The impact of childhood psychological trauma on adult life

Lolaeva Albina Slavovna ORCID: 0000-0002-9021-7531 PhD in Law Associate professor, Department of Constitutional Law, Gorsky State Agrarian University; Associate professor, Department of Civil Law and Procedure, K.L. Khetagurov North Ossetian State University 362027, Russia, Republic of North Ossetia-Alania, Vladikavkaz, Kirova str., 74, sq. 127 mirag.8184@yandex.ru Other publications by this author

Hudalova Madina Zaharovna ORCID: 0000-0002-9111-2803 PhD in Psychology Head of the Department of Psychology, K. L. Khetagurov North Ossetian State University 362025, Russia, Republic of North Ossetia-Alania, Vladikavkaz, Vatutina str., 44-46 mado2006@mail.ru

Introduction

Relevance. Childhood psychological trauma is a term that can be used to describe emotionally or psychologically painful events that occur in childhood and can have a long–term impact on the physical and mental health of an adult. These events include domestic physical, sexual, or emotional abuse, substance abuse by parents or their mental illnesses, neglect, parental divorce, and more.

Childhood psychological traumas can significantly affect adult life and they can have long-term consequences for a person's physical, emotional and psychological health:

1. Mental health problems. Childhood psychological trauma can increase the likelihood that a person will be injured:

2. Physical health problems. Childhood trauma can lead to physical health problems such as autoimmune diseases, chronic pain, and cardiovascular diseases.

3. Problems in relationships. Adults who have experienced trauma in childhood may find it difficult to establish and maintain meaningful social connections.

4. Substance abuse. Childhood injuries can cause problems with substance abuse as a means of overcoming emotional suffering.

5. Emotional dysregulation. Childhood trauma can affect a person's ability to control their emotions, which can complicate the processes of overcoming stress.

Given that different types of injuries can have different effects on a person, the consequences of childhood trauma for adult life can be complex and diverse. Violence on a physical, emotional or sexual level, neglect, exposure to abuse or other traumatic events are the most typical types of childhood psychological trauma.

The object of the study is the concept of child psychological trauma. The subject is the mechanisms of occurrence, features of manifestation and consequences of childhood psychological trauma.

The aim of the study is to study the impact of childhood injuries on adult life, as well as to identify the relationship between childhood psychotrauma and post-traumatic symptoms in adults.

To achieve the goal, the following tasks are set:

- to define the concept and types of child psychological trauma;

- to investigate the mechanisms of the occurrence and formation of child psychological trauma;

- describe some ways of studying child psychological trauma;

- to identify the consequences of childhood psychological trauma;

- develop recommendations for the prevention and overcoming of childhood psychological trauma in adulthood.

The theoretical part

According to research, childhood traumas can have various detrimental effects on mental and physical health, interpersonal relationships and general well-being of an adult ^{[1,2,6,10,11, etc.]}. For example, people who experienced trauma in childhood may be more prone to mental illnesses such as anxiety, depression and post-traumatic stress disorder (PTSD). They may also have an increased risk of substance abuse, self-harm, and suicide.

Adults who have experienced childhood trauma may find it difficult to establish and maintain good relationships with others. Childhood trauma can have an impact on social and interpersonal interaction. It can also affect brain development, which can lead to problems with memory, concentration and learning.

It is important to understand that not everyone who has experienced trauma in childhood will suffer harmful consequences in adulthood; on the contrary, certain people can develop resilience and learn coping skills that will allow them to cope with difficulties. Early intervention and support are very useful for those who have experienced adverse events to overcome the consequences of childhood trauma and improve mental and physical health in adulthood.

The concept of "psychological trauma" came to psychology from a related scientific field – psychiatry. The beginning of the modern history of psychiatry is usually associated with the name of the outstanding psychiatrist Emil Kraepelin and the publication of his work "Introduction to a psychiatric clinic" (1900). It should be emphasized the importance of scientific research by this scientist, which has changed our understanding of mental disorders and contributed to the inclusion of psychiatry in medicine.

The rejection of humanitarian concepts about the psyche in favor of an etiopathogenetic approach to the classification of mental disorders indicates its orientation towards a natural scientific methodology.

With this new methodology, psychiatrists have been able to more accurately understand the causes and mechanisms of mental disorders, which in turn allows them to develop effective treatment strategies and interprofessional cooperation.

E. Kraepelin managed to create an amazing nosological concept, which is of great scientific importance at the present time, but his harmonious and accurate classification extremely schematized the approach to the mental life of patients. As a result, the central concept in psychiatry of the late nineteenth and early twentieth centuries is not a patient with his individual history, suffering, but a symptom, and then a comparison of symptoms and clinical cases to characterize the syndrome ^{[7, p. 124]}. E. Kraepelin argued that mental disorders are determined by the same etiopathogenetic factors as all others diseases, i.e. caused by viruses, bacteria, injuries or toxins.

Unlike his colleagues, psychiatrists, who are polemicizing on this issue, Z. As early as 1892, Freud wrote that "any event that causes a painful feeling of horror, fear, shame, mental pain, loss can have a traumatic effect on the psyche. The probability that this incident acquires the character of an injury depends on the susceptibility of the victim" ^{[14, p. 147]}.

K. G. Jung in his work "Psychosis and its content" (1907) presented his idea: the vast majority of manifestations of severe mental disorder are caused solely by the patient's previous experiences. Based on clinical data (1,395 mentally ill patients treated at Burgholzli), K. G. Jung demonstrated the inconsistency of the prevailing version that the basis of mental illness is an organic brain change: in about 80% of the patients he observed, the brain was either completely unchanged, or its changes were so insignificant that they could not cause mental disorders activities. In this work, the author cites many examples where the onset of symptoms is associated with some significant, affectively charged life event ^{[16, p. 201]}.

A very rational approach to the consideration of mental disorders was proposed by K. Jaspers in the work "General psychopathology" (1913). He called for first eliminating possible organic brain damage associated with exposure to infections, intoxications and injuries, and then differentiating all mental disorders into two large groups. K. Jaspers attributed the first group to "diseases" that have a certain course and are accompanied by certain personality changes. He designated the second group as "phases", which at times any person can enter in accordance with a genetic predisposition ^{[17, p. 99]}.

At that time, psychiatry underwent a major change in its view of mental disorders. Many experts have come to the conclusion that it is necessary to look at them as complex problems related to the social environment, biological and genetic factors, as well as the inner world of each patient. This approach has made it possible to understand and treat mental disorders more effectively, taking into account their diversity and the individuality of each person. Thus, psychiatry has continued to evolve to better deal with the complexities associated with mental health. In general, research on psychoactive drugs diverts researchers' attention from the real mental problems of patients in psychology and medicine. And, as M. M. Reshetnikov rightly notes, "only the tragic experience of the First World War, which brought a huge amount of clinical material, raised the question of traumatic neurosis, which is functional in nature and has a psychological origin, i.e. is not associated with previous intoxication, infectious pathogen or traumatic damage to brain tissue" ^{[13, p. 129]}.

In scientific research, the term "psychotrauma" was practically not found until the 80s of the last century, but the situation changed markedly at the turn of the twentieth and twenty-first centuries.

According to E.N. Cherepanova, "psychological trauma is a special kind of experience, the result of a special interaction between a person and the world around them, a normal reaction to complex, traumatic circumstances, a condition that occurs in a person who has experienced something beyond the ordinary human experience" ^{[15, p. 88]}.

Exploring the psychological mechanism of trauma, P. Levin notes that "in order to avoid injury, the body needs to completely use up the energy that was mobilized to face danger" ^{[8, p. 158]}. If active reactions are blocked and neither escape nor struggle is possible, a fading reaction occurs in the body, similar to the readiness for death, the biological meaning of which is to reduce sensitivity to pain. According to the ideas of F. E. Vasilyuk and L.I. Bozhovich, experience is the main unit of the inner life of a person, reflecting the events and circumstances of life in the form of mental states in which emotional, volitional and intellectual components are merged in their relation to the subject himself ^{[3, p. 231]}.

E.A. Petrova argues that "the concept of "psychological trauma" means a violation of the normal functioning of the psyche as a result of exposure to adverse environmental factors or stress, which is quite amenable to correction, like any other disorder in the body" ^{[12, p. 97]}.

In the view of A. Volodko, "psychological trauma is a reactive mental formation (reaction to events significant for a given person) that causes long–term emotional experiences and has a long-term psychological impact" ^[4].

The concept of "psychological trauma" is most closely related to the study of the problems of post-traumatic disorder (PTSD), crisis psychology, which examines the experience of an imbalance between threatening circumstances and individual opportunities to overcome them. Such experiences are accompanied by a feeling of fear, helplessness and insecurity, and cause a shock in understanding oneself and the world. What kind of traumatic or stressful situation a person will have depends on the protective mechanisms and the external environment. A person becomes traumatized if it is not possible to transform pain into experience.

PTSD is a consequence of a traumatic situation, which is understood as "extreme situations with a powerful negative impact on the individual, requiring serious efforts to cope with the consequences of exposure and fundamentally violating the sense of security" ^{[9, p. 147]}.

Thus, we see "the difficulties associated with the introduction of the concept of "psychological trauma" into officially recognized science" ^{[5, p. 9]}.

So, one of the forms of manifestation of child psychological trauma can be emotional abuse, which includes both emotional abuse and emotional neglect. B. Egeland explains emotional abuse and emotional neglect as follows: "They are more subtle and often more difficult to detect than physical abuse and neglect. Verbal hostility, ridicule, belittlement and rejection are characteristic features of emotional violence. Emotional neglect is usually characterized by the fact that parents are emotionally and psychologically unavailable, detached, avoid and do not respond to the needs and desires of the child ^{[19, p. 22]}.

Wright, Crawford and Del Castillo found that emotional abuse "may actually be the most common form of child abuse, but it is also the most hidden, under-reported and least studied form of abuse" ^{[23, p. 60]}. They further define: "A relationship that exists between a parent and a child, rather than a specific event or series of events [and] encompasses a recurring pattern of destructive interactions between parent and child. Emotionally mistreatment can be represented actively (for example, verbal insults, expulsion, terrorization, isolation) or inaction (for example, ignoring, psychological immunity or inaccessibility) ^{[23, p. 61]}.

The effects of childhood trauma can have a number of long-term negative effects throughout human development, including psychological, social, cognitive, and physical consequences. In their scientific article, Infurna, Rivers, Reich and Zautra argue that childhood trauma is "one of those early life experiences that not only has a detrimental effect in childhood and adolescence, but can also leave a "scar" in midlife and old age" ^{[22, p. 2]}.

Erickson, a neo-Freudian psychologist, disagreed with Freud's psychoanalytic theory, which represents a series of evolving desires or needs from birth to adolescence ^[18]. Erickson believed that "the "struggle" (conflicts that need to be resolved) occurs throughout life and that development does not end with the onset of biological maturity at puberty" ^{[21, p. 5]}. Erickson revised Freud's psychoanalytic theory based on research and facts, and created a psychosocial theory of development illustrating eight individual stages of development from birth to death.  Despite the creation of a new, more accurate theory, Erickson "remained resolutely committed to the idea that the most severe forms of psychopathology are always explained by disorders and unresolved conflicts at the earliest stages of development" ^{[21, p. 5]}.

Childhood trauma destroys the stability and sense of self of a child, undermining his self-esteem and often remaining with him until adulthood. This trauma can affect a person in adulthood, as he experiences feelings of shame and guilt, feels disconnected and unable to communicate with other people, has difficulty controlling emotions, experiences increased anxiety and depression, anger.

The empirical part

There is a strong link between childhood trauma and destructive behaviors such as smoking, unprotected sex, and chronic diseases such as heart disease and cancer. Survivors of abuse are more likely to experience stress and anxiety in the future. This long-term stress and anxiety can cause physical symptoms as well as emotional problems throughout life.

One of the most devastating effects of childhood trauma on adults is its effect on self-perception. Injuries sustained in childhood and in adulthood lead to the fact that people are more likely to form a victim's way of thinking ^{[2, p. 260]}. This ideology can be dangerous because the way a person perceives himself affects his words, choices, career, opportunities and relationships. People who sincerely believe that the world wants them may be influenced by fear and lose the opportunity to follow their dreams.

So, in this study, it is supposed to study how childhood psychotrauma affects adults.

The study hypothesized that there is a significant impact of childhood trauma on adults.

The sample for the study was an adult population aged 18-50 years (n=100), who were recruited using online mailings (i.e. VKontakte, WhatsApp and e-mail). The online survey allowed us to collect information randomly throughout Russia.

The following standardized tests were used for the study.

1. The Childhood Trauma Questionnaire (CTQ), consisting of 28 items and representing a self-report. Five scales are used to assess CTQ: physical abuse, sexual abuse, emotional abuse, physical neglect and emotional neglect. Among the 28 issues under consideration are post-traumatic stress disorder, depression, eating disorders, addiction, suicidal thoughts, personality disorders and sexual problems.

2. The PCL-5 PTSD checklist. 20 symptoms of PTSD are assessed using PCL-5, which is a self-report questionnaire consisting of 20 items. PCL-5 is used for various purposes, including monitoring changes in symptoms before and after therapy and pre-diagnosis of PTSD.

All tests are standard and have established reliability and validity. The scales used for the study were available in Russian. Before completing the questionnaire, the respondents were conducted a semi-structured interview according to the schedule and their informed consent was taken to use their answers only for research purposes.

The procedure for conducting the study. Participants filled out questionnaires to conduct a study that examined childhood injuries and their consequences. The data was collected electronically via Google Forms. Before inviting participants to participate in the study, they had to give their consent. In addition, participants had to provide demographic data: name, age and gender. Participants were also warned that their comments would be kept confidential and used only for research purposes. According to the participants, there were no correct or incorrect answers.

Statistical analysis. Microsoft EXCEL was used to calculate the responses after data collection. The statistical analysis of the study was carried out using the mean, standard deviation and graphs to describe the distribution of higher and lower scores of men and women for each item in both scales, respectively. Each item was evaluated based on the fact that younger and older people contributed 50% to the test, respectively.

Table 1.

Test results

The CTQ questionnaire evaluates various childhood traumas such as emotional, physical and sexual abuse, as well as neglect on both an emotional and physical level. Judging by the average score, which was 58.5, the subjects may have experienced a moderate injury.

The standard deviation of CTQ is 20.5. The standard deviation calculates how much the scores deviate from the average. A higher standard deviation means a greater deviation from the average in points. A standard deviation of 20.5 in this case indicates that the level of childhood trauma reported by the participants varies greatly. Some people may have been traumatized to a much greater extent than others, depending on their personal circumstances.

A specific traumatic event or events is defined as the focus of the PCL-5 questionnaire measuring the symptoms of post-traumatic stress. Study participants reported moderate levels of post-traumatic stress symptoms on average, according to an average score of 23.5. The participants' traumatic experiences may have had a strong effect on them, leading to symptoms such as obsessive thoughts, avoidant behavior, and hyperexcitability.

The standard deviation of PCL-5 is 19.3. A higher standard deviation according to the PCL-5 questionnaire, as well as according to CTQ, means a greater variability in post-traumatic stress symptoms. This means that some people may have more pronounced symptoms, while others may have less pronounced or none at all.

A number of conclusions can be drawn from these results.

1. Individual differences. The differences in the results of both tests underline how important it is to take into account that each person experiences and overcomes childhood trauma in different ways. Symptoms of post-traumatic stress do not always manifest in trauma survivors, and when they do, their intensity can vary significantly.

2. Potential long-term effects. Although the findings indicate the existence of childhood trauma and symptoms of post-traumatic stress disorder, they do not establish a cause-and-effect relationship and do not provide a specific idea of the long-term consequences for adults. Understanding the exact impact of childhood trauma and post-traumatic stress symptoms on the well-being and functioning of people in adulthood requires additional research and study.

In general, according to the presented average scores and standard deviations, the study participants indicated a moderate degree of severity of childhood trauma and symptoms of post-traumatic stress. However, significant standard deviations indicate a wide range of people's experiences and reactions to trauma. The various effects of childhood trauma on adult life require additional research, as well as special interventions.

Table 2

Correlation matrix

The intensity and direction of the relationship between the two variables are indicated by a correlation coefficient, in this case 0.720. The correlation with a value of 0.720 is considered moderately strong. This means that PCL-5 scores, which indicate an increased risk of post-traumatic stress disorder symptoms, are likely to increase if CTQ scores, which indicate a higher level of childhood trauma, increase.

The metric of statistical significance is a p-value equal to 0.001. The probability that the observed correlation coefficient (0.720) is the result of randomness is shown by this statistic. The relationship between CTQ and PCL-5 turns out to be extremely significant with a p-value of 0.001. Or, to put it another way, it is extremely unlikely that the observed relationship is the result of random fluctuations in the data.

The results indicate a close relationship between childhood trauma and the development of symptoms of post-traumatic stress disorder in adults. The correlation coefficient of 0.720 shows that CTQ scores can explain a significant part of the variation in PCL-5 scores. According to a positive correlation, the likelihood of developing symptoms of post-traumatic stress disorder increases as childhood trauma increases.

It is important to note that correlation does not indicate a causal relationship. The findings do not prove a causal relationship, even if there is a significant correlation between childhood trauma and symptoms of post-traumatic stress disorder. Other factors such as genetic predisposition, social support, and coping methods can also influence post-traumatic stress disorder. Therefore, more research is needed to fully understand the complex relationships between childhood trauma and its long-term impact on mental health.

Conclusions

So, there is a moderately positive association between childhood trauma (CTQ) and symptoms of post-traumatic stress disorder (PCL-5) in adults, as evidenced by a correlation coefficient of 0.720 and a high p-value. These findings highlight how important it is to provide therapy for childhood trauma and to offer the right support and intervention to reduce the likelihood that a person may subsequently develop post-traumatic stress disorder.

Post-traumatic symptoms in adults (according to the PCL-5 questionnaire) and childhood trauma (according to the CTQ questionnaire) are significantly correlated with each other. According to linear regression analysis, a small but significant portion of the variance is due to childhood trauma, which also has a statistically significant impact on outcomes in adulthood. These results suggest that childhood trauma can have long-term effects on a person even in adulthood.

Thus, the hypothesis put forward was confirmed: a moderate significant effect of childhood trauma on adulthood and the correlation of childhood trauma with post-traumatic characteristics in adulthood.

Conclusion

So, we can conclude that a person who has experienced some kind of trauma in childhood gets a dangerous experience, which leads to a psychological disorder after reaching a certain age. Childhood interpersonal injuries can have a detrimental effect on a child's development, especially with regard to psychological and interpersonal functioning. Their potentially negative consequences for the psychological sphere are diverse: an increased risk of depression, anxiety, post-traumatic stress symptoms, aggression, dissociation, substance use, risky sexual behavior, as well as borderline, antisocial, schizotypal, avoidant and schizoid personality disorders. In the long term, these psychological consequences can become chronic and lead to high rates of suicidality and a low level of social functioning.

For this reason, the prevention of psychological trauma in adulthood is important.

There are many psychotherapeutic methods for treating injuries that are recommended when working with child psychological trauma. However, only a few of them are supported by extensive research and can be called "evidence-based". Although there is no single "best" method for treating injuries, people may find that they respond better to one type of treatment than to another. Here are the best methods of treating injury-related problems.

1. Cognitive behavioral therapy (CBT). This method focuses on recognizing problematic thinking patterns and working to change them, which then helps to change behaviors. This treatment requires a person to make weekly visits to learn skills that can be used to manage symptoms. Throughout the course of treatment, a person will practice skills outside of sessions. In the meantime, the service provider will take care to remove any obstacles and highlight progress. Standard CBT traditionally takes from 12 to 16 weeks.

2. Long-term exposure therapy (TDV). This is a special type of CBT, which primarily uses behavioral therapy methods. With TDV, people are gradually exposed to their memories, emotions, thoughts, and physical sensations associated with the trauma. Since avoidance is a common symptom of trauma, TDV helps people stop avoiding reminders of trauma. The types of impacts may include:

- imaginary effects: retelling the details of a traumatic event;

- in vivo exposure: repeated exposure to traumatic situations or people in everyday life that they avoid;

- interoceptive effect: the creation and subsequent experience of frightening physical sensations associated with trauma, but actually harmless.

3. Cognitive information processing (COI). KOI focuses on reassessing how a person thinks after a traumatic event. This treatment focuses on how people see themselves, others, and the world around them. Often problematic or irrational thinking keeps a person at a dead end and makes it difficult to recover from an injury. The KOI protocol helps a person assess their trauma and its impact on their thinking. A person learns the skills to assess whether his thoughts correspond to reality, and develops more useful ways to think about his injury. KOI is especially useful for those who feel intense shame due to a traumatic event.

4. Cognitive behavioral therapy focused on trauma (CBT-OT). Designed for children and adolescents, CBT-OT helps to improve a number of the effects of injury in minors. This treatment takes from 8 to 25 sessions, and both the child and the caregiver or an adult whom they trust participate in the treatment. CBT-OT is one of the most effective methods of trauma therapy, helping young people recover from post-traumatic stress disorder. CBT-OT solves other injury-related problems such as anxiety, depression, and behavioral problems. In addition, a guardian or an adult they trust can ease their anxiety about a traumatic event for a child and learn effective parenting skills.