Child Abuse and Drug Addiction: an important link

Child abuse is known to be a risk factor for a number of different mental-health problems and antisocial behaviour. For example, the Center's for Disease Control's famous Adverse Childhood Experiences research found a strong link between various adverse experiences in childhood and later physical, social, and mental health problems.

Researchers from the Albert Einstein College of Medicine in New York studied 143 people in an attempt to find out more about the link between child abuse and drug addiction. 48 of them were child molesters, 25 were recovering opiate addicts and the rest formed a healthy control group. The participants were asked whether they had suffered adult sexual advances while they were children or if they had had sexual intercourse with someone at least five years older before they were 13. The participants who were child molesters or recovering opium addicts had lost their virginity at a younger age than the healthy controls. However, while the child molesters were more likely to have been abused themselves the recovering addicts were no more likely to have suffered child abuse than the control group. But, this was a relatively small study and a number of other researchers have found a link between child abuse and drug addiction.

Cohen, Lisa J. ... [et al] - Comparison of Childhood Sexual Histories in Subjects with Pedophilia or Opiate Addiction and Healthy Controls: Is Childhood Sexual Abuse a Risk Factor for Addictions? Journal of Psychiatric Practice 16(6):394-404, November 2010

Center for Family Development

Childhood trauma memories: New Research

Psychologists have researched how people's memories of a traumatic event can effect how likely they are to develop post-traumatic stress disorder (PTSD) as a result of it. They've found that among adults with PTSD and acute stress disorder (ASD) trauma memories are fragmented and disorganised; are expressed more through the senses than words, and show increased emotional content. However, there has been much less research into how this process works in children. Researchers from the Institute of Psychiatry, King's College London studied 50 children being treated in hospital after an assault or a road-traffic accident. Some of the children developed ASD while others didn't and the children were asked to write the story (or narrative), both of the traumatic event itself and of another event which was unpleasant, but not traumatic. The children with ASD had significantly higher levels of disorganization in their trauma narrative compared to children without ASD and with their own non-trauma narrative. For all the children trauma narratives had significantly higher sensory content and lower positive emotion content than the comparison story. The severity of the children's ASD symptoms was significantly predicted by the level of disorganisation in the trauma narrative and the child's negative appraisals (e.g. 'this event has ruined my life,' 'I'm going mad to feel like this.') of the event.

Salmond, C. H. ... [et al] - The nature of trauma memories in acute stress disorder in children and adolescents Journal of Child Psychology and Psychiatry doi: 10.1111/j.1469-7610.2010.02340.x

Instutional life has negative effects on Executive Function

Previous research has shown that children who have spent at least some part of their life in an institution tend to have problems with executive functions. Executive functions are higher brain functions such as working memory, the ability to inhibit one's behavior, forward planning, the ability to move from one task to another, impulse control, the ability to start or initiate, and attention. Instruments such a the Behavior Rating Inventory of Executive Function can be used to measure executive functions.

Past research has concentrated on children aged between six and eleven so researchers at the University of Pittsburgh studied 418 children who had been adopted from institutions in Russia where they had been psychologically, but not physically, deprived. 130 of the children were pre-school age while the rest were older. The study found that the older the age the children had been adopted at the worse their executive function was and that those who were adopted after they were 18 months old had worse executive function than those who had been adopted when they were younger. The onset of adolescence was associated with a greater increase in executive function deficits for children adopted after 18 months than for those adopted when they were younger.

Merz, E. C. and McCall, R. B. Parent ratings of executive functioning in children adopted from psychosocially depriving institutions Journal of Child Psychology and Psychiatry doi: 10.1111/j.1469-7610.2010.02335.x

A study using the Vineland Adaptive Behavior Scales found similar delays, lags, and problems among a group of adopted children.
Becker-Weidman, A., (2009) “Effects of Early Maltreatment on Development: A Descriptive study using the Vineland,” Child Welfare, 88 (2)137-161.
Also see The Center For Family Development for very useful information.

Child Abuse & Psychosis: a link?

There is a growing recognition that having a difficult or traumatic childhood can increase the likelihood of people developing psychosis later in life but it is difficult to untangle what types of trauma or abuse are linked to an increased risk. A team of researchers from the Institute of Psychiatry, King's College London, UK, looked into this in a study of 428 people, 182 of whom had psychosis. The researchers asked people about difficulties and problems in their childhood and found that people with psychosis were three times more likely to report severe physical abuse by their mother before they were 12. There was also some - although not statistically significant - evidence that 'severe maternal antipathy' was linked to an increased risk of psychosis. However, paternal maltreatment and other forms of adversity were not linked to an increased risk of psychosis.

This is another important study the implications of which are that child abuse is a major public health issue with significant implications for later functioning. The Adverse Child Experiences research by the US Centers for Disease Control also point in the same direction. The ACE's studies clearly demonstrate that adverse childhood experiences result in later significant health difficulties, among other problems.

Fisher, H.L. ... [et al] - The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychotic disorder Psychological Medicine (2010), 40, 1967–1978

Cognitive Processing

Many children with histories of chronic early maltreatment within a care-giving relationship have been prenatally exposed to alcohol and/or drugs. The timing of the exposure and the intensity of prenatal exposure can have differing effects on the developing fetus, psychological functioning, and cognitive functions. These effects can sometimes be very subtle and not noticed or misinterpreted.

For example, some children are described as oppositional and defiant when what we may be observing is a cognitive processing and developmental deficit. As an example of this, the child may be perfectly capable of making a peanut butter and jelly sandwich. However, if you put a jar of peanut butter, a jar of jelly, a plate, knife, and bag of bread on the table and ask the child to tell you how to do this, you may find that the child had great difficulty doing so. This is a not uncommon experience with children prenatally exposed to chemicals. Understanding this cognitive processing deficit can be helpful for teachers and parents and ensure that the child's behavior is not misinterpreted.

Reference:
Becker-Weidman, A., & Shell, D., (Eds), Attachment Parenting, Jason Aronson, Lanham, MD, 2010.

NEW BOOK

I have written a new book,
Dyadic Developmental Psychotherapy: Essential Practices & Methods
which is due out later this year. It is as close to a treatment manual as one can get with an experimentally based approach for this evidence-based, effective, and empirically validated treatment.

The book describes the theory base of Dyadic Developmental Psychotherapy and the evidence base of the approach. Another chapter describes fourteen components of Dyadic Developmental Psychotherapy. A major chapter in the book describes the phases of treatment:
Developing the Alliance
Maintaining the Alliance
Exploration
Integration
Healing
and the differential uses of the components of Dyadic Developmental Psychotherapy in these phases.
There are chapters about working with care-givers and the importance of caregivers as the key-stone for successful treatment

The book has extensive transcripts and excerpts from actual treatment sessions to illustrate the components and phases and principles being described.

Therapists, parents, psychologists, researchers, professors, social workers, residential treatment staff, and child welfare staff will all find this book a valuable resource.

Dyadic Developmental Psychotherapy WIKI

There is a new Wiki devoted to Dyadic Developmental Psychotherapy that readers may want to view.
Click on this link to get there.

The url is: http://dyadicdevelopmentalpsychotherapy.wikia.com/wiki/Dyadic_Developmental_Psychotherapy_Wiki

The Wiki has just started, but already has many articles about Dyadic Developmental Psychotherapy and related topics that readers will find quite useful and interesting.