What is the most likely reason children’s psychological disorders are neglected?

As early experiences shape the architecture of the developing brain, they also lay the foundations of sound mental health. Disruptions to this developmental process can impair a child’s capacities for learning and relating to others — with lifelong implications. By improving children’s environments of relationships and experiences early in life, society can address many costly problems, including incarceration, homelessness, and the failure to complete high school.

Significant mental health problems can and do occur in young children. Children can show clear characteristics of anxiety disorders, attention-deficit/hyperactivity disorder, conduct disorder, depression, posttraumatic stress disorder, and neurodevelopmental disabilities, such as autism, at a very early age. That said, young children respond to and process emotional experiences and traumatic events in ways that are very different from adults and older children. Consequently, diagnosis in early childhood can be much more difficult than it is in adults.

What is the most likely reason children’s psychological disorders are neglected?
Experiences leave a chemical “signature” on the genes which determines whether and how the genes are expressed. Learn more

The interaction of genes and experience affects childhood mental health. Genes are not destiny. Our genes contain instructions that tell our bodies how to work, but the chemical “signature” of our environment can authorize or prevent those instructions from being carried out. The interaction between genetic predispositions and sustained, stress-inducing experiences early in life can lay an unstable foundation for mental health that endures well into the adult years.

Toxic stress can damage brain architecture and increase the likelihood that significant mental health problems will emerge either quickly or years later. Because of its enduring effects on brain development and other organ systems, toxic stress can impair school readiness, academic achievement, and both physical and mental health throughout the lifespan. Circumstances associated with family stress, such as persistent poverty, may elevate the risk of serious mental health problems. Young children who experience recurrent abuse or chronic neglect, domestic violence, or parental mental health or substance abuse problems are particularly vulnerable.

It’s never too late, but earlier is better. Some individuals demonstrate remarkable capacities to overcome the severe challenges of early, persistent maltreatment, trauma, and emotional harm, yet there are limits to the ability of young children to recover psychologically from adversity.

“Most potential mental health problems will not become mental health problems if we respond to them early.”

Even when children have been removed from traumatizing circumstances and placed in exceptionally nurturing homes, developmental improvements are often accompanied by continuing problems in self-regulation, emotional adaptability, relating to others, and self-understanding. When children overcome these burdens, they have typically been the beneficiaries of exceptional efforts on the part of supportive adults. These findings underscore the importance of prevention and timely intervention in circumstances that put young children at serious psychological risk.

It is essential to treat young children’s mental health problems within the context of their families, homes, and communities. The emotional well-being of young children is directly tied to the functioning of their caregivers and the families in which they live. When these relationships are abusive, threatening, chronically neglectful, or otherwise psychologically harmful, they are a potent risk factor for the development of early mental health problems. In contrast, when relationships are reliably responsive and supportive, they can actually buffer young children from the adverse effects of other stressors. Therefore, reducing the stressors affecting children requires addressing the stresses on their families.

What is the most likely reason children’s psychological disorders are neglected?
Researchers found children who were maltreated were more than twice as likely to develop serious mental ill health such as psychoses, schizophrenia and bipolar disorder

A study by the University of Birmingham has shown that children who have experienced child abuse or neglect are four times more likely to develop serious mental illness such as psychoses, schizophrenia and bipolar disorder.

Researchers studied GP records dating between 1995 and 2018 of 217,758 patients aged under 18 who had experienced, or were suspected to have experienced, childhood maltreatment or related concerns, and then compared them to the records of 423,410 patients who had not.

The study, published today in The Lancet Psychiatry, found those patients who were maltreated were more than twice as likely to develop serious mental ill health such as psychoses, schizophrenia and bipolar disorder, or require a prescription to treat mental ill health, compared to those who have no recorded experience of maltreatment. The researchers also found maltreated children were more than twice as likely to develop some form of mental illness, such as depression or anxiety.

Childhood maltreatment, defined as any form of physical, sexual or emotional abuse and neglect, is a global public health and human rights issue affecting more than one in three children aged under 18 (i).

This was the biggest study of its kind to explore the association between abuse or neglect in childhood and the development of mental illness.

The researchers also found a clear under-recording of child maltreatment in GP records, and say potential opportunities to spot child maltreatment or implement management plans for these vulnerable individuals are being missed.

First author Dr Joht Singh Chandan, Academic Clinical Fellow in Public Health at the University of Birmingham’s Institute of Applied Health Research, said: “Our findings, along with evidence from other global studies, demonstrates the substantial burden of mental ill health following child abuse or neglect.

“Considering the prevalence of maltreatment, it is clear we are not doing enough to prevent and detect this important risk factor for mental ill health.

“There is a desperate need to rethink our public health approach to preventing and detecting childhood maltreatment and its associated negative consequences.”

Corresponding author Julie Taylor, Professor of Child Protection at the University of Birmingham’s School of Nursing, said: “Services aiming to build resilience in survivors of maltreatment have shown great promise in the reduction in the development of mental ill health.

“Our study, the first if this size and magnitude to have been conducted in the UK, emphasises the importance of early intervention in abused or neglected children’s lives to prevent adverse outcomes.”

Corresponding author Dr Krish Nirantharakumar, also of the University of Birmingham, added: “There is an important public health message to focus, not only on approaches that prevent or detect childhood maltreatment, but also to explore methods of prevention and detection of mental ill health in those who have experienced childhood maltreatment.

“Building resilience in children, families, local services and communities of those at risk might be a way of improving mental health outcomes.”

For more information please contact Emma McKinney, Communications Manager (Health Sciences), University of Birmingham, tel: +44 (0) 121 414 6681, or contact the press office on +44 (0) 7789 921 165.

  • The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, teachers and more than 6,500 international students from over 150 countries.
  • Chandan et al (2019). ‘The burden of mental ill health associated with childhood maltreatment in the United Kingdom: A retrospective cohort study using The Health Improvement Network database’. Lancet Psychiatry. DOI: 10.1016/S2215-0366(19)30369-4
  • (i) World Health Organization. Violence Info – Child maltreatment. 2017. http://apps.who.int/violence-info/child-maltreatment/
  • This research was carried out by Dr Joht Singh Chandan, Dr Tom Thomas, Mr Krishna Margadhamane Gokhale, Professor Siddhartha Bandyopadhyay, Dr Krishnarajah Nirantharakumar and Professor Julie Taylor, all of the University of Birmingham.

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