Tuesday, 27 February 2007

The childhood we have can affect our risk of developing PTSD later in life

Why does a life-threatening experience lead to post-traumatic stress disorder (PTSD) in some people but not others? According to Karestan Koenen and colleagues, at least part of the answer lies in the kind of childhood they had.

The researchers have assessed the same group of 980 people every few years since they were born in New Zealand between 1972-73. When the participants were aged 32, the researchers asked them if they'd had a terrible or frightening experience since they were aged 26 (239 had), and whether they subsequently developed symptoms indicative of PTSD (35 of them had).

Participants who had low IQ as children, who exhibited childhood antisocial behaviour, and who were from poorer families, were more likely to have developed PTSD after a traumatic experience in adulthood. These factors had a cumulative effect, so those who had more than one of the childhood risk factors were even more likely to have developed PTSD after a trauma.

The researchers believe participants who had a lower childhood IQ may have lacked the cognitive resources as adults needed to translate their traumatic event into a narrative. Meanwhile, the participants who showed antisocial behaviour in childhood may have had poor self-regulation, and so lacked the emotional tolerance necessary for processing the traumatic event. Finally, a poorer family background could indicate a less stable childhood environment, which from animal research is known to have an effect on hormone and neurotransmitter regulation in the brain, thus increasing susceptibility to PTSD.

The researchers said clinicians could benefit from taking their clients' childhood cognitive and temperamental characteristics into account. “In fact”, they wrote, “psychotherapy that combines a developmentally informed approach...with more traditional trauma-focused treatment has been shown to be highly effective in treating adult PTSD”.

Koenen, K.C., Moffitt, T.E., Poulton, R., Martin, J. & Caspi, A. (2007). Early childhood factors associated with the development of post-traumatic stress disorder: results from a longitudinal birth cohort. Psychological Medicine, 37, 181-192.

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.

1 comment:

Ralph Graham said...

Of course I have much to learn and if shown more data I might come closer to agreement, but what little I know seems at variance with some of what has been said here.
Mr Jarrett quoted the researchers: “psychotherapy that combines a developmentally informed approach...with more traditional trauma-focused treatment has been shown to be highly effective in treating adult PTSD.” I suppose if I stay within the paradigm that says CBT is the therapy of choice and not much else will get much traction then it may ring true. So a developmentally informed approach may give some insight in how to frame the particular cognitive behaviour therapy being used. The "highly effective" result might be to bring some relief and soften a nasty symptom, but now that I have used a device that undercuts the CBT, getting speedily to the nub of what keeps a PTSD symptom alive, it’s clear in my paradigm that precursors to trauma are not relevant at all in the process of digging the culprit out. I speak of that part of Applied Metapsychology known as Traumatic Incident Reduction (TIR). Analogies can be crude but instructive. Imagine two cars bogged to the gunnels. It is plain that the type of car and its history may be relevant in the mechanics shop but both will be gotten debogged by the same method. Same, exactly. Whatever went on beforehand, the adult with PTSD in a TIR session will dutifully lead the therapist to the emotional pain, “stuck” there since the incident occurred and ever willing to break free if you stick to what you have learned. I remember wondering if I would ever get tired of the process, but when you see a former disbeliever walk free from a life spoiling symptom once and for all, you know it would take many lifetimes before you would tire of it. So, in the rarefied atmosphere within which this method goes to work, no, former development is truly irrelevant.

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