Early Childhood Trauma Research Articles

Male intimate partner violence: Examining the roles of childhood trauma, PTSD symptoms, and dominance.

One approach to understanding perpetration of intimate partner violence (IPV) by men focuses upon their childhood exposure to abuse or neglect as traumatic experiences, which may lead to PTSD symptoms; these symptoms can serve as risk factors for IPV perpetration. Another approach looks at the societal aspects of inequality between men and women as promoting male dominance over women and leading to IPV. The aim of the current study was to incorporate elements of each approach based on social learning theory through examining the role of dominance as a mediator between early childhood trauma, PTSD symptoms, and IPV perpetration severity. Participants consisted of 234 men drawn randomly from those receiving treatment at 66 domestic violence centers throughout Israel. They completed versions of the Revised Conflict Tactics Scale for IPV and Conflict Tactics Scale Parent-Child for history of family exposure to violence and physical neglect, the International Trauma Questionnaire for PTSD, and the Dominance Scale. The results indicated an indirect association between physical neglect in childhood and psychological, physical IPV severity, via PTSD and dominance. The results suggest a more integrated way of conceptualizing trauma, PTSD, and power and control issues for the perpetration of IPV. In addition, they emphasize the need to develop trauma-informed interventions that focus on dominance alongside other important trauma-relevant core themes that increase risk for IPV. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Trauma and Relational Care

Healing—the restorative process of becoming healthy and whole—is a central element in recovery from trauma. The integration of trauma-informed care into relational practice supports this healing process. The characteristics of relational child and youth care have been defined (Garfat & Fulcher, 2012) and organized into a framework (Freeman & Garfat, 2014). The impact of trauma and an example of relational trauma in early childhood are explained, and select characteristics are identified and described in the context of trauma-informed practice.

Time is of essence - Abnormal time perspectives mediate the impact of childhood trauma on depression severity

BackgroundMajor depressive disorder (MDD) is a multifaceted mental disorder where participants, in addition to various symptoms, often suffer from increased focus on past time perspective and higher incidence of childhood trauma. Whether the abnormal time perspective is a result of the depressive symptoms or, alternatively, mediates between childhood trauma and depression remains unclear. AimsTo examine the triangular relationship between early life trauma, time perspective, and depressive symptoms. MethodWe investigated a large-scale MDD sample (n = 93) and healthy subject sample (n = 69) with Beck depression inventory-II (BDI-II), Beck hopelessness scale (BHS), childhood traumatic questionnaire-Short Form (CTQ-SF), and the Zimbardo time perspective inventory (ZTPI). ResultsThe MDD patients reported more childhood trauma experiences, and were featured by abnormal time perspectives on past and future when compared to healthy control. By applying two alternative mediation models, we observed that the time perspective acted as a mediator between childhood trauma and depressive symptom severity, rather than as a consequence of depressive symptom. Furthermore, this abnormal time perspective was a risk factor to MDD, as the childhood trauma only mediated the time perspective in MDD. Finally, we showed that time perspective was a long-term personal trait and unchanged after the remission of depression symptoms under five-day transcranial magnetic stimulation. ConclusionsAbnormal time perspective mediates the impact of early childhood trauma on depressive symptomatology. Besides better understanding of the temporal basis of depressive symptoms, we highlight the importance of preventive time perspective therapy in subjects with childhood trauma.

Use of stainless steel crowns and zirconia crowns in posterior primary teeth for children in different age groups

Children are more susceptible to Early Childhood Caries and trauma. Post endodontic treatment, it is necessary for coverage of the treated teeth, and full crowns are considered to be the best option for the same. Preformed crowns for primary molars are available in many sizes and materials to be placed over decayed or developmentally defective teeth. They can be made completely of stainless steel, stainless steel with a white veneer cover or made wholly of a white ceramic material when aesthetics is concerned. The main aim of this study is to assess the prevalence of usage of stainless steel crowns and zirconia crowns in posterior teeth for pedo patients in different age groups. 89000 case sheets were reviewed between June 2019 - March 2020 for possible inclusion and exclusion criteria. Case sheets of 1496 pediatric patients who underwent stainless steel crown and zirconia crown placement in posterior teeth were obtained from a Private Dental Institute. Collected data were analysed using SPSS statistics software. Results showed that stainless steel crowns were more prevalently used among all age groups (99.54%) and were more prevalent among the age group 0-5 years (69.61%). Stainless steel crowns were also found to be more prevalent among male pediatric patients (57.80%). In Conclusion, stainless steel crowns were most prevalent among all age groups and are more prevalent among male pediatric patients.

The Effects of Bibliotherapy and Equine – Assisted Therapy on Traumatized Children

Background. Early childhood traumas leave serious consequences: during adolescence and adulthood people often experience internal conflicts, more often suffer from mental and somatic diseases, so it is important to look for therapies that can neutralize or reduce the effects of early traumas. One of the options is to apply a complex of bibliotherapy and equine assisted therapy. However, there is a lack of studies analysing how these two therapies affect the development.The aim was to explore the influence of bibliotherapy and equine-assisted therapy on the emotions and behaviour of children with early trauma.Methods. Qualitative research used interview, observation, and projection techniques.Results. Bibliotherapy created preconditions for the emergence of repressed feelings and for deeper, more sensitive dialogue with the psychologist. Riding helped to relax, captured the attention of the present, strengthened positive emotions.Conclusions. 1. Equine – assisted therapy affects the body and gives positive emotions, reduces child’s inner anxiety, improves mood and consolidates bibliotherapy results. 2. The combination of bibliotherapy and equine – assisted therapy creates the conditions for stabilizing and even transforming the negative emotions of children with early trauma and restoring the fullness of childhood life.Keywords: psychological trauma, child development, emotions, horse assisted therapy, bibliotherapy.

Healthy Sexuality for Sex Offenders.

This review will examine the current, although limited, literature on the development of healthy sexuality for sex offenders, as well as some of the related controversies surrounding sex offender specific therapies. Over the last decade, the definition of healthy sexuality has remained elusive while the boundary delineating unhealthy sexuality has radically changed. These changes are not reflected in current approaches to sex offender treatment which continue to focus on suppression of offenders' sexuality. Our attention to the management of sexual behaviors has led to a diminished, and perhaps impoverished, curiosity and understanding of what is driving problematic sexual behavior and also moves us further from an understanding of what leads to "healthy" sexual behavior. It is our contention that a consideration of sex offending behavior through the lens of early childhood trauma will lead to an improvement in our ability to assist these offenders in the development of sexually happier and more fulfilling lives while being able to function within the parameters of society's standards for legal behavior. The sex positive perspective of sex therapy will allow for a broader consideration of what defines and promotes healthy sexual behavior in an offender population.

Supporting Face-to-Face Birth Family Contact after Adoption from Care: Learning for Trauma-Sensitive Practice

Abstract There are recent calls to consider face-to-face birth family contact for more children adopted from care. Given that the threshold for this authoritative intervention is significant harm, post-adoption contact should be sensitive to the possible impact of early childhood trauma, and be adequately supported. This article draws on adopters’ reports of face-to-face contact with birth relatives, and their evaluation of social work support to suggest an approach to practice informed by principles of trauma-informed care. Twenty-six adoptive parents participated in focus groups, and seventy-three completed a web-based questionnaire, all from Northern Ireland where face-to-face post-adoption contact is expected. Findings are structured thematically around principles of trauma-informed care: trusting relationships; physical and emotional safety; choice and control; and narrative coherence. Most families had a social worker attending contact, and help with practical arrangements. Less common but important practices included: deliberate consideration of children’s perspectives; safeguarding their emotional well-being; and facilitating communication outside of visits. Findings suggest that visits are a context in which trauma-effects may surface, and social workers supporting contact should be sensitive to this possibility. This article suggests a systemic approach to helping all parties prepare for, manage and de-brief after contact, attending to both adult-to-adult and adult–child interactions.

Training providers at Children’s Advocacy Centers to treat early childhood trauma: Perspectives on barriers, facilitators, and sustainability

Nearly half of child maltreatment victims are under the age of six, yet mental health providers are rarely trained in evidence-based treatments for this population. As interdisciplinary agencies that coordinate responses to child maltreatment, Children’s Advocacy Centers (CACs) are well-positioned to facilitate access to trauma-focused treatment for an early childhood population, provided the proper training. The present study was a qualitative evaluation of the implementation of Child-Parent Psychotherapy (CPP), a treatment that addresses traumatic stress and child-parent attachment in children ages 0–5, in a statewide network of seventeen CACs. Participants were 17 clinicians, supervisors, and senior leaders from ten CACs who completed qualitative interviews about their experiences with implementation of CPP and their plans for sustainment of CPP. They were interviewed after approximately 8 months of an 18-month CPP training initiative and again approximately 2 months after the training initiative ended. Interview transcripts were coded using a conventional content analysis approach. We identified 11 major themes related to barriers and facilitators in the implementation and sustainment of CPP in CACs. Facilitators included meaningful expansion of services and certain aspects of the training process (e.g., group supervision). Barriers included difficulties with caregiver engagement and clinicians feeling “lost” during the extended learning process for CPP. Factors anticipated to affect future sustainment of CPP included staff turnover at CACs and the availability of CPP training in the future. Our results have implications for clinicians, administrators, and policymakers interested in the use of evidence-based treatments for specialty populations in multidisciplinary settings like CACs.

Plasma microRNA Array Analysis Identifies Overexpressed miR-19b-3p as a Biomarker of Bipolar Depression Distinguishing From Unipolar Depression.

ObjectivesThe clinical characteristics of bipolar disorder (current major depressive episode) (BD) overlap with unipolar depressive disorder (UD), which makes it difficult to perform an accurate diagnosis. We identified plasma microRNAs (miRNAs) that distinguished BD from UD and explored the relationship between miRNA expression levels and clinical characteristics.MethodsTotal miRNAs from blood plasma from seven UD patients, seven BD patients, and six controls were analyzed. The identified miRNAs were validated in a separate population group. Depression severity and early life adversities were assessed. Bioinformatic analysis was conducted to investigate the target genes that were identified and the pathways associated with the altered miRNAs.ResultsCompared to controls, 42 miRNAs were differentially expressed in patients. miR-19b-3p, miR-3921, and miR-1180-3p were selected to validate the microarray results. Only miR-19b-3p was validated as down-regulated in patients. The primary predicted genes associated with miR-19b-3p were MAPK1, PTEN, and PRKAA1. The most relevant KEGG pathways included mTOR, FoxO, and the PI3-K/Akt signaling pathway. BD patients were more likely to have higher expression levels of miR-19b-3p and more severe childhood trauma experience compared to UD patients.ConclusionsPlasma miR-19b-3p is a potential non-invasive biomarker that might be useful in distinguishing UD from BD. miR-19b3p was predicted to be involved in the pathway of inflammatory dysregulation associated with experiencing early childhood trauma.

CLINICAL AND RADIOGRAPHIC MANIFESTATIONS WITH 3-DIMENSIONAL PRINTED MODEL OF TRUE BONY ANKYLOSIS OF THE TEMPOROMANDIBULAR JOINT: A CASE REPORT

<h3>Clinical Presentation</h3> We present a case of a 20-year-old male who presented with facial asymmetry, severe trismus since early childhood, generalized physical weakness, and other skeletal deformities, including pigeon chest and kyphoscoliosis. No clear history of trauma was elicited. However, early childhood trauma was considered a possibility. <h3>Differential Diagnosis</h3> Severe trismus can be caused by various etiologies, including trauma, temporomandibular joint (TMJ) disorders, benign and malignant neoplasia, infections, and iatrogenic causes. However, with the history and clinical presentation, a TMJ condition, including bony and fibrous ankyloses, was considered. <h3>Diagnosis and Management</h3> Multidetector computed tomography (MDCT) was performed. Radiographic features were consistent with stage IV bony ankyloses of the left TMJ, according to the classification system of Sawhney et al. A 3-dimensional (3-D) printed medical model of the skull and the mandible was used for surgical simulation. Gap arthroplasty with interpositional temporalis muscle flap was performed, followed by vigorous physiotherapy. After surgery, mouth opening increased significantly from 0 to 35 mm. One year clinical follow-up was done. <h3>Discussion</h3> TMJ ankylosis is a pathologic condition in which the mandible is fused to the glenoid fossa by bony or fibrotic tissues, interfering with mastication, speech, oral hygiene, and nutrition. Multiple factors, including trauma, arthritis, infection, congenital deformities, or iatrogenic causes, can result in ankylosis, but trauma remains the most common etiology. In growing individuals, it can result in very severe craniomaxillofacial deformities and can also affect the airway. This case report discusses the clinical and radiographic features affecting the craniomaxillofacial structures associated with TMJ ankylosis and the applicability of 3-D printing in treatment planning. Because TMJ ankylosis can affect multiple aspects of the patient's life, an interdisciplinary management approach is required.

Maternal perinatal depression, circulating oxytocin levels and childhood emotional disorders at 4 years of age: The importance of psychosocial context

Oxytocin has been a hormone of interest in understanding both depression and parenting. Here, the role of oxytocin has been explored in understanding the interaction between perinatal depression, history of trauma and subsequent longer-term child socio-emotional outcomes. Data were obtained from 203 pregnant women from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a pregnancy cohort study with data collected across pregnancy, postpartum and until 4 years for mother and child. Maternal antenatal depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV) together with the Childhood Trauma Questionnaire to measure maternal trauma history. Maternal oxytocin levels were measured by enzyme immunoassay following extraction at four time points across pregnancy and the postpartum. The offspring consisted of 203 children followed up from birth until 4 years of age when they were assessed for DSM 5 depression and anxiety disorders (emotional disorders) using the Preschool Age Psychiatric Assessment. Maternal oxytocin levels increased over pregnancy and the postpartum in both control and depressed women with no difference between groups. Maternal childhood trauma and antenatal antidepressant use was also not associated with maternal oxytocin levels. Lower gestational age, maternal depression and early childhood trauma, and late pregnancy oxytocin concentrations were associated with later childhood emotional disorders; together they predicted 10% of variance for emotional disorders. Oxytocin is a hormone whose role in understanding intergenerational risk from pregnancy to child emotional disorders is dependent on relational context. Future research can expand on understanding these important early predictors of childhood mental health.

Complex trauma and the question of reasonableness of response in sexual harassment cases: Issues for treatment providers and forensic evaluators

This paper discusses considerations for treating or evaluating sexual harassment claims in individuals with a history of complex trauma. The author reviews how a history of repeated trauma in early childhood increases risk for later victimization, including sexual harassment (Courtois & Ford, 2013; Herman, 1992). Further, she provides a brief overview of how attachment disruptions and other adverse childhood experiences (ACE) create difficulties with emotion and interpersonal regulation. She discusses how the complexity of the symptom profile provides a unique context for therapeutic intervention and evaluation, as well as the importance of staying firmly grounded in one’s role when the courts are involved (Greenberg & Shuman Professional Psychology: Research and Practice, 28(1), 50–57, 1997). Utilizing her more than 30 years of experience as a forensic evaluator, the author provides case material throughout the manuscript to highlight potential pitfalls and strategies for maintaining the therapeutic alliance or role as a forensic evaluator.

T148. FIRST EPISODE PSYCHOSIS, TRAUMA AND SUBSTANCE USE IN A HIGH HIV PREVALENCE SETTING IN SUB-SAHARAN AFRICA

BackgroundHIV, substance use and trauma are associated with more severe symptoms and poorer outcomes in psychosis. We aim to describe the profile of adults with first episode psychosis (FEP) and associations with substance use and trauma in a cohort of patients in a low resource, high HIV prevalence setting in South Africa.MethodsWe recruited all adult patients (18–45 years) presenting with FEP to five psychiatric units in the eThekwini Municipality, KwaZulu-Natal Province. Psychiatric diagnosis was made using the MINI. We used the PANSS for psychotic symptoms, WHO ASSIST for substance use and CTQ for early childhood trauma. HIV status was confirmed by ELISA.ResultsSixty participants were recruited, mean age 26 years (SD 8, IQR 19–33), 68% (n=41) were male. Mean age at presentation was 24 and 31 years for males and females respectively, with males being significantly younger than females (p=0.0003). Duration of untreated psychosis (DUP) was 12.5 months (IQR 1–10.3 months). Lifetime tobacco, alcohol and cannabis use was reported at 57%, 55%, and 47% respectively. Substance use was more prevalent among males compared to females, p=0.10, 0.13 and 0.0001 for tobacco, alcohol and cannabis respectively. Lifetime cannabis use was associated with higher negative PANSS scores (mean score 32, SD 10) compared to non-users (mean score 17, SD 7), p=0.05. Sixty eight percent (n=41) reported any traumatic event. Sixty-two percent (n=37) experienced trauma before 18 years and 35% (n=21) reported traumatic experiences in adulthood. Individuals who reported trauma in adulthood had higher hostility scores in the PANSS compared to those who experienced no trauma in adulthood (p=0.05).Fifteen (25%) of the cohort was HIV infected. Females were more likely to be HIV infected (58% HIV infected females compared to 9.8% HIV infection in males, p=0.0001).Eleven of the 15 HIV infected patients had been on antiretroviral treatment prior to the psychosis onset and four were newly diagnosed at the time of psychosis presentation. Of the 11 individuals on antiretroviral treatment, 6 (45%) were virologically suppressed.There was no significant difference in PANSS scores by HIV status (p=0.5) and childhood trauma (p=0.5).DiscussionThe study found participants with FEP had a high prevalence of HIV, particularly in females, and high prevalence of tobacco, alcohol and cannabis use. This suggests that these individuals are particularly vulnerable to the triple burden of psychosis, substance use and HIV. In addition, they had long DUP suggesting delay in accessing treatment, which all serve as poorer prognostic indicators in an already overwhelmed health care setting.The high rates of trauma (more than half the sample reporting childhood trauma) is another major public health concern as trauma exposure has been associated with poorer physical and mental health outcomes. In this study the lack of association between childhood trauma and psychosis severity is inconsistent with literature and needs to be further explored. The association between adult exposure to trauma and increased hostility scores suggests the need to include psychological treatment strategies to address the trauma exposure to improve outcomes.

Behavioral development in children with prenatal substance exposure and neonatal abstinence syndrome: Associated factors and implications.

Prenatal substance exposure and neonatal abstinence syndrome (NAS) are risk factors for adverse behavioral outcomes in children at 24 months of age. The purpose of this study was to examine factors associated with abnormal behavioral development in children with prenatal substance exposure or NAS through 10 years of age. A retrospective, nonexperimental, longitudinal design to examine the effects of prenatal substance exposure and NAS on behavioral development at 1, 5, and 10 years of age, while controlling for intrapersonal, interpersonal, community, organizational, and public policy characteristics. A hierarchical multivariate logistic regression model was used to evaluate the influence of substance exposure and NAS on behavioral outcomes. Abnormal behavioral development was predicted at 10 years of age with polysubstance exposure to three substances (odds ratio [OR] = 2.711, p < 0.01) and NAS (OR = 2.077, p < .001). Psychiatric nursing care for children with prenatal substance exposure and NAS should include implementation of early and continued behavioral evaluation and childhood trauma and adversity surveillance in children through middle childhood.

Early Childhood Trauma Impact on Adolescent Brain Development, Decision Making Abilities, and Delinquent Behaviors: Policy Implications for Juveniles Tried in Adult Court Systems

AbstractBy examining previous literature on the brain’s developmental process during adolescence, this paper aims to determine how early childhood trauma potentially effects decision making in adolescence through exploring self‐regulation theory. Through a self‐regulation framework, the hope is to determine the connection, if any, between early childhood trauma, delinquent behavior, and involvement in the juvenile justice system. The author insists that not only do adolescents have less culpability due to their brain developmental stage compared to adults, but also early childhood trauma puts adolescents at a greater risk of impaired self‐regulation which allows for more probable delinquent behavior. This paper also considers implications for social policy makers and youth advocates concerned with juvenile offenders tried in adult courts and existing racial disparities in the system.

Childhood sexual abuse predicts treatment outcome in conversion disorder/functional neurological disorder. An observational longitudinal study.

ObjectiveExplore trauma, stress, and other predictive factors for treatment outcome in conversion disorder/functional neurological disorder (CD/FND).MethodsProspective observational design. Clinical cohort study among consecutive outpatients with DSM‐IV CD/FND in a specialized mental health institution for somatic symptom disorders and related disorders (SSRD), presented between 1 February 2010 and 31 December 2017. Patient files were assessed for early childhood trauma, childhood sexual abuse, current stress, and other predictive factors. Patient‐related routine outcome monitoring (PROM) data were evaluated for treatment outcome at physical (Patient Health Questionnaire [PHQ15], Physical Symptoms Questionnaire [PSQ]) level as primary outcome, and depression (Patient Health Questionnaire [PHQ9]), anxiety (General Anxiety Disorder [GAD7]), general functioning (Short Form 36 Health Survey [SF36]), and pain (Brief Pain Inventory [BPI]) as secondary outcome.ResultsA total of 64 outpatients were included in the study. 70.3% of the sample reported childhood trauma and 64.1% a recent life event. Mean scores of patients proceeding to treatment improved. Sexual abuse in childhood (F(1, 28) = 30.068, β = 0.608 p < .001) was significantly associated with worse physical (PHQ15, PSQ) treatment outcome. 42.2% reported comorbid depression, and this was significantly associated with worse concomitant depressive (PHQ9) (F[1, 39] = 11.526, β = 0.478, p = .002) and anxiety (GAD7) (F[1,34] = 7.950, β = 0.435, p = .008) outcome.ConclusionChildhood sexual abuse is significantly associated with poor treatment outcome in CD/FND. Randomized clinical trials evaluating treatment models addressing childhood sexual abuse in CD are needed.

California has begun screening for early childhood trauma, but critics urge caution

California has begun screening for early childhood trauma, but critics urge caution

Childhood Trauma and Attachment

This article describes the relationship between trauma in early childhood and attachment style, with the goal that clinicians can more effectively tailor individualized interventions to their clients. Recognizing how and why trauma influences attachment styles will provide the clinician with a more thorough understanding of the client and the client’s family system and will allow the clinician to select the most appropriate treatment interventions. Implications are provided for marriage, relationship, and family counselors. Furthermore, recommendations for future research are provided.

Attachment Style, Early Childhood Trauma, Alexithymia, and Dissociation Among Persons Addicted to Alcohol: Structural Equation Model of Dependencies.

AimAttachment theory is a broadly used paradigm for understanding human affective development. It is recognized that alexithymia is a key factor responsible for the non-adaptive strategies of regulating emotions in people addicted to alcohol. In addition, an important role is attributed to early childhood trauma and dissociation. The theoretical model was examined, in which connections between attachment styles, trauma, and alexithymia and dissociation were investigated in persons addicted to alcohol.MethodsThe total number of study participants amounted to 268 persons, including 116 women (43% of all subjects) and 152 men (57% of all subjects) at the age of 18–73 (M = 39.19; SD = 13.45). In order to measure the analyzed variables, the following questionnaires were applied: Michigan alcoholism screening test (MAST), attachment styles questionnaire (ASQ), 20-item Toronto Alexithymia Scale (TAS-20), traumatic experiences checklist (TEC), and curious experiences survey (CES).ResultsA comparative analysis between the group of alcohol addicts and non-addicts showed statistically significant differences related to attachment style, intensity of trauma, alexithymia, and dissociation. With structural equation models (i.e., AMOS and GLS), the adjustment of theoretical model to data was examined, which allowed the description of dependency paths. As a result of the conducted analysis of paths, it was found out that the model was accurately fitted to data, but only when an impact path related to a direct connection between an attachment style and an addiction was deleted. This impact is indirect, and from one side, it results from affective and cognitive deficits, i.e., alexithymia, and on the other side, from the intensity of traumatic experiences. No direct impact of dissociation on the development of an inclination to addiction was found, if contextual variables, i.e., alexithymia and trauma, are taken into account. The strongest direct relation was proven in the case of the anxious-ambivalent attachment style and alexithymia (β = 0.389; p < 0.01) and avoidant attachment style and alexithymia (β = 0.497; p < 0.01), which turned out a strong predictor fostering the development of alexithymia and the occurrence of traumas related to emotional negligence and mental violence and finally addiction.ConclusionOur studies revealed how important it is to investigate the role of individual variables in the context of developmental models. An extremely important element of the scientific achievement presented here is showing pillars of trauma, alexithymia, and dissociation in their cumulative impact on the development of emotional disorders resulting in addiction.

Physiological Differences to the Brain Resulting from Anoxia &amp;amp; Early Childhood Trauma

The report focuses on the case of John Lane, who was convicted of murdering his girlfriend's daughter Angela Palmer by cooking her alive inside an oven. Three previously published research studies, two books, and an interview with the author were utilyzed in providing information significant to the consideration of the nature of John Lane's particular form of mental illness. Anoxia and childhood trauma are explored as causal factors leading to a higher risk of persons developing psychological problems.