Adult Survivors Of Childhood Trauma Research Articles

How Does Trauma Make You Sick? The Role of Attachment in Explaining Somatic Symptoms of Survivors of Childhood Trauma.

Exposure to traumatic events during childhood is common, and the consequences for physical and mental health can be severe. Adverse childhood experiences (ACEs) such as physical abuse, sexual abuse, emotional abuse, and neglect appear to contribute to the onset and severity of a variety of somatic inflictions, including obesity, diabetes, cancer, and heart disease. The aim of this scoping review was to try to gain insight into how this might occur. Given the evidence of indirect (i.e., through unhealthy behaviours such as excessive drinking or poor eating habits) and direct (i.e., through its impact on the endocrine, immune, and cardiovascular systems as well as on the brain) effects of attachment on health, we examined the possibility that insecure attachment might contribute to the development of somatic symptoms in adult survivors of childhood trauma. Eleven studies met our inclusion criteria. Findings from this review suggest that insecure and disorganized attachment orientations are related to DNA damage, metabolic syndrome and obesity, physical pain, functional neurological disorder, and somatization in adults exposed to childhood trauma. We discuss the implications of this for the conceptualization and treatment of trauma and stress disorders.

Sleep Quality, Sleep-Related Experiences, and Dissociation in Adult Survivors of Childhood Trauma

ABSTRACT Objectives Exposure to traumatic stress in childhood increases the risk of sleep disturbances. Preliminary evidence suggests that the relationship between childhood trauma and sleep may depend on trauma chronicity. Additionally, little is known about the relationship between sleep and dissociation, a common symptom in post-traumatic stress disorder. This study examined sleep quality, sleep-related experiences, and dissociation in survivors of childhood trauma with different trauma chronicity. Method Nine-hundred-and-fourteen community-dwelling adults completed an online survey. They were divided into three groups: no childhood trauma, short-term childhood trauma, and chronic childhood trauma. Results We found that survivors of chronic childhood trauma had poorer sleep quality than survivors of short-term childhood trauma and individuals without a history of childhood trauma, controlling for age, number of trauma types experienced, psychological distress, and PTSD symptoms. The relationship between dissociation and sleep quality was moderated by trauma chronicity such that dissociation was associated with better sleep quality only in the chronic trauma group. Dissociation was positively associated with sleep-related experiences regardless of trauma exposure and trauma chronicity. Conclusion Our findings highlighted the differential impact of acute and chronic traumatic stress on sleep, and suggested that the relationship between dissociation and sleep could depend on trauma chronicity.

Acceptability and mechanisms of change associated with group cognitive behavioural therapy using the Recovering from Childhood Abuse Programme among women with CPTSD: a qualitative analysis

AbstractSurvivors of childhood trauma are at increased risk of complex post-traumatic stress disorder (CPTSD). The Recovering from Child Abuse Programme (RCAP) is a cognitive behavioural therapy (CBT) group promoting adaptive coping strategies which may help overcome CPTSD symptoms in adult survivors of childhood trauma. We sought to explore patient experiences of factors influencing treatment acceptability and potential mechanisms of therapeutic change in a sample of participants in the RCAP programme. As the group was delivered during the COVID-19 pandemic, necessitating a transition to remote therapy, we further aimed to capture experiences of the transition to telehealth delivery of the programme. A naturalistic sample of 10 women with CPTSD attending a specialist out-patient psychological trauma service participated in the study. Therapy sessions were recorded, transcribed verbatim and group members completed written feedback forms following each session. Reflexive thematic analysis was used to analyse the written feedback and transcripts. The RCAP was acceptable to group members and several themes were identified related to the experience of change in the group. Key themes centred on group solidarity; safety in the psychotherapeutic process; schema changes related to the self, others and future catalysed by the shifting of self-blame; increased emotional regulation to feel safer in the present; and increased future optimism. Therapeutic progress continued following the transition to telehealth, although face-to-face delivery was generally preferred. The programme was acceptable and led to cognitive change, enabling increased emotional regulation in the present and improved self-concept, thereby addressing key symptoms of CPTSD.Key learning aims(1)To identify potential mechanisms of therapeutic change related to participation in the Recovery from Childhood Abuse group CBT intervention.(2)To understand factors influencing acceptability of the group intervention among women with CPTSD to childhood sexual abuse.

Grief tending through the wilderness: toward a poetic consciousness for adult survivors of childhood trauma

ABSTRACT In this article, my approach to grief tending for the adult survivor of childhood trauma is to integrate a practice of poetic inquiry into one’s evolving relationship with oneself. As has been well documented by trauma theory, arts-based practices, here working strictly with poetry, are capable of embracing the often non-linear and multi-layered realities of our emotional woundings that are carried with us throughout our lives. By forging pathways through the wilderness of grief with poetic modes of inquiry and exploration, I suggest that we are able to shift healing work toward creative and empowering survivor-centred practices.

Musical Engagement is Linked to Posttraumatic Resilience: The Role of Gender, Personality, and Music Listening Styles After Childhood Trauma

Previous research on the links between music and posttraumatic resilience have typically relied on small sample sizes and case studies from clinical settings. To address this important gap, we conducted an online study to measure childhood trauma and adult musical engagement in everyday life in non-clinical contexts. The present study ( N = 634) investigated these links by administering online questionnaires about musical engagement, personality, and demographics to adult survivors of childhood trauma. Hierarchical regression analyses showed that social music listening predicted increased well-being in males while affective music listening predicted decreased well-being in males. Gender moderated the interaction between affective engagement and well-being: affective engagement was linked to increased well-being in females and a decrease in males. Furthermore, neuroticism moderated the interaction between narrative listening and well-being: narrative listening was linked to increased well-being for participants with low neuroticism and a decrease for those with high neuroticism. These findings may reflect general gender differences in coping styles: emotional reflection for females and emotional distraction for males, and suggest gender differences in attentional biases, rumination, and capacities for disassociation. Taken together, the results show that there are individual differences in musical engagement and posttraumatic resilience based on gender and personality. These findings are useful for the development of music-based coping strategies that mental health professionals can tailor for individual clients.

Adult survivors of childhood trauma: Complex trauma, complex needs.

Childhood trauma is common and can have profound consequences throughout aperson's life. Adult survivors of childhood abuse pose a number of challenges for general practitioners (GPs). The diagnosis of their medical and psychiatric illnesses is complex; the therapeutic relationship can be both delicate and critical to recovery; and the treatments are varied, often expensive and frequently inaccessible. The aim of this article is to provide a conceptual framework for the assessment and management of an adult survivor of childhood adversity. GPs can be effective and facilitate recovery-orientated, trauma-focused care, even when local services are limited. This model considers the person's presenting symptoms and the consultation interaction, and it is applicable regardless of diagnosis. Key principles include listening and engaging to understand why the person is presenting in this way, and approaching care in a targeted and collaborative manner. This can alleviate emotional distress for the patient, GP and care team.

Traumatic Experiences in Childhood and Adult Substance Use in a Nonclinical Sample: The Mediating Role of Arousal/Reactivity.

The vast majority of adults in the United States experience at least one traumatic event during childhood. According to the self-medication hypothesis of substance use disorders, adult survivors of childhood trauma may cope with trauma-related symptoms via alcohol or drug use. The purpose of this study is to identify through which specific PTSD symptom clusters childhood trauma exposure are associated with adult substance use. Participants of this study (N=627) were not recruited based on substance use or traumatic exposure. Results of this study demonstrate that arousal/reactivity partially mediates the association between childhood trauma and current substance use. Implications for treatment include recommendations for trauma-informed approaches that aim to decrease arousal/reactivity and subsequently substance use.

Learning to Heal from Those Who Know! The “Lived” Experience of a Peer Support Program for Adult Survivors of Childhood Trauma

ABSTRACTThis study explored the dual phenomenon of experiencing a peer support residential trauma program from the perspective of (a) a client, and (b) a facilitator. It sought both positive and negative subjective interpretations. Participants were former clients and current facilitators of the program. Data were collected through a focus group, and analyzed using interpretative phenomenological analysis. One superordinate theme, altruistic growth, overarched 2 subordinate themes. The first, modeling through respect, included subthemes of respect and hope and empowerment. The second subordinate theme, reciprocal model of care, encapsulated personal challenges such as facing the mirror, old demons, and burnout and breaking points. Conversely, participants mused on these challenges as opportunities for further healing through opportunities for self-nurturing and gratitude. Implications for treatment of adult survivors of childhood trauma are discussed. For facilitators, the program was seen as offering further personal reflection and a giving forward that was interpreted as altruistic growth.

Beyond Survival: Application of a Complex Trauma Treatment Model in the Christian Context

Disrupted systems of meaning are a core domain in which adults with a complex trauma history are impacted, often leading to adversely affected belief systems. For adult survivors of childhood trauma, experiences related to shame, betrayal, meaning-making, and mourning often complicate their spiritual and/or religious beliefs. This article uses a clinical case example to introduce and illustrate the relevance of a particular complex trauma intervention framework in the context of spiritually-informed treatment with adult Christian clients. Component-Based Psychotherapy (CBP; Hopper, Grossman, Spinazzola, & Zucker, in press) consists of four principal components: (a) relationship, (b) regulation, (c) parts work, and (d) narrative, and is predicated upon the importance of client-therapist parallel process to therapeutic movement and client change. Each treatment component is summarized and practically applied to case material, with particular focus on the ways in which client's faith beliefs and practices can serve as a potential resource and/or barrier in treatment. Particular integrative focus is given to the final treatment component (narrative), where issues of a client's lament, spiritual meaning making, and the therapist's potential vulnerabilities in working with this population are addressed.

The Relationship between Personality Disorder Features and Symptom Improvement at an Inpatient Treatment Program for Posttraumatic Stress Disorder

This study examined the association between personality disorder (PD) features and symptom improvement among adult survivors of childhood trauma in an inpatient program for posttraumatic stress disorder (PTSD). Participants completed questionnaires at admission, discharge, and six months following discharge. Multiple regression analyses were used to assess the combined effects of personality features on symptom improvement. Results indicated that improvement in trauma-related symptoms was not related to PD features. By contrast, the PD features were associated with change in other Axis I symptoms often comorbid with PTSD. Overall, results suggested that PD features do not impede improvement in trauma-related symptoms; however, specific accommodations might be needed to address comorbid disorders among individuals with PTSD.

Trauma-Informed Social Work Practice: Practice Considerations and Challenges

Adult survivors of childhood trauma are an especially challenging group of clients, given the long-term effects of the victimization and the present day difficulties these individuals face. In this article, trauma-informed practice is explained, incorporating the most recent theoretical and empirical literature. The purpose is to educate and provide support to clinicians who encounter survivors of childhood trauma in a range of settings that are particularly likely to serve this population like addictions, mental health, forensics/corrections, and child welfare. The social worker neither ignores nor dwells exclusively on the past trauma. Rather, trauma-informed practitioners are sensitive to the ways in which the client’s current difficulties can be understood in the context of the past trauma. Further, they validate and normalize the client’s experiences. Trauma-informed practice requires the practitioner to understand how the working alliance, itself, can be used to address the long-term effects of the trauma. Emphasis is placed on helping survivors understand how their past influences the present and on empowering them to manage their present lives more effectively, using core skills of social work practice.

The relationship between childhood trauma and neuropsychological functioning in first episode psychosis

There is an overlap between the neurocognitive deficits observed in adult survivors of childhood trauma and individuals with psychosis. Few studies examine the relationship between trauma and neurocognition in psychosis. The purpose of this study was to examine this in a first episode population. Thirty individuals with first episode psychosis who had completed a battery of neurocognitive testing in the longitudinal Northern Ireland First Episode Psychosis Study were subsequently interviewed and separated into two groups on the basis of childhood trauma. Between groups analysis was used to compare differences on measures of memory, executive functioning and verbal fluency. Twenty-one (70%) participants reported childhood trauma and nine (30%) reported no such history. Participants with a history of childhood trauma had a significantly higher pre-morbid IQ than the no childhood trauma group and experienced a significant decline in IQ when pre-morbid IQ estimates were compared to current IQ estimates. After controlling for pre-morbid IQ on all domains, the childhood trauma group had significantly poorer performance on tasks of semantic fluency, delayed visual recall, and visuospatial working memory. Childhood trauma may contribute to specific neurocognitive deficits and may predict a lower level of functioning relative to pre-morbid ability.

Review of Introduction to working with adult survivors of childhood trauma.

It is with great enthusiasm that I write this review of Carolyn Knight's new book, Introduction to Working with Adult Survivors of Childhood Trauma. Knight has done a wonderful job of writing a boo...

Treatment of Depressive Symptoms in Adult Survivors of Childhood Trauma

ABSTRACT This study examined differences in depression symptoms between four Personality Disorder (PD) groups in 123 adult survivors of abuse who completed a 6-week inpatient program for Post-traumatic Stress Disorder (PTSD). Data were collected at admission, discharge, 3-months, and 1-year post-treatment. Participants completed self-report measures at each time point. Based on Millon Clinical Multiaxial Inventory-II scores, participants were divided into four PD groups: avoidant, borderline, dependent, and histrionic. MANOVAs and ANOVAs were calculated to examine depression symptoms over time. Depression and hopelessness symptoms decreased post-treatment, and treatment gains were maintained at 1-year. Multiple regressions were calculated to determine which PD trait was the best predictor of response to treatment for depression. High dependent PD traits were the only significant predictor of lowered depression symptoms.

Personality characteristics of adult survivors of childhood trauma

Lenore Terr (1991) proposed a framework for childhood trauma that distinguishes between single-incident trauma (Type I) and repeated or prolonged trauma (Type II). Terr's framework and data collected from the National Comorbidity Survey (NCS) are used to examine differences in personality between adult survivors of childhood Type I trauma, childhood Type II trauma, and a control group of adults not traumatized as children. Groups were compared on five personality scales. Results indicate that individuals in the trauma categories scored higher in neuroticism and openness to new experiences than individuals in the control group. The Type I group was lower than the control group on interpersonal dependency, whereas the Type II group scored higher than the control group on this measure.

Psychotherapeutic approaches with survivors of childhood trauma.

The development and evaluation of psychotherapeutic approaches for survivors of childhood trauma has been complicated by numerous conceptual and methodological challenges. Randomized controlled clinical trials are rare, and most of these test cognitive behavioral therapy with sexually abused children. This article reviews psychosocial (nonpharmacological) treatment approaches with child and adult survivors of childhood trauma, highlighting methodologically sound studies of treatment efficacy. Implications of efficacy data for clinical practice and future research are discussed.

Psychiatric morbidity in adult survivors of childhood trauma.

This review focuses on child sexual abuse (CSA) as a prototype of childhood trauma and evaluates the evidence on psychiatric morbidity in adult survivors. An association between CSA and a wide range of psychiatric morbidity has been consistently documented in general population studies. The interpretation of this observed association is fraught with uncertainty that stems primarily from: (1) the retrospective nature of the data on CSA from adults' reports on their early experiences; (2) the adverse family context in which it occurs, which presents a major challenge for evaluating the effect of CSA per se; (3) the well documented lifetime comorbidity among psychiatric disorders, which leaves open questions about the specificity of CSA outcomes in adulthood. Twin study methods offer a solution to the problem of the familial context of CSA. Ascertainment of age of onset of adult disorders in future studies would increase the utility of findings for formulating psychological and biological causal models on the CSA-adult disorders connection. However, the retrospective nature of data on child abuse, because of legal and ethical restraints on research on children, is a formidable obstacle to advancing knowledge in this field.

Transforming the legacies of childhood trauma in couple therapy: The biopsychosocial assessment as compass and anchor

This paper explicates a brief overview of a synthetic couple therapy practice model along with a detailed account of the institutional, interactional, and intrapersonal factors that are relevant in completing a thorough bio‐psychosocial assessment. It is based on a chapter expected to be published by Columbia University Press in an upcoming book titled Couple Therapy with Trauma Survivors. The text presents a practice model that demonstrates why a couple therapy approach may be especially useful for survivors of childhood trauma. To provide a framework for this complex couple therapy practice model, we review the basis for a synthetic multi‐theoretical approach, the cultural constructs of “trauma,” the role of resilience, and the problematic aftereffects for adult survivors of childhood trauma. Following the description of each treatment phase of the couple therapy practice model, an outline for a biopsychosocial assessment is then introduced. At that point, specific institutional, interactional, and intrapersonal factors are reviewed and illuminated with specific clinical vignettes.

An Interview with Charles L. Whitfield, MD

Abstract Dr. Charles L. Whitfield is interviewed regarding his extensive clinical experience and research in the treatment of adult survivors of childhood trauma. He discusses the repercussions and effects of childhood maltreatment on adolescents and adults, as well as the stages of trauma recovery. He gives clinical advice regarding the treatment of abuse-related trauma and discusses some of the most recent research relating to abuse-related trauma clients.

Amnesia, Partial Amnesia, and Delayed Recall among Adult Survivors of Childhood Trauma

Clinical experience suggests that adult survivors of childhood trauma arrive at their memories in a number of ways, with varying degrees of associated distress and uncertainty and, in some cases, after memory lapses of varying duration and extent. Among those patients who enter psychotherapy as a result of early abuse, three general patterns of traumatic recall are identified: (1) relatively continuous and complete recall of childhood abuse experiences coupled with changing interpretations (delayed understanding) of these experiences, (2) partial amnesia for abuse events, accompanied by a mixture of delayed recall and delayed understanding, and (3) delayed recall following a period of profound and pervasive amnesia. These patterns are represented by three composite clinical vignettes. Variations among them suggest that the phenomena underlying traumatic recall are continuous not dichotomous. Future research into the nature of traumatic memory should be informed by clinical observation.