Long Term Consequences of Childhood Trauma

Physical Consequences

Aside from the immediate physical injuries children can experience through maltreatment, a child’s reactions to abuse or neglect can have lifelong and even intergenerational impacts. Childhood maltreatment can be linked to later physical, psychological, and behavioral consequences as well as costs to society as a whole.

These consequences may be independent of each other, but they also may be interrelated. For example, abuse or neglect may stunt physical development of the child’s brain and lead to psychological problems, such as low self-esteem, which could later lead to high-risk behaviors, such as substance use.

The outcomes for each child may vary widely and are affected by a combination of factors. These factors include:

the child’s age and developmental status when the maltreatment occurred;

the type, frequency, duration, and severity of the maltreatment;

the relationship between the child and the perpetrator.

Additionally, children who experience maltreatment often are affected by other adverse experiences (e.g., parental substance use, domestic violence, poverty), which can make it difficult to separate the unique effects of maltreatment

Federal research on adverse childhood experiences as well as how to prevent and reduce the longterm consequences of maltreatment establlish the following:

There is a straightforward link between physical abuse and physical health

Some long-term physical effects of abuse or neglect may occur immediately (e.g., brain damage caused by head trauma), others can take months or years to emerge or be detectable.

it is also important to recognize that maltreatment of any type can cause long-term physical consequences.

Childhood maltreatment has been linked to higher risk for a wide range of long-term and/or future health problems including—but not limited to—the following:

1. Diabetes
2. Lung disease
3. damage from malnutrition
4. Vision problems
5. Functional limitations (i.e., being limited in activities)
6. Heart attack
7. Arthritis
8. Back problems
9. High blood pressure
10. Brain damage
11. Migraine headaches
12. Chronic bronchitis/emphysema and chronic obstructive pulmonary disease
13. Cancer
14. Stroke
15. Bowel disease
16. Chronic fatigue syndrome

---

Child abuse and neglect also has been associated with certain regions of the brain failing to form, function, or grow properly. For example, a history of maltreatment may be correlated with: reduced brain volume which impacts the following brain regions such as:


• The amygdala, which is key to processing emotions
• The hippocampus, which is central to learning and memory
• The orbitofrontal cortex, which is responsible for reinforcement-based decision-making and emotion regulation
• The cerebellum, which helps coordinate motor behavior and executive functioning
• The corpus callosum, which is responsible for left brain/right brain communication and other processes (e.g., arousal, emotion, higher cognitive abilities

---

Epigenetics

An epigenetic change can be caused by life experiences, such as child maltreatment or substance exposure. One study found that children who had been maltreated exhibited changes in genes associated with various disorders,such as: cancer, cardiovascular disease, immune disorders, schizophrenia, bipolar disorder and depression


Fortunately, however, there is promising evidence that children’s brains may be able to recover with the help of appropriate interventions IF THEY OCCUR EARLY ENOUGH These changes can even be passed on to the person’s children.

Additionally, the type of maltreatment a child experiences can increase the risk for specific physical health conditions. For example one study found that children who experienced neglect were at increased risk for diabetes, poorer lung functioning, and vision and oral health problems. Children who had been physically abused were at higher risk for diabetes and malnutrition.

Children who were victims of sexual abuse were more likely to contract hepatitis C and HIV). This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare Information Gateway. This publication is available online at: Child Welfare Government Publications

---

Psychological Consequences

Maltreatment can cause victims to feel isolation, fear, and distrust. This can translate into lifelong psychological consequences that can manifest as emotional difficulties such as:

• Attachment and social difficulties.
• low self-esteem
• depression
• trouble forming and maintaining relationships
• Diminished executive functioning and cognitive skills
• working memory
• self-control
• cognitive flexibility (i.e., the ability to look at things and situations from different perspectives)
• difficulties learning and paying attention
• Poor mental and emotional health.
• depression
• anxiety and other psychiatric disorders throughout adulthood.

Studies have found that adults with a history of more than one Adverse Childhood Experiences had a higher prevalence of suicide attempts then those who did not. Further, adults with major depression who experienced abuse as children had poorer response outcomes to antidepressant treatment, especially if the maltreatment occurred when they were aged 7 or younger.

Posttraumatic stress.

Children who experienced abuse or neglect can develop posttraumatic stress disorder (PTSD), which is characterized by symptoms such as:

persistent re-experiencing of the traumatic events related to the abuse;

avoiding people, places, and events that are associated with their maltreatment;

feeling fear, horror, anger, guilt, or shame; startling easily;

exhibiting hypervigilance, irritability, or other changes in mood

PTSD in children can lead to depression, suicidal behavior, substance use, and oppositional or defiant behaviors well into adulthood

PTSD also affects their ability to succeed in school, and create and nurture important relationships.