Childhood Trauma in Mental Disorders: A Comprehensive Approach

Description

This volume presents a comprehensive overview of childhood trauma, considering the psychopathological definition and its neurobiological implications as well as its impact on different psychiatric disorders. The focus on childhood trauma rather than that occurring in adulthood is important due to its general “neuro-psyco-socio” and its specific biological implications, since trauma during childhood impacts directly on neurodevelopment. It has been suggested that early life stress increases vulnerability to psychiatric disorders; however, the exact mechanisms of this association are not yet completely understood. Although childhood trauma could be considered too unspecific to be an important risk factor for individual psychiatric disorders since it seems to occur across the board, it impacts differently on different psychiatric disorders, and it can modulate their clinical expression. Therefore, the assessment of early trauma needs to be included in the clinical evaluation of patients with psychiatric disorders. The volume will be an invaluable tool for psychiatrists, helping them to select suitable pharmacological, psychotherapeutic and rehabilitative treatments. Preface Contents Part I: General 1: Introduction on Childhood Trauma in Mental Disorders: A Comprehensive Approach References 2: The Concept of Childhood Trauma in Psychopathology: Definitions and Historical Perspectives 2.1 Introduction 2.2 Epidemiology of Childhood Trauma Worldwide 2.2.1 Physical and Sexual Abuse, Neglect, Witnessing Violence 2.2.2 Large-Scale Natural and Manmade Disasters: Children in Specific Regions of the World and Marginalized Children Are Disproportionately at Risk 2.2.3 Unintentional Injuries 2.3 Historical Perspectives on Childhood Trauma 2.4 The Relationship Between Childhood Trauma and Developmental Psychopathology 2.4.1 Childhood Trauma, Childhood Mental Disorders, and Adult Mental Disorders 2.4.2 Developmental Trajectories and Developmental Cascades 2.4.3 Equifinality and Multifinality 2.4.4 Typical Development, Resilient Development, and Pathological Development 2.5 Risk and Protective Factors 2.6 Theories of Vulnerability References Part II: Neurobiology 3: Neuroimaging and Cognition of Early Traumatic Experiences 3.1 Introduction 3.1.1 Trauma and Normal Brain Development 3.1.2 The Effects of Childhood Trauma on Neuropsychological Function and Cognitive Development 3.1.3 The Effects of Childhood Trauma on Brain Development and Morphology 3.1.3.1 Hippocampus 3.1.3.2 Amygdala 3.1.3.3 Prefrontal Cortex 3.1.3.4 Sensory Cortex and Fiber Pathways 3.1.3.5 Corpus Callosum 3.1.3.6 Cerebellum 3.2 Functional Magnetic Resonance Imaging Studies in Maltreated Subjects 3.2.1 Threat Processing 3.2.2 Reward Processing 3.2.3 Emotion Regulation 3.2.4 Executive Control 3.3 Conclusions References 4: Perinatal Mental Health and Childhood Trauma 4.1 Introduction 4.2 The Transmission of Exposure to Maltreatment from Mother to Child 4.3 Mechanisms and Risk Factors for the Association Between Maternal and Offspring Maltreatment 4.4 Biological Perspective: Transmission of Biological Abnormalities from Mothers with Childhood Maltreatment to Offspring 4.5 Psychosocial Point of View 4.6 Conclusion References 5: Electroencephalography and Childhood Trauma 5.1 Introduction 5.2 A Brief Introduction to the EEG Technique 5.2.1 Physical Bases of Electrophysiologic Activity 5.2.2 Types of EEG Recordings 5.2.2.1 Conventional EEG 5.2.2.2 Continuous EEG 5.2.2.3 Quantitative EEG 5.2.3 Types of EEG Analyses 5.2.3.1 Spectral Analysis 5.2.3.2 Frontal Asymmetry 5.2.3.3 Coherence 5.2.3.4 Event-Related Potentials (ERPs) 5.2.3.5 Source Analyses 5.3 EEG Evidences in Childhood Trauma 5.3.1 Spectral Analysis 5.3.2 Cortical Asymmetry 5.3.3 Coherence 5.3.4 ERPs 5.3.5 Source Analyses 5.4 Neurobiology of Childhood Trauma: A Neurophysiological Perspective 5.5 Conclusions References 6: Interaction Between Genes and Childhood Trauma on the Outcome of Psychiatric Disorders 6.1 The Complex Aetiology of Psychiatric Disorders 6.2 Gene–Environment Dialogue: Role of Genotype in the Development of Mental Disorders in Individuals Exposed to Childhood Adversity 6.2.1 Gene–Environment Correlation 6.2.2 Gene–Environment Interaction 6.3 Gene–Environment Interactions in Severe Mental Disorders: Childhood Trauma and GxE 6.3.1 Psychosis 6.3.2 Depressive Disorders 6.3.3 Anxiety Disorders 6.3.4 Substance-Dependence Disorder 6.3.5 Other Psychiatric Disorders 6.4 Polygenic Approaches in GxE Studies 6.5 Conclusions and Future Directions References 7: Childhood Trauma, Attachment Patterns, and Psychopathology: An Evolutionary Analysis 7.1 Introduction 7.2 Evolutionary Explanations for Early Environmental Sensitivity 7.3 Developmental Plasticity 7.3.1 Predictive Models 7.3.2 Differential Susceptibility 7.3.3 Constraints Models 7.4 Brain Mechanisms: Damage or Adaptation? 7.5 Adaptation, Well-Being, and Health 7.6 Clinical and Public Health Implications References Part III: Neuropsychiatric Disorders 8: Childhood Trauma in Bipolar Disorders 8.1 Introduction 8.2 Childhood Trauma in Bipolar Disorders 8.3 Childhood Trauma and Clinical Outcomes of Bipolar Disorders 8.4 Childhood Trauma and Psychopathological Dimensions of Bipolar Disorders 8.5 Childhood Trauma and Cognitive Profile in Bipolar Disorders 8.6 Neurobiological Consequences of Childhood Trauma in Bipolar Disorders 8.7 Conclusions References 9: Childhood Trauma in Depressive Disorders 9.1 Childhood Trauma Increases the Risk of MDD 9.2 Childhood Trauma and the Clinical Expression of MDD 9.2.1 Childhood Trauma and Subtypes of MDD 9.2.2 Childhood Trauma, MDD, and Illness Comorbidity 9.2.3 Gender Differences and Trauma Subtypes 9.2.4 Are Multiple Childhood Trauma Events Linked to More Severe Illness Severity in MDD? 9.2.5 Does the Time of Trauma Matter? 9.2.6 Childhood Trauma, MDD, and Physical Health 9.3 Response to Antidepressants and Psychosocial Interventions 9.4 Biological Mediators of the Links Between Childhood Trauma and MDD 9.4.1 HPA Axis 9.4.2 BDNF 9.4.3 MRI Changes 9.4.4 Childhood Trauma and the Reward System 9.4.5 Childhood Trauma and Sleep Abnormalities 9.4.6 Gene–Environment Interactions in MDD 9.4.7 Polygenic Risk Score for MDD and Childhood Trauma 9.4.8 Epigenetic Molecular Mechanisms 9.5 Clinical Recommendations in Daily Practice 9.6 Conclusion References 10: Childhood Trauma in Psychoses 10.1 Introduction 10.2 The Epidemiological Evidence for a Link Between Childhood Trauma and Psychosis 10.3 The Question of Causality 10.4 Differential Sensitivity to Trauma: The Role of Genetic and Epigenetic Variation 10.5 Biological Mechanisms Underlying the Link Between Trauma and Psychosis 10.5.1 The Brain 10.5.1.1 Hippocampus 10.5.1.2 Amygdala 10.5.1.3 Findings from Studies on Cortical Thickness 10.5.2 The Stress Response System 10.5.3 Immune System 10.6 Psychological Mechanisms Linking Trauma and Psychosis 10.7 Specificity of the Association Between Types of Trauma and Distinct Psychotic Symptoms 10.8 Treatment Considerations for Patients with a Trauma History 10.9 Conclusion References 11: PTSD During Childhood, Childhood Trauma, Childhood Maltreatment and How They Relate to Adult PTSD 11.1 Introduction 11.2 PTSD in Adulthood, as a Disorder Developed During Childhood 11.3 Childhood Trauma as a Risk Factor Due to Accumulation of Traumatic Experiences 11.4 Psychological Processes and Environmental Factors as a Consequence of Childhood Trauma and How They Relate to PTSD 11.5 Increased Risk for Adult PTSD Due to Psychobiologic Changes as a Result of Childhood Trauma 11.6 Intergenerational Transmission of Childhood Trauma to PTSD and Other Forms of Psychopathology 11.7 Discussion References 12: Childhood Trauma and Personality Disorder 12.1 Introduction 12.2 The Association of Childhood Trauma and Personality Disorder—Empirical Studies 12.2.1 Cross-Sectional Studies 12.2.1.1 Recent Developments 12.2.1.2 Disorder-Specific Empirical Findings 12.2.2 Longitudinal Studies 12.3 Behavioral Genetics 12.3.1 Twin Studies 12.3.2 Gene × Environment Interaction 12.3.3 Contextual Factors of Culture, Race, and Ethnicity 12.4 Neurobiology: At the Crossroads of Gene × Environment Interaction 12.4.1 Cortisol 12.4.2 Corticotropin-Releasing Hormone 12.4.3 NR3C1 and FKBP5 12.4.4 Trauma-Related Brain Structural Changes 12.4.5 Personality Disorder-Specific Effects of Trauma 12.4.6 Paranoia/Mistrust and CRH 12.5 Comorbid PTSD and Complex PTSD: Limitations of the General Theory 12.6 Childhood Trauma and Personality Disorder: Dimensional Relationships 12.7 Synthesis and Conclusions References 13: Childhood Trauma and Substance Dependence 13.1 Introduction 13.2 Mechanisms Linking Childhood Trauma and Substance Use Disorders 13.2.1 Brain and Neurocognitive Models and Mechanisms 13.2.1.1 Neurocognitive Markers 13.2.1.2 Dual-Process Models 13.2.2 Negative Reinforcement and Self-Medication Models and Mechanisms 13.2.2.1 Emotion Regulation Difficulties and Motives 13.2.2.2 Comorbid Psychiatric Disorders 13.2.3 Psychosocial Development Models and Mechanisms 13.2.3.1 Attachment and Relationship-Focused Models 13.2.3.2 Self-Esteem 13.2.3.3 Personality Risk Profiles 13.3 Moderating Effects of Sex/Gender and Race/Ethnicity Differences in the Relationship Between Childhood Trauma and Substance Use Disorders 13.4 Clinical Implications 13.5 Future Directions and Conclusions References 14: Childhood Trauma in Obsessive-Compulsive Disorder 14.1 Introduction 14.2 Early Life Stress or Trauma as Mechanisms of Obsessive-Compulsive (OC) Symptoms 14.2.1 Population-Based and Preclinical Research 14.2.2 Longitudinal Studies 14.3 Specific Antecedent Vulnerability in OCD to the Pathogenic Effects of Traumas/Stressors 14.4 Specific Latent Vulnerability to OCD and the Exacerbating Effect of Childhood Trauma 14.4.1 Etiological Importance of Trauma Incidence in OCD 14.4.2 Separating the Genetic and Environmental Sources of Increased Risk for OCD. Twin Studies Considering Traumas as Predisposing Environmental Factors 14.4.3 On the Relationship Between Types of Traumatic Life Events and OCD Severity, Course, and Phenotype 14.5 General Conclusions References 15: Childhood Trauma in Eating Disorders 15.1 Introduction 15.2 Prevalence of Eating Disorders in Populations with Childhood Trauma 15.3 Prevalence of Childhood Trauma in Populations with Eating Disorders 15.4 Clinical Correlates 15.4.1 Eating Disorder Severity 15.4.2 Response to Treatment 15.4.3 Comorbid Psychiatric Disorders 15.5 Potential Mechanisms 15.5.1 Psychological Mediators and Mechanisms 15.5.2 Neurobiological Mediators and Mechanisms 15.6 Clinical Implications 15.7 Conclusion References 16: Childhood Trauma and Dissociative Disorders 16.1 Introduction 16.2 Epidemiology of Dissociative Disorders 16.3 Childhood Trauma: The Evidence 16.4 Psychopathogenesis of Mental Fragmentation 16.5 Psychosomatic Implications of Dissociation 16.6 Dissociation in Trauma: Confounder or Common Denominator? 16.7 Alienation as the Basis of Dissociation 16.8 Dissociation and Altered Consciousness 16.9 Traumatic Memory as an Internal Driver 16.10 Dissociative Amnesia, Reenactment, and Identity 16.11 Disturbed Interpersonal Attachment, Betrayal, and Denial 16.12 Earliest Developmental Traumatization 16.13 Covert Trauma and “Apparently Normal” Families 16.14 Dissociation in Childhood and Adolescence 16.15 Society and Culture as Origin or Context of Trauma 16.16 Neurobiology of Dissociation: Orbitofrontal Hypothesis 16.17 Lateralization and Connectivity 16.18 Integration as Healing: Conclusive Remarks References 17: Trauma in Children with Neurodevelopmental Disorders: Autism, Intellectual Disability, and Attention-Deficit/Hyperactivity Disorder 17.1 Introduction 17.2 Case Example: Trauma and Autism Spectrum Disorder 17.3 Prevalence of Trauma in Neurodevelopmental Disorders 17.3.1 Current Barriers in Assessing Trauma in NDD 17.4 Autism Spectrum Disorder and Trauma 17.4.1 Peer Victimization 17.4.2 Adverse Childhood Experiences (ACEs) 17.5 Intellectual Disabilities and Trauma 17.5.1 Prevalence of Maltreatment 17.5.2 Adverse Childhood Experiences 17.6 Trauma in Attention-Deficit/Hyperactivity Disorder 17.7 Assessment and Treatment of Trauma in NDD 17.7.1 Assessment 17.7.2 Trauma-Informed Treatment 17.8 Conclusions References 18: Neurobiological Basis of Childhood Trauma and the Risk for Neurological Deficits Later in Life 18.1 Introduction 18.2 Neurobiological Basis of Trauma 18.2.1 The Neuroendocrine Pathway: The Role of the Hypothalamic–Pituitary–Adrenal Axis in Trauma 18.2.2 The Role of Neurotransmitters in Trauma 18.2.3 The Implications of Trauma on Cortical and Subcortical Structures 18.2.4 Trauma and Disturbances Correlated to Neurobiological Alterations 18.2.4.1 CTs and Chronic Diseases in Adulthood 18.2.4.2 CTs and Dementia Risk 18.2.4.3 CTs, Amnesia for Childhood Events, and Memory Integration in Adult Survivors 18.2.4.4 CTs and Other Disturbances: Sleep Disorders, Language, and Vasovagal Syncope 18.3 Conclusions References Part IV: Social and Therapeutic Implications 19: Childhood Trauma and Stigma 19.1 The Hurtful and Subverting Experience of Childhood Trauma 19.2 Defining the Concept of Stigma 19.3 From Childhood Trauma Experience to Stigmatization Experience: The Young “Self” Shame and the Attributional Style 19.4 Neuroscience of Stigma 19.5 Childhood Sexual Abuse and Stigma: A Paradigmatic Case 19.6 Stigma Strikes Twice: The Rough Reconstruction of the Self 19.7 Stigma: The Key for Therapeutic Intervention 19.8 Conclusion References 20: Treatment of Childhood Trauma: Pharmacological Approach 20.1 Introduction 20.2 Childhood Trauma and Different Classes of Medications 20.2.1 Antidepressants 20.2.2 Mood Stabilizers 20.2.3 Antipsychotics 20.2.4 Benzodiazepines 20.3 Novel Strategies: Targeting the Immune System 20.4 Conclusions References 21: Childhood Trauma-Related Interventions: Treatment at Different Stages Across the Life Span 21.1 Introduction 21.2 Brief Historical Perspective of Trauma and Treatment in Childhood 21.3 Trauma-Focused Diagnostics: Screeners and Assessments 21.4 Introduction to Interventions and Treatments 21.4.1 Psychological First Aid 21.4.2 Psychological First Aid for Children and Adolescents 21.4.3 Crisis Counseling 21.4.4 Skills for Psychological Recovery 21.4.5 Skills for Psychological Recovery for Children and Adolescents 21.5 Introduction to Psychotherapy 21.5.1 Trauma-Focused Cognitive Behavioral Therapy 21.5.2 Prolonged Exposure 21.5.3 Eye Movement Desensitization and Reprocessing 21.5.4 Dyadic Psychotherapies 21.6 The Function of Resiliency and Post-Traumatic Growth 21.7 Conclusions and Key Points References