult it can be to not find repetitive information in terms of being able to use various articles with different information to add.