Link Between Childhood Trauma and Mental Health

Every child in foster care has experienced some form of relational trauma. If nothing else, being separated from their biological parents and placed with strangers is traumatic. But most children in foster care have experienced relational trauma before they enter care as well. For foster parents, this often means enduring challenging behaviors and developmental delays that make parenting emotionally and physically draining. These traumatic experiences can also accelerate mental health issues. It can be helpful to understand why, so you can provide the right kind of care  – and cultivate even greater compassion for the children you’re serving.

Mental Health and Childhood Trauma

Research shows childhood relational trauma greatly increases the likelihood of mental health challenges.  In the critical years of childhood, every experience has the potential to make a long-term impact. A recent study from the Journal of Trauma, Violence and Abuse found that 32-80 percent of children in foster care in the U.S. have been diagnosed with a mental illness. It also found that 30 percent of children in foster care were diagnosed with two or three mental disorders.

Childhood relational trauma alters the physical and chemical makeup of the brain as it develops. Relational trauma includes experiences like neglect, emotional abuse, physical abuse, sexual abuse, exposure to domestic violence, and others. They’re often perpetrated by primary caregivers or other significant people in a child’s life. The effects of such trauma on a person’s development cannot be overstated.

Understanding Relational Trauma

Childhood relational trauma refers to repeated adverse interactions within close relationships, particularly those with caregivers. These experiences disrupt a child’s sense of safety, security and trust. This differs from acute trauma, which is often related to a single external event, like a natural disaster or car accident. Relational trauma is ongoing and occurs in the context of relationships. Among many other adverse effects, relational trauma can erode a child’s self-esteem, emotional regulation and ability to form healthy relationships.

The Impact on Mental Health

The impact of childhood relational trauma on mental health can be extensive and varied. It can manifest in both immediate and long-term consequences. Many of these mental health issues can overlap or lead to the development of another. The most common include:

1. Complex Post-Traumatic Stress Disorder (CPTSD)

Because relational trauma occurs over time, it can lead to Complex Post-Traumatic Stress Disorder (CPTSD).* This manifests differently than PTSD, which is typically caused from short-term acute trauma. 

CPTSD from relational trauma can impact a person’s self-worth, confidence in overcoming challenges, ability to trust others, ability to build connected relationships, and more. Children with CPTSD from relational trauma may exhibit: 

• Anxiety
• Shame
• Flashbacks or nightmares
• Heightened emotional responses like impulsivity or aggressiveness 
• Difficulties sustaining relationships
• Survival behaviors like hoarding or violence

2. Anxiety and Depression

Closely related to CPTSD are the mental health issues of anxiety and depression. While a propensity toward one of these issues can be genetic, children who experience relational trauma have a greater risk. The persistent sense of danger and lack of emotional support can lead to chronic stress. This can disrupt the normal functioning of the brain’s stress-response systems. The brains of children who have experienced relational trauma are physically and chemically different from a child in safe, loving relationships. They have higher cortisol (stress hormone) levels and a larger amygdala (a gland that triggers the “fight or flight” response). Therefore, children who have experienced relational trauma are at greater risk of chronic anxiety and heightened emotional responses. 

Children who have experienced relational trauma often have a lower sense of self-worth and live with more shame. This can lead to a chronic sense of hopelessness and worthlessness. They may also have difficulty believing in their ability to shape their own future, which can lead to depression.

3. Attachment Disorders

Healthy attachment to caregivers is crucial for a child’s emotional development. Relational trauma disrupts this connection, making it more challenging for children to form healthy attachments. Children with attachment disorders often feel unsafe in relationships and may struggle to form secure bonds with others — even safe and caring adults. If left unaddressed, this can cause difficulties in relationships throughout their lives.

4. Borderline Personality Disorder (BPD)

There is a significant correlation between childhood relational trauma and the development of BPD in adulthood. BPD is characterized by unstable moods, self-image, and relationships, along with impulsive behaviors. The emotional instability often stems from the unresolved trauma and the lack of healthy coping mechanisms developed during childhood.

Addressing the Impact

Understanding the link between childhood relational trauma and mental health underscores the importance of early intervention and support. Effective interventions include:

Trauma-Responsive Care

Trauma-responsive care involves recognizing and understanding the pervasive impact of trauma and integrating this understanding into all aspects of caregiving, therapy and service delivery. This approach emphasizes safety, trustworthiness, choice, collaboration and empowerment.

Therapy

Various therapeutic approaches can help individuals heal from relational trauma, including Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Trust-Based Relational Intervention (TBRI), Eye Movement Desensitization and Reprocessing (EMDR), and trauma-focused psychotherapy. These therapies aim to help individuals process traumatic memories, develop healthier coping mechanisms, support healing through the youth-caregiver relationship, and rebuild a sense of safety and self-worth.

Omni Family of Services offers TF-CBT, TBRI and other trauma treatment interventions to help children and adults heal from trauma. Learn more about our services here.

Securely Attached Relationships

Building emotionally safe, securely attached relationships is crucial for healing from relational trauma. Positive, stable relationships with caregivers, peers, and mentors can provide the emotional support and security necessary for recovery.

Trauma that happens in the context of relationships must be healed in the context of trusted relationships – especially when that trauma occurs in childhood. Omni Family of Services offers trauma-responsive behavioral health and mental health services, and we are committed to supporting and equipping foster and adoptive parents so everyone can thrive. Learn more about what we do here.

*CPTSD is not recognized in the DSM-5 but is recognized in the ICD-11 (International Classification of Diseases)