Consequences of Early
Traumatic Experiences

by David Baldwin, PhD

Its an odd feeling to return home from a trip and see a quote from my web page in a post to the T-S list, almost as if I know what I'm talking about -- but also kind of nice, I guess. Thank you.

At 09:33 AM 4/5/97 -0700, Jake Jacobs quoted from my web site (on Page 2) that:

There is also evidence that early traumatic experiences (e.g., during childhood), especially if these are prolonged or repeated, may increase the risk of developing PTSD after traumatic exposure as an adult.

Anyway, I think my assertion here partly reflects a clear clinical sense that those people more seriously affected by recent single-incident traumas (such as a car accident, disaster, or rape) are those who have experienced previous traumas -- especially early, severe and unresolved ones. "Complex" PTSD, or DESNOS (the proposed 'Disorder of Extreme Stress Not Otherwise Specified' diagnosis), are good examples of this perspective (see van der Kolk et al, 1996; all citations are given below).

While I recognize that my clinical impressions may be biased by unrepresentative selection of clients, there are consistent nonhuman primate data suggesting that neuroendocrine functioning in adults is affected by prolonged separations from mother during infancy when these separation durations were experimentally manipulated (Rosenblum et al 1994; see also Coplan et al 1996, Kraemer 1992, and Suomi 1991). And there are consistent human data -- for example, that plasma cortisol responses to rape differ depending on presence of prior (and severe) rape experience (e.g., Resnick, Yehuda, Pitman & Foy, 1995). [More recently, a report by Heim and colleagues (2000) from Charles Nemeroff's lab at Emory explores this mechanism in "the first human study to report persistent changes in stress reactivity in adult survivors of early trauma".]

Work by Antelman, LeDoux, Putnam, Sapolsky -- and you, Jake -- (all cited in the detailed reference list at the end of my Page 2, and some repeated below) seems at least consistent with this assertion. Additional work relevant to this claim can be found in stuff by Bruce Perry, Robert Post, and Allan Schore (see below).

References

Antelman, S., Kocan, D., Knopf, S., Edwards, D., & Caggiula, A. (1992). One brief exposure to a psychological stressor induces long-lasting, time-dependent sensitization of both the cateleptic and neurochemical responses to haloperidol. Life Sciences, 51, 261-266.

Coplan, J., Andrews, M., Rosenblum, L., Owens, M., Friedman, S., Gorman, J. & Nemeroff, C. (1996). Persistent elevations of cerebrospinal fluid concentrations of corticotropin-releasing factor in adult nonhuman primates exposed to early life stressors: Implications for the pathophysiology of mood and anxiety disorders. Proc. Natl. Acad. Sci, USA, Vol 93, pp 1619-1623.
[Thanks to Dennis Grant for contributing this citation.]

DeBellis, M., & Putnam, F. (1994). The psychobiology of childhood maltreatment. Child and Adolescent Psychiatric Clinics of North America, 3(4), 663-678.

Heim, C.; Newport, J.; Heit, S.; Graham, Y.; Wilcox, M.; Bonsall, R.; Miller, A.; and Nemeroff, C. (2000). Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. Journal of the American Medical Association, 284 (5), 592-597.

Jacobs, J., & Nadel, L. (1985). Stress-induced recovery of fears and phobias. Psychological Review, 92(4), 512-531.

Kraemer, GW. (1992). A psychobiological theory of attachment. Behavioral & Brain Sciences, 15(3), 493-541.

Perry, B. (1997). Incubated in terror: Neurodevelopmental factors in the cycle of violence. In: J. Osofsky (Ed.) Children, Youth and Violence: Searching for solutions. New York: Guilford.

Post, RM (1992). Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. Am. J. Psychiatry, 149(8), 999-1010.

Rosenblum, L. et al (1994). Adverse early experiences affect noradrenergic and serotonergic functioning in adult primates. Biological Psychiatry, 35, 221-227.

Schore, AN (1994). Affect Regulation and the Origin of the Self: the Neurobiology of Emotional Development. Hillsdale, NJ: Lawrence Erlbaum.

Schore, AN (1996). The experience-dependent maturation of a regulatory system on the orbital frontal cortex and the origin of developmental psychopathology. Development and Psychopathology, 8, 59-87.

Schore, AN (2001a). The effects of a secure attachment relationship on right brain development, affect regulation, and infant mental health. Infant Journal of Mental Health, 22, 7-66.

Schore, AN (2001b). The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Journal of Mental Health22, 201-269.

Suomi, SJ (1991). Early stress and adult emotional reactivity in rhesus monkeys. Ciba Foundation Symposium, 156, 171-198.

Van der Kolk, B. et al (1996). Dissociation, somatization, and affect dysregulation: the complexity of adaptation to trauma. Am J Psychiatry, 153(7), 83-93.

Please note that the Trauma Pages' Bookstore at this site (in association with Amazon.com) recommends a bibliography of books on trauma. The texts listed there may interest professionals, university students, and the public. Some of the references above, or books by these authors, are included in that bibliography. Some others are listed as full-text articles from my 'Articles' page. -- dvb
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