Updated: Jan 19
You've likely seen the impact of early childhood trauma at some point in your life, whether professionally, personally, or at random.
Perhaps you've seen the impact of trauma in a person who asked you for change in a parking lot. Or felt it in a strained relationship with someone in your life. Maybe you've seen it in a colleague who never seems to stay in the same house or relationships for too long.
No matter how or if you've encountered it personally, we've all felt the greater impact of childhood trauma in society.
Licensed clinicial social worker Forrest Lien has seen the various ways children and adults struggle with trauma after working with them for over 40 years. "Trauma impacts people in various ways and on a spectrum, from bothersome to debilitating," he says. "And their struggles, such as relationship problems or an addiction, often trickle into the the lives of those around them."
And those struggles impact the larger communities too.
According to psychiatrist and trauma specialist Dr. Bessel van der Kolk, childhood trauma "is probably the single most important public health challenge in the United States, a challenge that has the potential to be largely resolved by appropriate prevention and intervention.”
Impacts of early trauma on an individual
Depending on its severity and duration, early trauma can negatively impact the brain and neurobiology during critical periods of development and may result in poor emotional and physical self-regulation, poor self-esteem and an inability to trust others.
"When the impact of trauma is severe, people struggle with more than just trauma issues. There are those who have trauma disorders," says Lien. "For those in the moderate to severe disordered range, the effects of trauma dramatically impacts their lives."
Dr. van der Kolk coined the term developmental trauma disorder, known as reactive attachment disorder (RAD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), to best define an early trauma-based disorder. Developmental trauma disorder (DTD) describes the effects of long-term exposure to trauma, typically profound abuse and neglect by caregivers (but can include other traumatic events such as prolonged and serious medical procedures or community violence), during the first three years of life.
Children with DTD, also known as RAD, endure:
“Complex disruptions of affect regulation; disturbed attachment patterns; rapid behavioral regressions and shifts in emotional states; loss of autonomous strivings; aggressive behavior against self and others; failure to achieve developmental competencies; loss of bodily regulation in the areas of sleep, food, and self-care; altered schemas of the world; anticipatory behavior and traumatic expectations; multiple somatic problems, gastrointestinal distress to headaches; apparent lack of awareness of danger and resulting self endangering behaviors; self-hatred and self-blame; and chronic feelings of ineffectiveness (van der Kolk, 2005, p. 406).
Without early and effective intervention, children with DTD (or RAD) struggle to function in relationships and society into and through adulthood.
Long-term impacts of childhood trauma on individuals and in society
To ignore the impact of childhood trauma doesn't make it disappear. The Centers for Disease Control and Prevention-Kaiser Permanente Adverse Childhood Experiences (ACE) Study found a direct correlation between childhood abuse and neglect and well-being into adulthood.
Long-term impacts of childhood abuse and neglect and in society include:
Alcoholism and alcohol abuse
Chronic obstructive pulmonary disease
Health-related quality of life
Illicit drug use
Ischemic heart disease
“People with childhood histories of trauma, abuse and neglect make up almost the entire criminal justice population in the US (Teplin, Abram, McClelland, Dulcan & Mericle)” (van der Kolk, 2005, p. 402).
Poor work performance
Risk for intimate partner violence
Multiple sexual partners
Sexually transmitted diseases
Early initiation of smoking
Early initiation of sexual activity
Risk for sexual violence
Poor academic achievement
Without early and effective intervention, those with DTD/RAD often grow up to perpetuate intergenerational trauma.
Getting to the root of the problem
Early and effective intervention is key to healing and hope for individuals, families and communities impacted by trauma. There is not one easy answer. But we can keep learning together. We can collectively work on effective remedies only when we truly recognize and understand the true impact of trauma.
While policies and programs currently exist, many only provide temporary fixes for the symptoms of trauma. Or people create programs to get to the root of trauma only to misunderstand its complexities and miss the mark. Oftentimes, this creates even more problems.
It’s a scenario RAD Advocates President Amy VanTine knows all too well after adopting a child with RAD/DTD herself and advocating for other struggling families.
"Many parents of children with RAD desperately seek help for their children. They're often hopeful to find a clinician or a facility that claims to be trauma-informed, only to realize that the people leading the charge don't fully understand the disorder," says VanTine. "They end up wasting valuable time and resources while the child gets sicker and the family falls apart."
While the path is far from paved, one surefire way forward is via education. And it can start with you, no matter who you are. Whether you are a clinician, a teacher or a person who never had any interest in trauma before, there's always more to learn and share with others.
"Here at RAD Advocates, we believe in the strength of collaboration," says VanTine. "Everyone can be a RAD advocate and make a difference in their own way."
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About the CDC-Kaiser ACE Study. (2016, June 14). Retrieved February 13, 2019, from https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/about.html
Developmental Trauma Disorder, van der Kolk, 2005, Psychiatric Annals, pp. 401–408