User talk:Bigbarbpurrdd

Childhood adversities and trauma and its developmental impact.

•	Childhood adversity – Adverse childhood is when a child faces several circumstances or events that result in a serious threat towards that child’s physical and psychological wellbeing. These events could be anything from abuse in the household, possibility of neglect, bullying, discrimination, poverty, community violence or any serious accidents or injuries 5. When a child faces such adverse experiences during his early developmental age, those experiences can have a huge impact on how the child will grow up to be. Every first experiences that the child gets exposed to in the early years of his life, are disproportionately powerful in shaping that child and the way his brain organizes itself 6. Now, in order to fully understand how such early exposures an impact on the child’s psychological development can have, the first step is to understand the model of the brain. •	Model of the brain – The brain can be divided into four interconnected areas: the brainstem, diencephalon, limbic and the cortex. The structural and the functional complexities of the brain increases from the lower, simpler areas of the brainstem up to the cortex. This model of brain can also be explained using an upside-down triangle where the brainstem, on lower and the smaller peak of the triangle controls basic functions such as body temperature regulation, breathing, heart rate and etc. and the cortex, on upper and more larger part of the triangle controls the complex function such as creative thinking, languages, values, time, hope etc.6 Now, based on model of the brain, all the experiences that one encounters, are processed from the bottom up to the top. Meaning, in order to get to the cortex, the smarter part of the brain, the experience first goes through the brainstem, which is not so smart part of the brain. In other words, the most primitive, reactive part of the brain is the first part to interpret and act on the information coming in from the senses. Thus, the brain is organized to act and feel before the process of thinking and analyzing occurs.

•	Early exposure to trauma and its significant effect on the child’s developing brain. As explained earlier, the brain first grows from the brainstem where only the basic function can be performed such as breathing, temperature regulation etc., and the brain grows as the child ages to become more smarter and fully understand his surroundings. As the child grows and his brain develops, each biological system not just for that child but humans in general, has the ability to change in response to certain experiences and that change becomes a record of the past experiences or a memory. In a developing brain, the neurons are exquisitely sensitive to experiences and neural networks in every part of the brain also can make memories7. These memories can be anything from remembering someone’s name or a phone number and these are functional memories of the neural network of the cortex. There are also emotional memories such as a song reminding of a loved one, or a smell of warm and freshly baked cookies reminding the childhood. There are also the motor vestibular memories and curling up in the fetal position is also an act of remembering. Now, while these stored memories help the child as he grows in remembering his childhood due to any cues that he may encounter, the traumatic memories create complex memory traces that involve all region of the brain7.

When the child is in his early developmental age (3 or under), the cortex of that child is not fully developed and the neural networks are not mature enough to create linear narrative memory which is the who, what, when, where, why memory. While the cortex is not mature at that age, in the lower areas of the brain other neural networks continue processing all the information they receive from their surrounding. Such association and memories that get created in the lower, the not so smart part of the brain can result in huge impact on how that trauma or any memory gets stored in the brain.6

As explained, in a young child that around the age of three or under, their cortex is not fully developed and the neural networks are not mature enough to make linear memories and the memories created by the lower parts of the brain could be not so accurate one as they are unable to process the senses similar to the cortex. If a child of such young age experiences abuse, that child’s brain creates an association between the features of the abuser or the circumstance of the abuse – hair colour, tone of voice, the music playing in the background and a sense of fear.6 This complex an confusing association make by the lower part of the brain can influence behaviour for years; and later in life, if that same child is being served in a restaurant by a brown-haired man who hovers over that child while taking the order might elicit a panic attack. But, because there is no strong or accurate cognitive recollection – no linear memory of that incident – the panic is often experienced and interpreted as being random and independent to any previous experience. Thus, a lifelong set of beliefs and behaviours can emerge when trauma is experienced at a young age.6 In addition to such panic attacks caused by provocative cues that the child had no liner memory of, other childhood adversities such as emotional neglect, parental loss and many more, can also be considered as major risk factors which could lead to several psychiatric disorders during adulthood if untreated. Further, these untreated disorders can also develop into Post Traumatic Stress Disorder (PTSD) which typically occurs following an exposure to a traumatic event and is defined by a distinct symptom clusters of re-experiencing, avoiding and numbing, and arousal persisting for more than one month after experienced trauma. While this trauma persists and grows, childhood trauma has been associated with lower levels of cognitive functioning and a greater risk for later dementia.6,3 •	Developmental trauma and the child’s capacity for social interactions as an adult. When the child experience trauma during the early years of his development, the brain creates traumatic memories after each and every adverse experience7. Any new experience that child faces will always be categorized as a potential threat until it is proven to be safe and positive. When the child gets exposed to a trigger or evocative cue that reminds them of that traumatic experience, the child’s heart rate will go up, visual changes in the body posture. The body’s core regulatory system can be altered by traumatic experience. A child exposed to unpredictable or extreme stress will become dysregulated and living in a traumatizing environment will continually cause the child to experience dysregulation and through this, that child creates a personal catalog or a code book that shapes the lens through which they perceive the world7. Furthermore, while having an adverse childhood can have the negative impacts as explained, having an healthy environment alters that. When a child is raised in a nurturing, caring, supportive environment and that child’s need are always fulfilled, that child experiences regulation. Ultimately, as the child grows up with such attention and care, the networks in that child’s brain, as they grow up, allows them to regulate themselves and connect to the people around them in a healthy way. Thus, a consistent, nurturing caregiver builds an internal view for the child that the people are safe, predictable and caring and this internal view of the world becomes a self-fulfilling prophecy which projects what is expected and helps elicit what’s expected7. •	Stress activation and building resilience – While a child who had a nurturing, caring and a regulated upbringing creates a positive worldview and helps him to self-regulate when he gets older, a dysregulated upbringing due to dysregulated parents and other stressors caused due to them also creates several developmental problems due to unpredictable or random patterns of stress activation.7 When the parental support towards the child is inadequate due to an overwhelmed, exhausted, dysregulated parent, this can give a hard time to the parent to provide the child’s needs in a consistent and predictable manner. Failure to do so could result in two problems – When a dysregulated child gets regulated by a overwhelmed parent after a long time of the child being under prolonged stressed, this results in the sensitization of the child’s stress response system. During prolonged cases of trauma, the CNRs of the regulatory system changes and adapts so that they can better cope with the current challenges. This system works hard to keep individual in balance but this process is difficult and exhaustive under extreme and unpredictable conditions. For example, when a hypervigilance of a boy living with domestic violence constantly scans his home for potential threats is adaptive; although in a classroom, this can prevent him from paying attention to the teacher and that resulting in him being labeled with ADHD which is maladaptive7. This also impacts on the child’s capacity to create and make connections about relationships. While the infant is creating his working model of the world and the caregiver responds in unpredictable ways, or is episodically rough, frustrated, cold, or absent, the child begins to create a different sort of worldview that fits the situation or instances that the child grew up in. In this case, it’s the child’s adaptive or coping mechanisms that help fit his worldview. Thus, as the child grows up, he will elicit from the world what he project into the world but what gets projected by him is completely based on what happened to him as a child7.

In addition, the orphans and other abandoned children, have also been reported to be exposed to several traumatic events resulting in higher emotional difficulties and those emotional difficulties are associated with lags in their cognitive development3,5. Therefore, exposure to trauma and other emotional difficulties during the child’s development is linked to be the cause of their behaviour and life as an adult. While the children that have grown up in a higher socioeconomic surrounding and have a better overall wellbeing with regards to all the resources provided and all the needs being fulfilled by the parents, children developed under lower socioeconomic surrounding have difficulties in regulating themselves and others around them 4,5.

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