Childhood trauma is often described as serious adverse childhood experiences. Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse. They may also witness abuse of a sibling or parent, or have a mentally ill parent. Childhood trauma has been correlated with later negative effects on health and psychological wellbeing. Children's ages and levels of maturity play a role in how they are impacted by trauma. However, resilience is also a common outcome; many children who experience adverse childhood experiences do not develop mental or physical health problems.
Health
Childhood traumatic experiences leads to stress that increases an individual's allostatic load, negatively affecting the immune system, nervous system, and endocrine system. Exposure to chronic stress can triple or quadruple the risk to adverse medical outcomes. Childhood trauma is often linked to various health issues including depression, hypertension, autoimmune diseases, lung cancer, and premature mortality.
The effects of childhood trauma on brain development can hinder emotional regulation and impair social skill development. Research indicates that children raised in traumatic or risky family environments often display excessive internalizing (e.g., social withdrawal, anxiety) or externalizing (e.g., aggressive behavior), and suicidal behavior. Recent research has found that physical and sexual abuse are associated with mood and anxiety disorders in adulthood, while emotional abuse is linked to personality disorders and schizophrenia later in life. Recent research suggests that mental health outcomes from childhood trauma may be better understood through a dimensional framework (internalizing and externalizing) as opposed to specific disorders.
Psychological impact
Neglect, abandonment, sexual abuse, emotional abuse, and physical abuse are all forms of psychological trauma that can have long-lasting effects on a child's mental health. These types of abuse disrupt a child's sense of safety and trust, which can lead to various mental disorders including post-traumatic stress disorder (PTSD), attachment issues, depression, and substance abuse. Sensitive and critical stages of child development can result in altered neurological functioning, adaptive to a malevolent environment but difficult for more benign environments.
Trauma experienced in childhood may also increase vulnerability to developing severe mental health conditions, such as psychosis, as the individual may have a compromised ability to regulate their emotions. In a study done by Stefania Tognin and Maria Calem comparing healthy comparisons (HC) and individuals at clinically high risk for developing psychosis (CHR), 65.6% CHR patients and 23.1% HC experienced some level of childhood trauma. The conclusion of the study shows that there is a correlation between the effects of childhood trauma and the being at high risk for psychosis. Children with disabilities are twice as likely to experience abuse or neglect, often due to dependency on caregivers. Those with communication challenges may struggle to report abuse, leading to prolonged exposure to harm. Access to trauma-informed mental health care is often limited, making recovery more difficult. Children from lower-income families face unique stressors that compound their traumatic experiences such as economic hardship often leads to housing instability, food insecurity, and exposure to unsafe environments, all of which heighten stress and trauma responses. These children may struggle to access mental health services due to cost, transportation barriers, or inadequate insurance coverage. Educational disparities mean low-income children may attend underfunded schools, which may not provide adequate trauma-informed care or mental health support.
Effects on adults As an adult, feelings of anxiety, worry, shame, guilt, helplessness, hopelessness, grief, sadness, and anger that started with a trauma in childhood can persist. In addition, those who experience trauma as a child are more likely to face mental health challenges such as anxiety, depression, suicide and self harm, PTSD, substance misuse, and relationship difficulties. The effects of childhood trauma are not limited to emotional consequences; survivors of childhood trauma are also at higher risk of developing asthma, coronary heart disease, diabetes, or strokes. They are also more likely to develop a "heightened stress response," which can cause difficulties in emotional regulation, sleep difficulties, lower immune function, and increased risk of a number of physical illnesses throughout adulthood. Societal norms affect how children express emotional distress—some may be encouraged to "tough it out" rather than receive support.
Women are more likely to experience sexual abuse, while men more often face physical abuse and neglect; however, stigma may prevent them from seeking help. LGBTQ+ youth face disproportionately high levels of trauma due to bullying, family rejection, and discrimination. Marginalized racial and ethnic groups face unique forms of trauma, including racial discrimination, systemic inequalities, and lack of access to mental health care. Black, Latino, and Indigenous children are often under-diagnosed or misdiagnosed when seeking psychological help. Immigrant children may experience additional trauma related to family separation, xenophobia, and stress associated with migration.
Epigenetics
Childhood trauma can leave epigenetic marks on a child's genes, which chemically modify gene expression by silencing or activating genes, or DNA methylation. This can alter fundamental biological processes and adversely affect health outcomes throughout life. A 2013 study found that people who had experienced childhood trauma had different neuropathology than people with PTSD from trauma experienced after childhood. This research has centered primarily around epigenetic changes to stress receptors in the brain. However, research into the epigenetic impact of trauma has extended to other genes, including protein-coding genes.
Survivors of war trauma or childhood maltreatment are at increased risk for trauma-spectrum disorders such as PTSD. In addition, traumatic stress has been associated with alterations in the neuroendocrine and immune systems, enhancing the risk for physical diseases. In particular, epigenetic alterations in genes regulating the hypothalamus–pituitary–adrenal axis as well as the immune system have been observed in survivors of childhood and adult trauma.
Transgenerational effects
Traumatic experiences might even affect psychological and biological parameters in the next generation. Parental trauma exposure is associated with greater risk for PTSD, as well as mood and anxiety disorders in offspring. Biological alterations associated with PTSD and/or other stress-related disorders have been observed in offspring of trauma survivors who have not themselves experienced trauma or psychiatric disorder. Research in animals has demonstrated that stress exposure can result in epigenetic changes in subject's offspring, potentially increasing vulnerability to psychiatric symptoms in offspring of trauma survivors. Enduring behavioral responses to stress and epigenetic alterations in adult offspring may be facilitated by changes in gametes, in utero environment, variations in early postnatal care, and/or other early life experiences that are influenced by parental exposure.
These changes could result in enduring changes to the stress response as well as physical health risk. The effects of parental trauma could be transmitted to the next generation by parental distress and the pre- and post-natal environment, as well as by epigenetic marks transmitted via the germline. While epigenetic research has a high potential of advancing our understanding of the consequences of trauma, the findings have to be interpreted with caution, as epigenetics only represent one piece of a complex puzzle of interacting biological and environmental factors.
People can pass their epigenetic marks including de-myelinated neurons to their children. Exposure to childhood trauma, along with environmental stress, can also cause alterations in genes and gene expressions. A growing body of literature suggests that children's experiences of trauma and abuse within close relationships not only jeopardize their well-being in childhood, but can also have long-lasting consequences including emotion regulation issues, which can then be passed onto subsequent generations through child-parent interactions and learned behaviors.(see also behavioral epigenetics, historical trauma, and cycle of violence)
Socioeconomic costs The social and economic costs of child abuse and neglect are difficult to calculate. Some costs are straightforward and directly related to maltreatment, such as hospital costs for medical treatment of injuries sustained due to physical abuse and foster care costs resulting from the removal of children when they are not safe with their families. Other costs, which are less directly tied to the incidence of abuse, include lower academic achievement, adult criminality, and lifelong mental health problems. Both direct and indirect costs impact society and the economy. For example, children who experience maltreatment are more likely to perform poorly in school, which can limit their future economic opportunities and increase likelihood of unemployment.
The long-term psychological effects of abuse, such as depression, PTSD, and substance abuse can lead to increased healthcare costs and higher mortality rates. A study by the Centers for Disease Control and Prevention (CDC) estimated that the lifetime cost of child maltreatment in the United States is over $124 billion annually, taking into account both direct costs, which include healthcare and child welfare services, and indirect costs, which include lost productivity, criminal justice expenses, and special education services. Both direct and indirect costs significantly impact society and the economy.
Poverty amplifies trauma, exposing children to housing instability, food insecurity, and dangerous environments. Low-income families often struggle to access mental health care due to cost and transportation barriers. Underfunded schools may lack trauma-informed resources, leaving affected children without proper support.
Resilience
Exposure to maltreatment in childhood significantly predicts a variety of negative outcomes in adulthood. However, not all children who are exposed to a potentially traumatic event develop subsequent struggles with mental or physical health. Therefore, there are factors that reduce the impact of potentially traumatic events and protect an individual from developing mental health problems after exposure to a potentially traumatic event. These are called resiliency factors.
Research regarding children who showed adaptive development while facing adversity began in the 1970s and continues to this day. Resilience is defined as "the process of, capacity for, or outcome of successful adaptation despite challenging or threatening circumstances." The concept of resilience stems from research that showed experiencing positive emotions had a restorative and preventive effect on the experience of negative emotions more broadly with regard to physical and psychological wellbeing in general and more specifically with reactions to trauma. This line of research has contributed to the development of interventions that focus on promoting resilience as opposed to focusing on deficits in an individual who has experienced a traumatic event. Resilience has been found to decrease risk of suicide, depression, anxiety and other mental health struggles associated with exposure to trauma in childhood.