[Emergence of early childhood trauma in adult psychiatric symptomatology].
Trauma comes as a result of the subject's exposure to extremely negative and stressful events, such as natural or human-provoked catastrophes, wars, serious injuries, violent deaths, tortures, terrorist attacks, rapes and other sexual crimes. A child's exposure to traumatic circumstances of this level during the crucial period of self-structuring creates rather difficult conditions for its development. Moreover, if the child does not have the opportunity to elaborate and analyze all these stressful conditions and put them into words, serious consequences, both psychological and somatic, may occur in adult life. Specific factors and child characteristics, namely, the age, the developmental stage within which the trauma occurs, its type (physical or sexual abuse, neglect or traumatic social events), frequency, duration and intensity, have been proved to seriously affect the trauma's consequences. The immediate emotional impact of trauma may include isolation, fear, feeling of weakness or loss of the sense of confidence. Moreover, mood disorders such as depression and withdrawal, negative effects on cognitive ability, language development and academic performance, difficulties in creating a secure link and post-traumatic stress disorder (PTSD) are also observed. The long-term consequences for the individual's mental health can be expressed through the following: post-traumatic stress disorder (PTSD) combined or not with depression and anxiety disorder, mood disorders, personality disorders, poor control of impulsions, dissociation disorder, psychotic disorder. Finally, apart from the dramatic impact of trauma on the person itself, there is also a high social cost to be paid as a result of the individual's poor adjustment and dysfunction in the community. Early support and intervention in the child's environment may significantly minimize the negative effects of trauma. Beyond the expression of genes, good maternal care as well as psychological support, lead to normal DNA methylation and brain development. Supporting the family and break the silence that frequently covers the traumatic events and feelings, will give the opportunity for the elaboration of all these aspects which could capture and imprison the subject in a dramatic circle of psychopathology. Moreover, the effectiveness of early interventions and child psychotherapy is now a common ground, so we have to use all our clinical instruments (dialogue, symbolic play, drawing, storytelling) in order to help the child and have the best possible result. Finally, concerning clinical practice, the emergence of early childhood trauma in adult psychiatric symptomatology is so frequent that mental health experts should take it into serious account while developing an appropriate clinical treatment for such patients.
2nd Department of Psychiatry, "Attikon" University General Hospital, of Athens, Athens.
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Bouras
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Lazaratou
D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology; D006801:Humans; D001523:Mental Disorders / Q000209:etiology* / Q000523:psychology*; D011570:Psychiatry; D011599:Psychopathology; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D014754:Violence; D014947:Wounds and Injuries / Q000523:psychology*