The Impact of Trauma - TeachTrauma

What is the impact of trauma?

Trauma can impact individuals in many ways, including socially, psychologically, academically, neurophysiologically, and socioeconomically, and can impair physical health as well [1].

Traumatized individuals, particularly those who are traumatized in childhood and adolescence, are at increased risk for:

Social and behavioral problems, including, but not limited to: relationship difficulties, risky sexual behavior, aggression and criminal behaviors [2] [3] [4] [5].

Impaired psychological health throughout the lifespan, including, but not limited to: PTSD, depression, substance use/abuse, and suicide attempts [3] [5] [6] [7] [8] [9] [10] [11].
- Adverse childhood experiences are related to the onset of a range psychological disorders as well [12].
- Additionally, adults who had four or more adverse childhood experiences were 7.3 times more likely to have at least one diagnosis from each of the following four types of disorders: mood, anxiety, impulse control, and substance abuse disorders [13].

Cognitive and academic problems, including, but not limited to: low IQ and reading scores, delayed language and cognitive development, and poor academic performance [14] [15] [16].

Neuropsychological alterations involving areas of the brain that regulate emotion, control of emotions, judgment, and problem solving [17] [18] [19], in addition to the stress response system [17] [18] [20].

Impaired physical health that can endure for decades, such as increased risk of cancer, heart disease, liver disease, pulmonary disease, auto-immune disease, and obesity [9] [21] [22].

Higher use of mental health and medical services [3] [5] [6] [22].

Increased rates of unemployment, poverty, and Medicaid usage [29].

Childhood mortality or early death [9] [23].

In addition to causing suffering for traumatized individuals, trauma has a negative effect on society and the economy:

For every three additional types of trauma a child experiences, the child is:

53% more likely to be involved in the juvenile justice system,

204% more likely to receive mental health services,

216% more likely to receive child welfare services,

and 25% more likely to receive health services [6].

The economic cost:

Child abuse survivors access the healthcare system 2-2.5 times more often than non-abused people [24].

16.7-37.5% of United States healthcare dollar is spent on abuse-related mental and medical costs [25].

Estimates of the annual cost of child abuse and neglect in the United States range $24 to $124 billion, depending which direct (e.g., child welfare, health care, mental health care, maltreatment-related law enforcement and legal services) and indirect costs (e.g., increased spending due to long-term problems including impaired mental and physical health, criminality, incarceration, special education, teenage pregnancy, unemployment, and reduced opportunity costs) are included [26] [27].

The lifetime cost of a single case of child abuse and neglect in the United States was estimated to be $6.1 million (where lost opportunity costs contribute the highest expense) [28].

[1] Fairbank, J. A., Putnam, F. W., & Harris, W. W. (2014). Child traumatic stress: Prevalence, trends, risk and impact. In M. J. Friedman, T. M. Keane, P. A. Resick (Eds.), Handbook of PTSD: Science and practice (pp. 121-145). New York, NY, US: Guilford Press.

[2] Cloitre, M., Miranda, R., Stovall-McClough, K. C., & Han, H. (2005). Beyond PTSD: Emotion regulation and interpersonal problems as predictors of functional impairment in survivors of childhood abuse. Behavior Therapy, 36(2), 119-124.

[3] Jonson-Reid, M., Kohl, P. L., & Drake, B. (2012). Child and adult outcomes of chronic child maltreatment. Pediatrics, 129(5), 839-845.

[4] Manly, J. T., Cicchetti, D., & Barnett, D. (1994). The impact of subtype, frequency, chronicity, and severity of child maltreatment on social competence and behavior problems. Development and Psychopathology, 6(01), 121-143.

[5] Millett, L. S., Kohl, P. L., Jonson-Reid, M., Drake, B., & Petra, M. (2013). Child maltreatment victimization and subsequent perpetration of young adult intimate partner violence: An exploration of mediating factors. Child Maltreatment, 18(2), 71-84.

[6] Briggs, E. C., Fairbank, J. A., Greeson, J. K., Layne, C. M., Steinberg, A. M., Amaya-Jackson, L. M., … & Pynoos, R. S. (2013). Links between child and adolescent trauma exposure and service use histories in a national clinic-referred sample. Psychological Trauma: Theory, Research, Practice, and Policy, 5(2), 101.

[7] Dube, S. R., Anda, R. F., Felitti, V. J., Chapman, D. P., Williamson, D. F., & Giles, W. H. (2001). Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: Findings from the Adverse Childhood Experiences Study. Jama, 286(24), 3089-3096.

[8] Edwards, V. J., Holden, G. W., Felitti, V. J., & Anda, R. F. (2003). Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: Results from the adverse childhood experiences study. American Journal of Psychiatry, 160(8), 1453-1460.

[9] Gilbert, R., Widom, C. S., Browne, K., Fergusson, D., Webb, E., & Janson, S. (2009). Burden and consequences of child maltreatment in high-income countries. The Lancet, 373(9657), 68-81.

[10] Kilpatrick, D. G., Saunders, B. E., & Smith, D. W. (2003). Youth victimization: Prevalence and implications, research in brief. Washington, DC: Office of Justice Programs, National Institute of Justice.

[11] Putnam, F. W. (2003). Ten-year research update review: Child sexual abuse. Journal of the American Academy of Child & Adolescent Psychiatry, 42(3), 269-278.

[12] McLaughlin, K. A., Green, J. G., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2012). Childhood adversities and first onset of psychiatric disorders in a national sample of US adolescents. Archives of General Psychiatry, 69(11), 1151-1160.