Two thirds of the studies (16 of 24, 67%) in our systematic review used the Childhood Trauma Questionnaire (Bernstein et al., 2003) which measures five types of maltreatment experiences. Three types are related to abuse, namely, physical, sexual, and emotional abuse, whereas the two others are forms of neglect, physical and emotional. In their study, van Harmelen et al. (2013) used the NEMESIS interview (De Graff et al., 2002) to measure the same dimensions, apart from physical neglect, which is not documented. Veague & Hooley (2014) also used an interview protocol composed of 11 questions tapping on physical, sexual, and emotional abuse as well as witnessing domestic violence. Neukel and colleagues (2019) administered the Childhood Experience of Care and Abuse Interview (CECA; Bifulco et al., 1994) to participants to assess childhood abuse experiences (physical and/or sexual). Two studies relied on child protection reports as indicators of child maltreatment (Demers et al., 2018; Jedd et al., 2015). One study used the Child Abuse and Trauma Scale (CATS; Sanders & Becker-Lausen, 1995) which measures physical and emotional abuse and neglect (Kirkham & Levita, 2019). Olsavsky et al. (2019) used three different questions, one for emotional abuse (being verbally insulted or threatened), one for physical abuse (being pushed, grabbed, slapped, or shoved), and one concerning the exposure to domestic violence. Finally, Kim et al. (2014) used the Adult Attachment Interview (AAI; George et al., 1996) to screen for adults with unresolved traumas, such as experiences of loss and/or abuse.
Limbic scars: long-term consequences of childhood maltreatment revealed by functional and structural magnetic resonance imaging.
Background: Childhood maltreatment represents a strong risk factor for the development of depression and posttraumatic stress disorder (PTSD) in later life. In the present study, we investigated the neurobiological underpinnings of this association. Since both depression and PTSD have been associated with increased amygdala responsiveness to negative stimuli as well as reduced hippocampal gray matter volume, we speculated that childhood maltreatment results in similar functional and structural alterations in previously maltreated but healthy adults.
Methods: One hundred forty-eight healthy subjects were enrolled via public notices and newspaper announcements and were carefully screened for psychiatric disorders. Amygdala responsiveness was measured by means of functional magnetic resonance imaging and an emotional face-matching paradigm particularly designed to activate the amygdala in response to threat-related faces. Voxel-based morphometry was used to study morphological alterations. Childhood maltreatment was assessed by the 25-item Childhood Trauma Questionnaire (CTQ).
Results: We observed a strong association of CTQ scores with amygdala responsiveness to threat-related facial expressions. The morphometric analysis yielded reduced gray matter volumes in the hippocampus, insula, orbitofrontal cortex, anterior cingulate gyrus, and caudate in subjects with high CTQ scores. Both of these associations were not influenced by trait anxiety, depression level, age, intelligence, education, or more recent stressful life events.
Conclusions: Childhood maltreatment is associated with remarkable functional and structural changes even decades later in adulthood. These changes strongly resemble findings described in depression and PTSD. Therefore, the present results might suggest that limbic hyperresponsiveness and reduced hippocampal volumes could be mediators between the experiences of adversities during childhood and the development of emotional disorders.
The number of children who experience neglect or abuse is high—about ten out of every thousand children in the United States in 2008.29 Identifying and helping these children is especially difficult unless there are bruises or physical injuries. The effects of early life attachment can lie dormant in the brain until later life. The impact of these hidden effects is that, by adolescence, eighty percent of abused children will be diagnosed with a major psychiatric disorder. Imaging studies of abuse survivors often show that brain areas controlling emotion and cognition are abnormal and underlie these psychiatric disorders and difficulties functioning as a productive citizen. Animal research has provided great insight into how early life caregiving can impact these brain areas and has highlighted unexpected functioning of the brain in early life and the enormous role of the caregiver in controlling the brain’s response to trauma. The comparison of normal attachment formation and pain-related attachment suggests similar behaviors in early life are expressed as attachment to the caregiver, and the activation of different neural substrates may lay the foundation for the enduring effects of early life trauma.
- Community Violence
- Complex Trauma
- Early Childhood Trauma
- Intimate Partner Violence
- Medical Trauma
- Physical Abuse
- Refugee Trauma
- Sexual Abuse
- Sex Trafficking
- Terrorism and Violence
- Traumatic Grief
A trauma bond is the type of emotional attachment that forms between abusers and victims (Casassa, Knight, & Mengo, 2021). This type of bond describes the attachment between narcissistic parents and their children and these attachments can maintain their grip even as children grow into adults
Statement of Relevance: The balance of power in relationships has been an important differentiator of different forms of family violence. This project is the first to apply interdependence theory as a qualitative framework to determine that families affected by parental alienation have asymmetries in power between parents. Results indicate that all “high-conflict” divorced families are not equal, and that a better understanding of abusive power dynamics can be used to identify more effective methods of intervention.
According to the betrayal trauma theory first proposed by Jennifer Freyd of the University of Oregon, the extent of trauma associated with abuse is often linked to the level of perceived betrayal involved. Due to a fear of confrontation with the abuser and the potential loss of the abuser’s support, abuse victims are far more likely to shut out conscious recall of the abuse, even years later. Various other symptoms associated with betrayal trauma include alexithymia (inability to recognize emotions), depression, anxiety, panic attacks, suicidal behavior, anger, and physical health complaints.
Another common problem linked to the suppression of memories surrounding betrayal trauma is dissociation. Defined by Freyd and her colleagues as, ““the lack of integration of thoughts, feelings, and experiences into the stream of consciousness,” dissociation can range from mild detachment from immediate reality (such as daydreaming) to more severe symptoms including loss of memory, fragmenting of identity, and complex posttraumatic disorder (C-PTSD).
“When we think about betrayal in terms of the marble jar metaphor, most of us think of someone we trust doing something so terrible that it forces us to grab the jar and dump out every single marble. What’s the worst betrayal of trust? He sleeps with my best friends. She lies about where the money went. He/she chooses someone over me. Someone uses my vulnerability against me (an act of emotional treason that causes most of us to slam the entire jar to the ground rather than just dumping out the marbles). All terrible betrayals, definitely, but there is a particular sort of betrayal that is more insidious and equally corrosive to trust.
“In fact, this betrayal usually happens long before the other ones. I’m talking about the betrayal of disengagement. Of not caring. Of letting the connection go. Of not being willing to devote time and effort to the relationship. The word betrayal evokes experiences of cheating, lying, breaking a confidence, failing to defend us to someone else who’s gossiping about us, and not choosing us over other people. These behaviors are certainly betrayals, but they’re not the only form of betrayal. If I had to choose the form of betrayal that emerged most frequently from my research and that was the most dangerous in terms of corroding the trust connection, I would would say disengagement.
“When the people we love or with whom we have a deep connection stop caring, stop paying attention, stop investing and fighting for the relationship, trust begins to slip away and hurt starts seeping in. Disengagement triggers shame and our greatest fears – the fears of being abandoned, unworthy, and unlovable. What can make this covert betrayal so much more dangerous than something like a lie or an affair is that we can’t point to the source of our pain — there’s no event, no obvious evidence of brokenness. It can feel crazy-making.”