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Childhood Trauma
Prof. Craig Jackson
Head of Psychology
BCU
[email protected]
Childhood trauma
Craig Jackson
Preamble
They fuck you up, your mum and dad
They may not mean to, but they do
They fill you with the faults they had
And add some extra, just for you.
This be the verse
A childhood where nothing ever happened – Philip Larkin
Childhood trauma
Craig Jackson
Trauma
Most experience some trauma in course of life
Minor trauma is a part of everyday life
For most people these setbacks are only transient
Some will have psychiatric and social complications
Childhood trauma
Craig Jackson
Traumatic events are common
Lifetime prevalence of specific traumatic events
Type of trauma
Prevalence
Assault
Serious car or motor vehicle crash
Other serious accident or injury
Natural disaster
Other shocking experience
Diagnosed with a life threatening illness
Learning about traumas to others
Unexpected death of close friend or relative
Any trauma
Childhood trauma
Craig Jackson
38%
28%
14%
17%
43%
5%
62%
60%
90%
What children think of stress
Stress
Looks like a flaming deamon
Sounds like an eagle squaking
Tastes like a burnt sausage
Smells like sour milk
Feels like stroking a hedgchog
Stress is when mum says NO!!!!!
by Andrew (aged 10)
Year 5
Potley Hill Primary School
Childhood trauma
Craig Jackson
Acute Stress VS Chronic Stress
A response
Not a disease
Common
After-effects
Leave behind
Life threatening
One-off
Ever-present
By proxy
Childhood trauma
Craig Jackson
Introduction
Different types of trauma:
Childhood abuse
physical
emotional
sexual
Neglect
Traumatic incidents
first-hand
witness
War and Displacement
refugees
Child-to-child
bullying
(Natural) Disasters
first-hand
witness / proxy
Childhood trauma
Craig Jackson
Epidemiology – NSPCC statistics
• 1 child dies per week as the result of adult cruelty
• 25% of all rape victims are children
• Most abuse is committed by someone the child knows and trusts
• Abuse is often known about or suspected by an another adult
• 75% sexually abused children do not tell anyone at the time
• 30% are not able to tell anyone about the experience later
• 80 children killed per year by parents carers in England & Wales
• Number of babies being killed has risen steadily since 1997
• Babies 5 times more likely to be killed than any other age group
• 30,000+ children are on child protection registers
• 600+ added to the child protection registers per week
• 1 in 10 adults seriously abuse or neglect during childhood
Childhood trauma
Craig Jackson
Epidemiology - perspective
Traumatic Brain Injury
TBI
Leading cause of death of children >1yr
Brain injury - leading cause of death and disability in trauma
victims
1994 - USA data
9000 deaths in 0 - 19 age group
68,000 hospitalized
Mortality rate of 35%
Childhood trauma
Craig Jackson
Facts and figures
Child abuse 15 times more likely to occur in homes where
there is domestic violence
American Humane Association
Childhood trauma
Craig Jackson
Facts and figures
45 - 63 % of mothers of abused children were also abused
concurrently
Pagelow 1989
Childhood trauma
Craig Jackson
Facts and figures
As violence towards mother becomes more extreme and
frequent, children in the home experience a 300% increase in
frequency of physical violence from the batterer
Strauss and Gelles 1990
Childhood trauma
Craig Jackson
Victimized parents abusing their children
Rate of child abuse by mothers who were victimized by
partner was twice as high as that of women whose partners
did not assault them
Strauss and Gelles 1990
Childhood trauma
Craig Jackson
Generation link
“Cycle of abuse” theory
Domestic violence
Elder abuse
Child abuse
Childhood trauma
Craig Jackson
Facts and figures
62% of women reporting childhood abuse have experienced
domestic violence
Commonwealth Fund
Childhood trauma
Craig Jackson
“Childhood trauma a cause of ADHD?”
“Disease” camp vs. “Environmental” camp
Can certain circumstances increase chances of ADHD?
522 children aged 6 - 17
280 ADHD
242 Comparisons
Early childhood trauma was a cause
Boys more functionally impaired than girls
Low social class made ADHD more likely
Maternal smoking made ADHD more likely
Greatest risk factor was family conflict
Bierderman et al. 2002
Childhood trauma
Mumme - 1 yr olds!
Craig Jackson
“Spanking makes children violent?”
Gershoff 2002, reviewed 88 studies on spanking
Strongly linked with immediate compliance!
But also...
Aggression
Antisocial behaviour
Abuse of children and spouses
Corporal punishment escalates into maltreatment?
No - Punishment is not causative of hostile adults
Frequency
Method
Administration
Emotional context
Combination
Childhood trauma
Likelihood of developing aggression
Craig Jackson
“Abuse survivors see emotions differently”
Experience can alter perceptions of emotion
Pollak et al. 2002
Studied abuse survivors (8-10 yrs)
Faces with morphed photos - combination of emotions
happy
fearful
sad
angry
Abused and Non-abused reacted similarly to happy faces
Abused children more sensitive to angry faces
Childhood trauma
Craig Jackson
“Abused boys have more health problems”
“Male victims of sexual abuse 3 times more likely to suffer
health problems”
93 boys abused by same teacher
6 yrs after abuse survivors aged 14-16
Health problems between abused and non-abused NOT
different
Abused boys significantly more time at GP than controls for
unexplained symptoms
Price et al. 2002
Interpretative differences of abuse studies
Childhood trauma
Craig Jackson
“Future criminals can be spotted early”
Association between behaviour at 3yrs and adult criminality
Spec. behaviour problems in pre-school place child at risk of
conviction of adult offence
Social circumstances not relevant - Therefore, poverty
doesn’t lead to crime!
828 adult offenders retrospectively compared with nonoffenders. Offender group had history of:
Temper tantrums
Inability to socialise
ADD actions
Soiling
Discipline difficulties
Stevenson 2001
Childhood trauma
Craig Jackson
“Daycare leads to aggression”
Increased daycare hours = increased aggression
Belsky 2002
2000 children in US - mean time was 26 hours per week
Quality of care not important
Parenting style not important
Linear relationship between aggression and hours spent in
daycare
Childhood trauma
Craig Jackson
“Broken homes lead to psychiatric problems”
Longitudinal study of 1 million children over 20 years
Children with 1 parent were twice as likely to:
develop psychiatric problems
attempt suicide
develop alcohol-related disease
develop drug-related ill-health (X3 girls) (X4 boys)
Financial hardship linked to emotional problems
Parental quality linked to emotional problems
Childhood trauma
Craig Jackson
Outrageous claims?
Childhood trauma a cause of ADHD
Spanking makes children violent
Abuse survivors see emotions differently
Abused boys have more health problems
Future criminals can be spotted early
Daycare leads to aggression
Broken homes lead to psychiatric problems
Childhood trauma
Craig Jackson
Post Traumatic Stress Disorder - PTSD
Response to specific traumatic / extreme event
DSM IV &
ICD-10
1. Experience intense fear
2. Persistent re-experience
3. Avoidance of associations
4. Persistent increased arousal since event
5. Flashbacks
6. Hyper-arousal – sleep, irritability, concentration, hypervigilance, startle
Childhood trauma
Craig Jackson
Post Traumatic Stress Disorder - PTSD
Psychiatric diagnosis is not a disease
Distress and suffering is not psychopathology
PTSD constructed from political ideas
PTSD linked to changes in society and individual lifestyle
Diagnoses must be objective
PTSD lacks precision
What is subjective distress or objective disorder
Psuedocondition – transforms social ills into medical ones
Childhood trauma
Craig Jackson
Psychiatric diagnoses in juvenile offenders
93% Conduct Disorder
82% Substance Abuse Disorder
18% ADHD
26% Learning Disabilities
32% Anxiety Disorders
22% Mood Disorders
15% Associative Disorders
Stanford University, Division of Child Psychiatry
Childhood trauma
Craig Jackson
Psychopathology of disruptive behaviour disorders
Trauma Related Disorders
Personality Disorders
DISRUPTIVE
BEHAVIOUR
DISORDERS
Mood & Affective Disorders
Substance misuse
Stanford University, Division of Child Psychiatry
Childhood trauma
Craig Jackson
Connecting family violence with childhood abuse
Domestic violence present in 41% of families where child
abuse was present - Oregon DHR
43% of child fatalities occured in families where mother was
being abused - Massachusetts DHR
If mother is not safe, neither is the child
Childhood trauma
Craig Jackson
Witnessing domestic violence
Children who witness abuse often display same emotional
responses / behaviours as the physically and emotionally
abused victim
Childhood trauma
Craig Jackson
Psychological markers of childhood trauma
Isolation
Guilt
Depression
Fear
Isolation
Loss
Common “legacies” of childhood sexual, physical or
emotional abuse
Childhood trauma
Craig Jackson
Behavioural markers of childhood trauma
Forgetting
False memory syndrome - statute of limits
Denial
Avoidance
Control
Eating disorders
OCD
Rationalisation
Acceptance
Negative self
Distraction
Self harm
Childhood trauma
Sexualisation
Craig Jackson
Self harm
Behavioural markers of childhood trauma
Immediate consequences of abuse or neglect may involve
physical or psychological trauma
Residual effects - emotional and developmental scars
Often before problem behaviours in adolescence / adulthood
Research shown abused or neglected children are likely
candidates for delinquency and adult criminality
The relationship of maltreatment to subsequent drug or
alcohol misuse is less clear
Ireland & Widom 1994
Childhood trauma
Craig Jackson
Deliberate Self Harm: behavioural markers
DSH (Parasuicide)
intentional, non-suicide, non-life threatening act
Female: Male
At risk:
2:1
15-24 biggest group
Female
Isolation
Negative life events
bereavement
abuse
Pre-existing psychiatric conditions
Family history of DSH
Intolerable stress
Impulsive, Immature, Aggressive personality
Childhood trauma
Craig Jackson
Deliberate Self Harm: methods
• Cutting
Forearms and wrists
Legs and feet
Laterality
Genitalia (abuse survivors)
• Burning
• Pills and Toxins (detection)
5th biggest cause of hospital admissions in UK
Childhood trauma
Craig Jackson
Deliberate Self Harm: pre-meditation
Premeditation can be biggest sympathy inhibitor
• Saving up pills / blades
• Avoiding discovery
• Long sleeves
• Prepared excuse stories
• Bandage stockpiles
Childhood trauma
Craig Jackson
Deliberate Self Harm: motivation
• Cry for help
have they talked to anyone prior to DSH?
• Escape from situation
control & mastery
• Punishment and Manipulation of others
loved ones
failing relationships
inferiority
Childhood trauma
Craig Jackson
Factitious injury
Feigned physical / psychological symptoms or signs
Aim is to receive medical care
Most are female, “stable” networks, many working in healthcare
Only confront if evidence of factitious harm is established
Supportive confrontation: aware of role of behaviour in their
illness
offer psychological help with this
Patients usually stop behaviour but leave clinic
Offer of psychiatric care rarely taken up
Childhood trauma
Craig Jackson
What conclusions can we really make?
?
Childhood trauma
Craig Jackson