Emotional scars : Impact of childhood trauma on depressive and anxiety disorders

Background

Almost on a weekly basis, we are confronted by horrific images of children enduring

inconceivable traumas, such as the frequent school shootings in the US, the reports of

abducted girls being held captive for years, and the many children exposed to war in the

Middle East. On those days, we hug our children a little closer. We feel grateful for what

we have, and mourn what others have lost. What we do not think about are the countless

children who experience trauma just as distressing, but far too common to make headlines.

Everyday, children are victims of emotional neglect, face physical and sexual abuse,

domestic violence, loss of family members, poverty and mental illness; about 1 in 8

American children will experience some form of childhood trauma serious enough to be

confirmed by government authorities. Many more go unreported. These traumas can have

disastrous effects on children’s physical and mental health and mark them for the rest of their

lives as victims.

“Tragedies are covered daily in the news, but the commonplace domestic abuse and

neglect of our youngest citizens often goes overlooked and unnoticed. That needs to

change.” wrote Beth Finkestein in the Daily Beast of 6/10/13.

While examining our adult patients and listening to their biographical stories, we are

witnessing and confronted with their painful childhoods and hidden memories on a daily

basis. What about our patients suffering from depression or anxiety? Which adverse

childhood memories relate to their current feelings of despair? How can depression and/

or anxiety be related to their ‘unhealed wounds’? What is the effect of ‘a painful past’ on the

course of their depressive and anxiety illness? And which are the potential risk factors for a

disabling chronic course?

Increasing insight into the long-term effects of childhood trauma is of great public

relevance and important for our clinical practice. Although the link between childhood

trauma and adult psychopathology is well established, less is known about the exact nature

of this relationship and the underlying mechanisms. Therefore, our research focuses on

specific associations between childhood trauma and depressive and anxiety disorders,

and on specific risk indicators of incidence and course of depressive and anxiety disorders.

We take a broad perspective by exploring if, and which, potential mediating factors play a

role in the association between childhood trauma and depressive and/or anxiety disorders.

A more in-depth understanding of this interrelationship may help to develop and extend

personalized prevention and treatment programs. In this introduction, we present

background information on childhood trauma, depressive and/or anxiety disorders, and

the Netherlands Study of Depression and Anxiety (NESDA), followed by the general aims

and an outline of this thesis.