Why trauma in childhood can cause mental disorder in adolescence

One third of mental disorder diagnoses in adolescents is associated with childhood trauma, research from the University of São Paulo School of Medicine (USP) conducted in partnership with the University of Bath in the United Kingdom. The results were published in February at The Lancet Global Health.

THE study He analyzed the information from 4,229 adolescents from the 2004 Pelotas Birth Cohort, a survey that accompanies a large group of people from the city of Rio Grande do Sul since birth and evaluates the effects of risk factors on health over the years.

Psychiatric diagnoses (anxiety, mood swings, attention deficit and hyperactivity, conduct and opposition disorders) were evaluated at 15 and 18 years. Cumulative trauma throughout life was analyzed through the caregiver’s account until he was 11 years old. At 15 and 18, the trauma was evaluated by the report of the guardian added to that of the teenagers themselves.

The researchers analyzed exposure to 12 types of trauma, including serious accident, fire, natural disasters, attack or threat, physical or sexual abuse, domestic violence and parents’ death. At 18, 81.2% had already experienced some traumatic situation. In addition, these experiences were responsible for 30.6% of psychiatric disorders in this age group.

According to pediatrician Alicia Matijasevich, an associate professor at the Department of Preventive Medicine at USP School of Medicine and one of the study authors, one of the factors that motivated research is the fact that adolescence is a critical period for the development of the individual’s mental health, when many psychiatric disorders emerge or get worse. “Previous studies, conducted in rich countries, have already indicated that exposure to childhood trauma can substantially increase the risk of lifelong mental disorders,” adds Matijasevic, stressing that literature from medium and low -income countries is still scarce.

But people of all age groups may, to a greater or lesser extent, be susceptible to emotional shaking when exposed to stressful events. Many variables – such as the dimension of the stressor event and the way this is received and experienced – can make the person more or less vulnerable to psychological or psychiatric illness.

In childhood and adolescence, however, there are other additional aspects that should be considered, precisely because it is at this stage of life when emotional development and maturation, resilience and problem solving ability. In addition, from the point of view of neuropsychiatric development, exposure to trauma in childhood can affect and modify the functioning of brain structures involved in mood regulation, memory, cognition, planning and control of impulses.

“In short, it’s a critical age group,” says psychiatrist Elton Kanomata of Israeli Hospital Albert Einstein. “Early exposure to trauma can negatively influence mental health in childhood and adolescence, and this can significantly increase the risk of developing mental disorders throughout life.”

According to Kanomata, when it comes to trauma, any extremely stressful event or experience that goes beyond the ability to manage and mental and emotional processing by the victim, whether concrete or subjective events. Even if the person is not exposed to trauma, when hearing about an accident or catastrophe, for example, can be impacted by the news and become a trauma.

Low -income countries

The study points out that in countries of medium and low income the prevalence of adversities in childhood is higher and mental health services are more limited compared to high -income countries. “This difference is due to multiple factors, including socioeconomic inequalities, greater exposure to community and domestic violence, political instability and limited access to mental health services,” says USP teacher. “Although we have not made a direct comparison of Brazilian data with specific studies from other countries, we refer to previous research indicating that children and adolescents in low -income countries face higher rates of trauma exposure.”

The researcher points out that, as mental health services in these countries are more scarce, this aggravates the impact of these adversities. In many cases, lack of access to appropriate diagnosis and treatment can lead to a progression of mental disorders, resulting in greater difficulties in adulthood. “The stigma associated with mental disorders makes it even more difficult to implement preventive strategies,” adds Alicia Matijasevich.

For Kanomata, research portrays a national problem. “Although the sample represents a single city [Pelotas] And not the whole country, this study points to challenges shared by the entire population: exposure to crime, lack of safety, accidents and natural disasters, domestic violence, physical and sexual abuse, parental neglect, lack of access to health and education, ”he says.

In the psychiatrist’s view, a challenge to face this problem is the unequal distribution of doctors in the country, which limits the performance of mental health services to prevent, diagnose and treat emotional disorders.

Most common disorders

In Brazilian research, conduct disorders and opposition, anxiety and humor were the most common among adolescents. Conduct and opposition disorders are characterized by problems in the self -control of emotions and persistent behaviors of disobedience, aggressiveness and violation of social norms. They usually arise in childhood or adolescence and may have a significant impact on the school’s school, family and social life.

Anxiety disorders are a group of psychiatric conditions characterized by excessive fear, persistent concern and disproportionate responses to everyday situations. They can cause significant suffering and interfere with daily activities, academic performance, social relations and the quality of life of adolescents.

Finally, mood disorders (such as depression and bipolar affective disorder) are psychiatric conditions characterized by significant and persistent changes in the emotional state, which may include periods of deep depression, excessive euphoria, or fluctuations between these extremes. They affect psychological well-being, behavior and functionality of the individual in everyday life.

Prevention strategies

In the assessment of Matijasevich, the results of the study are fundamental for the early identification of adolescents at greater risk of developing mental disorders, especially in more vulnerable contexts. “The association between cumulative exposure to trauma and increased risk of psychiatric disorders in adolescence suggests that prevention and early intervention can have a significant impact on reducing the load of these disorders on the population,” he says.

Kanomata agrees and says that the study highlights the importance of different strategies, both individually and for the elaboration of effective public health policies for prevention, early identification and specific treatments. “The first and most important goal is well-being. The preventive approach is important for people not to get to illness,” he comments.

Some warning signs that parents, family and teachers may detect are: mood swings (anxious, depressed, irritable, easy crying), behavioral changes (restlessness, aggressiveness, untimely behaviors), cognitive changes (fall in school performance, inattention, difficulty in concentration), social difficulties (isolation, excessive distrust), sleep changes (insomnia, excessive sleepiness) and change in appetite (with loss or gain weight).

“The early identification of psychological signs is very important, as they can indicate emotional suffering and vulnerability. These signs allow more specific therapeutic approaches and usually without the need to use medications,” says the psychiatrist. As a result, young people can deal with trauma more effectively and suffer less from the impact of these lifelong disorders.

Study: Adolescents feel that they receive little emotional support from parents

This content was originally published in why childhood trauma can cause mental disorder in adolescence on CNN Brazil.

Source: CNN Brasil