Childers 1

Anthony Childers

Megan Lockard

EN101 4807

14 March 2023

The Intersection of Childhood Trauma and Illness: A Complex Relationship

Mental illness has become an increasingly prevalent issue in the United States, affecting

nearly 30% of mental disorders and individuals aged 14 to 35 (Devi et al.1). More disturbingly,

according to the Substance Abuse and Mental Health Services Administration, two-thirds of all

children will report a traumatic incident by the age of 16 (Understanding Child Trauma).

Unfortunately, access to readily available and affordable specialized trauma-based care for

adolescents is limited and complex barriers obstruct proper treatment in the United States. The

experience of psychological trauma plays a crucial role in creating adverse effects on the

development of severe mental and physical illnesses. Acknowledging the different types of

trauma and how they manifest in adolescents is necessary to provide appropriate diagnosis and

treatment, preventing severe mental illness in adulthood.

To begin, it is necessary to acknowledge what trauma is and the common forms of

trauma. In juxtaposition to everyday stress, trauma is a perpetual state of anxiety; even as the

event has passed, the body will continue reliving the experience. The part of the brain

responsible for determining what is safe from what is dangerous continues to be active. It will

signal to the body that it is still in danger after the challenging event has subsided. Whether or

not someone was actively present to serve as a support system during a traumatic event shapes
 Childers 2

how that trauma develops later into disorders like post-traumatic stress disorder and complex

post-traumatic stress disorder (Mental Health Services in Australia: Stress and trauma). Children

may experience continuous stress from sexual abuse, neglect, household dysfunction, witnessing

a loved one suffer (big ‘T’ Trauma), or events that do not pertain to violence or disaster but cause

significant distress (little ‘t’ trauma). Trauma may also involve cultural influences that require a

unique perspective and informed medical professionals. Experiences like those can seem like

everyday living for some kids who live in unsafe neighborhoods, with each case distinct and

requiring specific care.

The consequences of highly stressful childhood experiences are emotional dysregulation,

low self-esteem, flashbacks or intrusive thoughts, issues with trust and relationships, and

substance abuse. When left untreated, this symptomology can manifest itself into severe mental

illness. Major psychological disorders associated with childhood trauma include post-traumatic

stress disorder, depression, anxiety disorders, borderline personality disorder, dissociative

disorders, and substance abuse disorders. PTSD can be characterized as a disorder involving

intrusive thoughts and memories concerning a traumatic memory as if they are being relived.

When assessing the risk for developing post-traumatic stress disorder, according to the National

Center for PTSD, 15 to 43% of children before the age of 18 will experience at least one

traumatic event. Of those who experienced it, up to 43% will develop PTSD (How Common is

PTSD in Children and Teens?). In addition, physical, emotional, or sexual abuse experienced

during childhood is a significant risk factor for developing depression and borderline personality

disorder (BPD) in adulthood. Most people are familiar with depression, a mood disorder

affecting a person's thoughts, emotions, and behaviors with a wide range of severity and
 Childers 3

symptoms from person to person. BPD is a personality disorder that creates instability in

interpersonal relationships, self-image, mood, and impulsivity. A 2015 study found that

individuals who experienced childhood abuse were more likely to experience depression in

adulthood than those who did not experience abuse (Lippard and Nemeroff 5).

Abuse and neglect in childhood can be attributed to 30% to 90% of cases concerning

BPD (Bozzatello et al., 2021). Furthermore, a study on adverse childhood experiences (ACE)

conducted by the CDC, which consisted of over 17,000 adults on their experiences with

childhood abuse, found them four times as likely to develop anxiety disorders than those who

experienced no adverse childhood experiences (CDC, 2021). Dissociative disorders stem from

childhood trauma and act as a coping mechanism, separating themselves from the painful or

traumatic experience. The disorder has various symptoms, such as feeling disconnected from

one's body, memory loss, feeling like one is watching themselves from a distance, and two more

distinctive and consistent personalities. According to an article published last year by Mass

General Brigham McLean, “DID is associated with long-term exposure to trauma, often chronic

traumatic experiences during early childhood,” (Dissociative Identity Disorder (DID)).

Moreover, the national survey of adolescents findings that teens who had experienced physical or

sexual abuse/assault were up to three times more likely to report past or current substance abuse

than those without a history of trauma exemplifies the well-established link between trauma

exposure and substance abuse (Khoury et al.2). These illnesses impose great distress and

dysfunction on one's life. To imagine these issues affecting children is jarring. The harsh reality

is that childhood trauma’s association with the later development of severe mental illness is

incredibly evident and is nearly a promised result in most cases.

 Childers 4

Trauma is not only a disruption to mental health but physical too. Often, the physical

damage far outweighs the mental. The body exercises physical responses to mental stress the

same way it would to physical stress. Health conditions like diabetes, obesity, stroke, cancer, and

heart problems are the most common. Individuals with untreated mental health issues are less

likely to make healthy choices and are more likely to turn to unhealthy coping mechanisms like

drinking and smoking (Post-Traumatic Stress Disorder (PTSD)). Physical health can

significantly decline due to untreated childhood trauma resulting from stress on the body by

diminishing an individual’s likelihood of seeking help. Sadly, comorbidity is not rare among

these physical or mental health complications when involving childhood abuse. Untreated

psychological trauma in childhood determines the physical condition of adolescence in

adulthood. When the mind suffers, the body keeps the score. Recognizing the complex

relationship between childhood trauma and physical health can help healthcare providers identify

individuals at increased risk and provide appropriate support and treatment to promote overall

health and well-being.

There are apparent issues surrounding trauma and the benefits of early treatment, yet,

mental health services for youth in the U.S. are not as well as they should be. According to The

Journal of the American Medical Association, only 63% of U.S. counties have a mental health

facility that provides outpatient treatment for children and adolescents, and only one-third have

an outpatient facility with special programs for youth with severe emotional disturbance.

(Cummings et al.1). Mental health care in America remains inaccessible and underfunded. As a

result, we have communities in desperate need of help while being the least likely to receive it.

According to the American Psychiatric Association, those of low-income, racial-ethnic

 Childers 5

communities and LGBTQ, and other minority groups are at higher risk of experiencing mental

health problems and yet have less access to care. Regarding accessibility, the main barrier lies in

insufficient mental healthcare professionals. According to the National Institute of Mental health,

there are only 8.4 child and adolescent psychiatrists per 100,000 youth in the United States.

Another challenge presents itself when shifting toward the discussion of affordability: mental

health care is often not covered by insurance plans or may have high copays, deductibles, or

out-of-pocket expenses, making it difficult for families to afford treatment. The cost of care acts

as an agent of discouragement, installing fear and the worry of burden within the youth, fearing

their families will not be able to afford the costs of diagnosis and treatment.

Accessibility and affordability pose significant challenges to better mental health

resources for youth. However, mental health illiteracy in families and schools also contributes to

the complex barriers and proper mental health care for adolescents. Mental health care is often

stigmatized, causing young people to avoid seeking treatment. The avoidance of seeking help

can lead to misdiagnosis or inappropriate treatment. Efforts exist to fix this issue, like the

Affordable Care Act expansion of Mental Health Care coverage; however, much more must be

done to ensure that all young people have access to adequate and affordable mental health care.

The constantly developing nature of the adolescent brain only makes the treatment and mediation

of the effects of trauma much more of a necessity to provide. Unfortunately, there is not enough

effort toward treatment and securing access to said treatment for adolescents facing trauma in

America.

Work must be done to improve overall psychiatric care for youth because it is the key to

preventing severe mental illness later on. Easily accessible treatment for trauma-informed care is
 Childers 6

the most effective way to mitigate the effects of childhood trauma. In the same ACEs study

mentioned previously, the CDC recognized the importance of early detection and intervention in

childhood trauma leading to significant improvements in physical and mental health (CDC,

2021). Early identification of childhood trauma can also improve mental health outcomes in

adulthood. In addition, a clinical report published by the American Academy of Children and

Adolescent Psychiatry showed that those who received early childhood trauma interventions

were less likely to experience depression and anxiety in adulthood (Understanding the

behavioral and emotional consequences of child abuse). Early detection allows factors like

gender, culture, and cognitive and emotional maturity to be accounted for when developing

treatment and introducing care that considers unique developmental needs. Administering

tailored interventions appropriate and adequate to the individual helps address the root cause of

the trauma so they can learn healthy coping mechanisms and develop skills that promote healing

and resilience to possible future traumas. Recognizing and differentiating between types of

trauma and how they manifest in adolescence is vital to providing appropriate diagnoses and

treatment and possibly preventing long-term severe mental illness in adulthood.

Although mental health discussions occur more than in previous decades, mental health

literacy is still very young in development and a troubling topic for many. Trauma experienced in

childhood and adolescence can create complex and stressful lingering mental and physical health

adversity that only becomes more troubling to treat later into adulthood—the hurdles in

specialized treatment for youth only perpetuates this. Often, environments dealing with

significant amounts of trauma are also less likely to have access to appropriate mental care. The

best way to lessen childhood trauma’s effect is to have treatment guided by trauma-based care,
 Childers 7

such as Cognitive Behavior Therapy and Eye Movement Desensitization and Reprocessing,

provided in a simple way for youth struggling with the trauma to receive. In addition, expanding

insurance coverage, the capability of primary care facilities, and increasing the number of mental

health providers provide youth with mental health treatments that overcome issues involving

accessibility and affordability. Increased awareness and education on Mental Health should be a

part of the school curriculum to help destigmatize mental health further. Better mental health

literacy helps children understand and recognize mental health issues early on. It is essential to

prioritize addressing the issues surrounding trauma and the benefits of early treatment to ensure

the well-being of our youth and their future.

 Childers 8

Works Cited

“Adverse Childhood Experiences (Aces).” Centers for Disease Control and Prevention, Centers

for Disease Control and Prevention, 2 Apr. 2021,

https://www.cdc.gov/violenceprevention/aces/index.html.

Cheryl K, LCSW. “Childhood Trauma Affects Mental Health.” Corner Canyon HC, 25 May

2022,

https://cornercanyonhc.com/blog/how-childhood-trauma-affects-mental-health-and-welln

ess/.

Cummings, Janet R et al. “Improving access to mental health services for youth in the United

States.” JAMA vol. 309,6 (2013): 553-4. doi:10.1001/jama.2013.437

Devi, Fiona, et al. “The Prevalence of Childhood Trauma in Psychiatric Outpatients - Annals of

General Psychiatry.” BioMed Central, BioMed Central, 14 Aug. 2019,

https://doi.org/10.1186/s12991-019-0239-1.

"Dissociative Identity Disorder (DID)." McLean Hospital, 2021,

www.mcleanhospital.org/essential/did.

Hopper, Elizabeth. “What Is the Contact Hypothesis in Psychology?” ThoughtCo, ThoughtCo,

26 Oct. 2019, https://www.thoughtco.com/contact-hypothesis-4772161.

Khoury, Lamya, et al. “Substance Use, Childhood Traumatic Experience, and Posttraumatic

Stress Disorder in an Urban Civilian Population.” Depression and Anxiety, U.S. National

Library of Medicine, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3051362/.

Lippard, Elizabeth T C, and Charles B Nemeroff. “The Devastating Clinical Consequences of

Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response
 Childers 9

in Mood Disorders.” The American journal of psychiatry vol. 177,1 2020: 20–36.

doi:10.1176/appi.ajp.2019.19010020

“Post-Traumatic Stress Disorder: PTSD: Symptoms, Treatment & Definition.” Cleveland Clinic,

https://my.clevelandclinic.org/health/diseases/9545-post-traumatic-stress-disorder-ptsd.

“Mental Health Services in Australia: Stress and Trauma.” Australian Institute of Health and

Welfare, https://www.aihw.gov.au/reports/mental-health-services/stress-and-trauma.

Simeon, Daphne, et al. "Dissociative disorders in psychiatric inpatients." The American Journal

of Psychiatry, vol. 160, no. 3, 2003, pp. 479–485.

“Understanding Child Trauma.” SAMHSA,

https://www.samhsa.gov/child-trauma/understanding-child-trauma.

“Va.gov: Veterans Affairs.” How Common Is PTSD in Children and Teens?, 18 Sept. 2018,

https://www.ptsd.va.gov/understand/common/common_children_teens.asp.