Stable Relationships with Caregivers Can Help Children Overcome Trauma

Stress and trauma in children can be hugely debilitating, with long-term implications for physical as well as psychological health that can stretch into adulthood in unexpected ways. But Emory researchers are finding that stable relationships with caregivers can help children overcome trauma and thrive, even in highly adverse circumstances.

Jennifer Stevens, associate professor of psychiatry and behavioral sciences, has devoted her research in recent years to discovering the causes and effects of trauma in children. Stevens, along with her research partner, Tanja Jovanovic (formerly of Emory School of Medicine, now at Wayne State University), have published papers delving into the primary causes of stress and reported findings that could lead to more effective therapies for children. Much of the team's research has been completed at Emory School of Medicine's Grady Trauma Project, where Stevens is the co-director.

"We see a lot of exposure to neighborhood violence and domestic violence," says Jovanovic. "Outside of the inner city, what we normally see with early childhood trauma can be abuse, neglect, or maltreatment. Extreme poverty can be a cause in adverse situations, and a lot of the kids we research are victims of bullying."

Immediate manifestations of stress include problems with attention and focus (the researchers say trauma can be misdiagnosed as ADHD), which may lead to issues at school and spiraling consequences, Stevens says: "We see an association between kids who have experienced more violence and kids who seem to have the highest externalizing symptoms, like acting out and being quick to get angry in a stressful situation, which contributes to conflicts at school."

Jennifer Stevens

Beyond the short-term hazards, trauma during childhood can have a negative impact on overall health throughout life. "In pubertal development and from our brain-imaging studies, we've seen that childhood trauma — in particular, exposure to violence — can change the way children's brains respond to threat stimuli," Stevens says. "In addition, childhood trauma can leave epigenetic marks (chemical modification of DNA), which can change whether certain genes will be expressed in a way that reflects faster aging. So in the adult phase, there are huge effects on cardiovascular disease in particular, as well as potential diseases like metabolic syndrome, diabetes, and things of that nature."

"A lot of times these problems can seem systemic and hard to solve, but having a caregiver who is available is vitally important," Stevens says. "We've spoken with many women who suffered childhood trauma and tried to tell their parents about it at the time. The ones whose parents did not believe or accept what they said continued to have very impairing mental health symptoms as adults. When parents had been supportive and listened, the women's long-term mental health was much better." Stevens and Jovanovic published their findings on the important protective effects that caregivers can have on brain development earlier this year, in the journal Development and Psychopathology.

Despite high trauma loads, as Stevens and Jovanovic show, children with solid caregiver relationships can surmount hardships and flourish, sometimes to a remarkable degree.