ADVERSE CHILDHOOD EXPERIENCES, POST-TRAUMATIC STRESS DISORDER (PTSD) AND MENTAL HEALTH

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Introduction

Trauma is any occurrence, usually not any ordinary that harms the spirit, self and body. It covers a wide range of experiences that are hurtful, including the traumas that has emotional, mental, sexual and physical realm of our being (Blackburn et al 2012p.18). There are different forms of traumas that regularly occur and these are called Adverse Childhood Experiences (ACE). According to Felitti et al (1998p.249), the largest study of Adverse Childhood Experiences (ACE) ever done to examine the economic, social and medical effects of Adverse Childhood Experiences over the lifespan of children. The number of participants in the study was 18,000. Mendelsohn et al (2011p.77) pointed out the components of Adverse Childhood Experiences. These include the childhood emotional, sexual and physical abuse and neglect. Similarly, another component is a child growing up with substance abuse, domestic violence, crime or even parental loss.

From the study conducted by Felitti et al (1998p.246), the study findings reveal that Adverse Childhood experiences in life affect adults in different ways. To begin, the burden of the disease and the costs of medical care to the adult, Adverse Childhood Experiences affect adults in wellbeing, increases the suicide rates and depression. Moreover, drug abuse and alcoholism is common to adults who are affected by Adverse Childhood Experiences. Other effects on adults include disability and job performance and finally effect on the subsequent generations.

According to Schiraldi (2000 p.102), Adverse Childhood Experiences are linked to the ten most death causes in United States. The top ten risk factors include a history of sexually transmitted diseases, over fifty sexual partners, injected drug use, illicit drug use, alcoholism, suicide attempts, depression, physical inactivity, severe obesity and smoking.

According to Thomas (2008 p.113), if the trauma is accepted by the people as real and the survivors or victims experiences is validated and its expression supported its short term effects also referred to as  acute traumatic stress, can be processed, expressed, metabolized or ameliorated in a healthy way so that no or few lasting detrimental effects eventually remain. However, if traumatic experience reality is invalidated or denied by the victim, important or by close others such as family, assisting professionals, friends, and then the individual may not be able to completely heal from the traumatic adverse effects. If the trauma persists, with no support and validation in expressing its related pain, it may grow into Post Traumatic Stress Disorder (PTSD), that Van (1998p.97) believe is the main disorder among the trauma survivors who are unrecovered.

To get healed from trauma, the person who has experience trauma has to be able to mourn the related pain. To mourn, the individual must remember well enough the trauma and accurately name it. Whitfield (1997p.331) pointed out that remembering and mourning a trauma of the past may be difficult since there exist many roadblocks compared to the others. For instance, many people refuse to believe that a parent or a relative could or would neglect or abuse their own child or a relative child. Perhaps this forms the basis for the plethora of support and disbelief in the court systems and the media n favor of the accused charged with abusing or molesting their child or the ones close to them. Brandyberry et al (1998p.271) observed that it is common knowledge that over 90% of the people who abuse a child knows well the child before abusing them, and most of them are related to the children.

Blackburn et al (2012p.56) observed the psychological sequelea or the pathological results of Adverse Childhood Experiences. The symptoms of Post Traumatic Stress Disorder (PSTD) or DSM IV include traumatic event exposure, are experiencing, hyper arousal, numbing/avoidance and functional impairments. Similarly the complex Post Traumatic Stress Disorder or the extreme stress disorders include; alterations in affective arousal regulations, alterations in consciousness and attention, somatisation, characterological changes that are chronic and finally systems of meaning alterations.

Felitti et al (1998p.109) observed that in addition to Post Traumatic Stress Disorder, early life trauma is linked with impaired self awareness, sense of self and significant disturbance in regulation of emotion and interpersonal functioning. The prevalence of Post Traumatic Stress Disorder related to trauma of early life can be gauged by the study by Felitti et al (1998p.109). the DSM-IV field trials Post Traumatic Stress Disorder identified the Post Traumatic Stress Disorder prevalence in a clinical sample and combined community as 77% for sexual abuse on children and 45% for physical abuse of children and 85% for people with sexual and physical abuse (Mendelsohn et al 2011p.87).Moreover, in the mental healthcare settings, the prevalence of childhood abuse reported a rate ranging from 35% to 50%, depending on the service (Mendelsohn et al 2011p.89).

The factors increasing a person’s vulnerability to Post Traumatic Stress Disorder include the female gender, genetic vulnerability, psychiatric illness history such as anxiety and depression, repeated or prolonged exposure to trauma, poor social system of support and childhood trauma. However, the protective factors against Post Traumatic Stress Disorder as observed by Schiraldi (2000p.329) include; the early care givers of a child which play a very crucial role in buffering the child against the stressful situations impact, and more importantly, assist build resilience against adverse experiences in the future. Additionally, the presence of early attachments that are secure is a protective factor.

The neurobiology of Post Traumatic Stress Disorder related to early life trauma is explained in studies by Thomas (2008 p.137). The study shows that Post Traumatic Stress Disorder involves both emotional under modulation and emotional over modulation in a bid to restrict emotional experiences that are unwanted. The emotional under modulation includes hyper arousal, re-experiencing, anger and fear states. However emotional over modulation includes analgesia, numbing and states of dissociation.

Van (1998p.24) asserted that the interpersonal dysfunction includes; sensitivity to criticism, social isolation, revicimization such as domestic violence, physical assaults and adult rape, difficulty in standing for oneself, functioning problems and child rearing difficulties. The social emotions are elicited by social interactions and also involve language, social intentionality and meaning. However, the non social emotions according to Blackburn et al (2012p.226) emerge as a result of a posing stimulus to direct physiological relevance such as fleeing, fighting and food.

In analyzing the self reflection and sense of self in Post Traumatic Stress Disorder related to trauma of early life, Felitti et al (1998p.252.............


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