How Childhood Emotional Abuse Changes the Brain

Childhood emotional abuse and neglect can result in permanent changes to the developing human brain. These changes in brain structure appear to be significant enough to potentially cause psychological and emotional problems in adulthood, such as psychological disorders and/or substance abuse.

Around 14% of Americans report experiencing emotional abuse and/or neglect during their childhood. Emotional abuse can include:

• Insulting, name-calling, or swearing at a child
• Threatening to physically harm the child without actually doing so
• Terrorizing or otherwise making the child feel afraid

Emotional neglect involves failing to meet a child's emotional needs. This can include failing to:

• Believe in the child
• Create a close-knit family
  
• Make the child feel special or important
• Provide support
• Want the child to be successful
  

How Abuse Alters Brain Structure

As we grow, our brains undergo periods of rapid development. Negative experiences can disrupt those developmental periods, leading to changes in our brains later on.

Research supports this idea and suggests that the timing and duration of childhood abuse can impact the way it affects adults later in life. Abuse that occurs early in childhood for a prolonged period of time, for example, can lead to particularly negative outcomes.

Dr. Martin Teicher and his colleagues at McLean Hospital, Harvard Medical School, and Northeastern University studied this by using magnetic resonance imaging (MRI) technology to identify measured changes in brain structure among young adults who had experienced childhood abuse or neglect.

They found clear differences in nine brain regions between those who had suffered childhood trauma and those who had not. The most obvious changes were in the brain regions that help balance emotions and impulses, as well as self-aware thinking.

Their results indicate that people who have been through childhood abuse or neglect do have an increased risk of developing mental health issues later on. This may translate into a higher risk of substance abuse. This is because they have a hard time controlling their urges and making rational decisions due to the physical changes in their brain development.

Brain Structure Changes

Childhood abuse and neglect can have several negative effects on how the brain develops. Some of these are:

• Decreased size of the corpus callosum, which integrates cortical functioning—motor, sensory, and cognitive performances—between the hemispheres
• Decreased size of the hippocampus, which is important in learning and memory
• Dysfunction at different levels of the hypothalamic-pituitary-adrenal (HPA) axis, which is involved in the stress response
• Less volume of the prefrontal cortex, which affects behavior, emotional balance, and perception
• Overactivity in the amygdala, which is responsible for processing emotions and determining reactions to potentially stressful or dangerous situations
• Reduced volume of the cerebellum, which can affect motor skills and coordination

Behavior, Emotions, and Social Function

Because childhood abuse, neglect, and trauma change brain structure and chemical function, maltreatment can also affect the way children behave, regulate emotions, and function socially. These potential effects include:

• Being constantly on alert and unable to relax, no matter the situation
• Feeling fearful most or all of the time
• Finding social situations more challenging
• Learning deficits
• Not hitting developmental milestones in a timely fashion
• A tendency to develop a mental health condition
• A weakened ability to process positive feedback

These effects can continue to cause issues in adulthood if they're not addressed. Adults who experienced maltreatment during childhood may have trouble with interpersonal relationships—or they may avoid them altogether.

This could be related to attachment theory, or the idea that our early relationship with caregivers influences the way we relate to people later on in life. Emotional abuse and neglect don't allow for a secure attachment to form between a child and caregiver, which causes distress for the child and influences the way they see themselves and others.

Adults who went through childhood emotional abuse or neglect may also experience:

• Emotional dysregulation
• Feelings of hopelessness
• Low self-esteem
• Negative automatic thoughts
• Problems coping with stressors

Other Factors of Maltreatment

How childhood abuse or neglect affects an adult also depends on a variety of factors:

• How often the abuse occurred
• What age the child was during the abuse
• Who the abuser was
• Whether or not the child had a dependable, loving adult in their life as well
• How long the abuse lasted
• If there were any interventions in the abuse
• The kind and severity of the abuse
• Other individual factors

Treatment

Through treatment, it is possible to address the effects of childhood emotional abuse and neglect. Treatment in these cases is highly individual since maltreatment can take many forms and each person's response to it may differ.

Any form of treatment would likely include therapy and, depending on whether or not any other mental conditions are present, may include medication as well. Some effective forms of therapy are:

• Exposure therapy: Exposure therapy involves interacting with something that typically provokes fear while slowly learning to remain calm. This form of therapy may improve neural connections between several regions in the brain.
• Family therapy: Family therapy is a psychological treatment intended to improve relationships within the entire family and create a better, more supportive home environment. This type of treatment may improve HPA axis functioning and lead to a healthier stress response. 
• Mindfulness-based approaches: Mindfulness-based therapy focuses on helping people develop a sense of awareness of their thoughts and feelings so they can understand them and better regulate them. These approaches may help improve resiliency against stress by benefiting several brain regions and improving neural connections.
• Trauma-focused cognitive behavioral therapy (TF-CBT): TF-CBT focuses on helping people learn new coping skills, restructure negative or unhelpful thoughts, regulate their moods, and overcome trauma by crafting a trauma narrative. This form of therapy may help reduce overactivity in the amygdala.

Frequently Asked Questions

What is the definition of childhood maltreatment?

Childhood maltreatment is any type of abuse and/or neglect against a child younger than 18 by a parent, caregiver, or another adult. It can include physical abuse, sexual abuse, emotional abuse, and neglect.

What are the signs of child abuse?

Signs of child abuse can include physical symptoms, like unexplained pain, bruises, changes in weight, headaches, or abdominal pain. Behavioral symptoms can include aggression toward peers, social withdrawal, poor performance at school, sexualized behavior, or self-harm. Poor hygiene, issues with eating, or being dressed inappropriately for the weather may also indicate maltreatment.