Stanford Study Links Childhood Trauma to Mental Health Problems, Obesity
Stanford University Medical Center released a study today which shows a stronger-than-anticipated correlation between childhood trauma and later mental health issues such as cognitive, behavioral and attentional difficulties. The study also linked such traumatic events to adverse health outcomes, specifically obesity and its related consequences. The study underscores the importance of screening for trauma in children, since undiagnosed Post Traumatic Stress Disorder (PTSD) can look like other disorders, such as ADHD. The treatments for the two disorders are very different, and treating PTSD with ADHD protocols might even exacerbate the PTSD, since it leaves traumatic memories unaddressed.
Victor Carrion, MD, the senior author of the study being published today in Child Abuse & Neglect: The International Journal, said that when children experience community violence such as shootings, spousal abuse, parental substance abuse, or familial incarceration, they register a constant environmental threat. That perceived threat translates into physiological hyperarousal, which may translate into a myriad of symptoms, such as interrupted sleep and an inability to concentrate. Furthermore, a body in constant alert mode is compromised in its basic homeostatic functions, contributing to a disturbed metabolism, increased heart rate and inflammatory processes. No one gets used to trauma, and therefore the effects of violent events on a child’s body and psyche are cumulative and proportional to the degree of trauma that he or she was exposed to.
The study evaluated medical records from 701 children treated at a primary-care clinic in Bayview-Hunter's Point, a San Francisco neighborhood with high rates of poverty and violence. About half the children were African-American; the rest came from other ethnic backgrounds. Each child's exposure to adverse events was scored on a scale from 0 to 9, with one point given for each type of adversity. The researchers also evaluated the medical records for evidence of obesity and learning or behavior problems. Two-thirds of the children in the study had experienced at least one category of adversity, and 12 percent experienced four or more categories. An adversity score of 4 or more seemed to be the tipping point of profound psychological injury: the kids were 30 times more likely to show behavioral and cognitive impairments, and twice as likely to be obese. Even an adversity score of 1 left children with a ten-fold increased risk for these outcomes.
The tragedy is that most children are not routinely screened for PTSD; physicians tend not to ask about traumatic events in the child’s life. Instead, the residual symptoms receive the brunt of attention, with the resultant misdiagnoses. PTSD, when correctly diagnosed, is highly treatable, but it is imperative that the trauma is not avoided. By not asking about trauma, this is precisely what happens. Carrion says we need to create trauma-informed systems among those who work for the welfare of children. If left untreated, trauma becomes very costly, both to the individual and the society at large.
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