Consequences and Impact of Violence and Abuse
More than one million children experience sexual or physical abuse and neglect in the United States each year. This abuse leads to problems later on in life, including somatic symptoms, medical symptoms, psychological problems, and substance abuse. Also, children with a history of early life stress (ELS) are more likely to engage in harmful coping strategies, including suicide attempts. Their vulnerability to stress later in life predisposes them to both mental and physical disorders. According to Assistant Professor in the Department of Psychiatry and Behavioral Sciences at Emory University Gretchen N. Neigh, Ph.D. and colleagues, the fight-or-flight response is an instinct that allows organisms to respond when its physical well-being is threatened.4 Stress response is quite adaptive in the short term, promoting escape and survival tactics.4 However, as stress becomes chronic, the level of stress hormones increase, making an individual vulnerable to stress-related diseases. ELS consequences also include common medical disorders, such as obesity, cardiovascular disease, cerebrovascular disease, diabetes mellitus, cancer, and autoimmune disorders.
Clinical data shows that long-term ELS has adverse effects on mental health.4 For instance, the developmental timing of the abuse may contribute to certain outcomes: posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are equally likely to develop in children abused before age 13; however, PTSD is more likely to develop in children who are abused after age 13. Nevertheless, ELS does not produce adverse effects in all children.4
Neigh and colleagues remind readers that the risk of developing a mental disorder is also heritable. Psychiatric genetic research focuses on understanding genetic variation that influences an individual to become vulnerable to a disease.4 Regarding stress-related psychiatric illnesses, it has been found that genes with allelic variants in the serotonin transporter gene and genes that code for elements of the HPA axis are thought to contribute to the risk of disease due to ELS.
Effects of abuse also trickles down from generation to generation.4 For example, exposure to a depressed mother may alter the fetus’ HPA axis. Also, animal models have shown that exposing a pregnant female to a stressful or abusive environment is like directly exposing the fetus. The brain of the fetus adjusts just as it would if it were born and experiencing the abuse directly. Therefore, the effects of trauma cross generational boundaries.
Research has indicated that exposure to stress in childhood can result in adverse mental and physical health.4 Even before birth children are sensitive to stress, showing that it can cross generational boundaries.4 According to Neigh and colleagues, minimizing ELS will reduce the risk and severity of mental and physical illnesses, as well as stop the transgenerational cycle of abuse pathology; however, it is a societal problem, not likely to change overnight.4
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 McCauley J, Kern DE, Kolodner K, et al. Clinical characteristics of women with a history of childhood abuse: unhealed wounds. JAMA. 1997;277:1362-1368.
 Gladstone GL, Parker GB, Mitchell PB, et al. Implications of childhood trauma for depressed women: an analysis of pathways from childhood sexual abuse to deliberate self-harm and revictimization. Am J Psychiatry. 2004;161:1417-1425.
 Neigh, G.N.; Ritschel, L.A.; and Nemeroff, C.B. (2010, Nov. 17). Biological Consequences and Transgenerational Impact of Violence and Abuse: Understanding the Risks Associated with Early Life Stress. Psychiatric Times. Retrieved from http://www.psychiatrictimes.com/ptsd/content/article/10168/1727751.
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 Goodwin RD, Stein MB. Association between childhood trauma and physical disorders among adults in the United States. Psychol Med. 2004;34:509-520.
 Maercker A, Michael T, Fehm L, et al. Age of traumatisation as a predictor of post-traumatic stress disorder or major depression in young women. Br J Psychiatry. 2004;184:482-487.
 Caldji C, Tannenbaum B, Sharma S, et al. Maternal care during infancy regulates the development of neural systems mediating the expression of fearfulness in the rat. Proc Natl Acad Sci U S A. 1998;95:5335-5340.
 Bradley RG, Binder EB, Epstein MP, et al. Influence of child abuse on adult depression: moderation by the corticotropin-releasing hormone receptor gene. Arch Gen Psychiatry. 2008;65:190-200.
 Brennan PA, Pargas R, Walker EF, et al. Maternal depression and infant cortisol: influences of timing, comorbidity and treatment. J Child Psychol Psychiatry. 2008;49:1099-1107.
 Kapoor A, Matthews SG. Short periods of prenatal stress affect growth, behaviour and hypothalamo-pituitary-adrenal axis activity in male guinea pig offspring. J Physiol. 2005;566:967-977.
 Yehuda R, Golier JA, Harvey PD, et al. Relationship between cortisol and age-related memory impairments in Holocaust survivors with PTSD. Psychoneuroendocrinology. 2005;30:678-687.