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The Impact Of Different Types Of Abuse On Children

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Sexual and physical abuse is related to grey matter volume loss in corpus callosum, the prefrontal cortex, the visual cortex and hippocampus (Sheffield et al. , 2013) and reduced cortical thickness in brain regions implicated in emotional processing (Gold et al. , 2016) These reductions in volume of specified brain areas are associated and play crucial role in development of psychiatric disorders such as PTSD and Depression (Chen et al. , 2010). Sheffield and colleges (2013) also found that psychotic patients reported significantly more child sexual abuse than controls. Moreover, sexual abuse plays a unique role in the development of the brain compared to other forms of abuse and neglect (De Bellis, 2002).

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However, parental verbal abuse, as a form of emotional abuse was associated with abnormalities in white matter (WM) tract integrity. Choi and colleges (2009) identified three WM tract regions that had significantly reduced fractional anisotropy (FA): 1) arcuate fasciculus in left superior temporal gyrus, 2) posterior cingulum bundle of the left hippocampus, and 3) the left body of the fornix. Moreover, fractional anisotropy in region 2 was inversely associated with limbic irritability, depression and dissociation. Fractional anisotropy in region 3 was inversely correlated with somatization and anxiety (Choi et al. , 2009). Moreover, additional findings show that the configuration of neurometabolites (NAA, Cr, and Cho) in the rostral prefrontal cortex and functionally related premotor cortex and somatosensory are different in a patient with a general anxiety disorder, who were exposed to child emotional abuse (Raparia et al. 2016).

Nonetheless, physical neglect may have severe consequences and has been associated with alteration in grey matter brain structures in childhood and adulthood (McCrory et al. , 2010). Fractional anisotropy changes, particularly in the cingulum, are linked to anxiety, a major transdiagnostic predictor of affective disorder (Tendolkar et a. , 2017). Physical neglect, according to Tendolkar and colleges (2017) predicted a decrease of fractional anisotropy in the bilateral anterior thalamic radiation around the middle frontal gyrus and the right inferior frontal-occipital fasciculus, the inferior longitudinal fasciculus, the cingulum, and precuneus. Therefore, reduced fractional anisotropy in the posterior cingulum mediated effects of physical neglect during childhood on anxiety levels at trend level.

Last but not least perspective postulates possible impact of, different types of abuse and neglect on psychopathology in form of symptoms vs. stabile pathological traits on the transdiagnostic level. On one side, childhood physical abuse and childhood sexual abuse have been associated with dissocial and impulsive traits in bulimia nervosa (Steiger et al. , 2010), borderline personality disorder (Steiger et al. , 1996), and submissiveness (Leonard et al. , 2003) what suggest presence of stable psychopathological traits. Additionally, a study by Spinhoven and colleges (2012) implies that patients with exposure to sexual and physical abuse in childhood show higher levels of Cluster A personality pathology (in particular schizotypal traits) on the Assessment of DSM-IV Personality Disorders (ADP-IV).

On the other side, higher child emotional abuse frequency predicted increased adult psychopathology symptoms (Berzenski et al. , 2018). Therefore, according to Berzenski and colleges (2018) child emotional abuse characteristics signal important differences in experience, with differential implications for later adjustment. Furthermore, Wekerle and colleagues (2009) found that emotional abuse was a significant predictor of internalizing and externalizing problems in adolescent boys and girls. Moreover, recent reports suggest that childhood emotional abuse is related to eating-disorder symptom severity, and to comorbid depression, affective instability, impulsivity, and feeling of ineffectiveness (Kong and Bernstein, 2009; Groleau et al. , 2012) suggesting presence of transdiagnostic psychopathological states/symptoms. Emotional neglect is a major risk for internalizing difficulties such a depression and anxiety symptoms (Colvert et al. , 2008), and externalizing such as violent behavior (Chapple, Tyler, & Bersani, 2005). Emotional neglect is associated with increased overall psychiatric symptoms (Young, Lennie, & Minnis, 2011)

31 October 2020

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