Mental health articles

Clinical syndromes associated with trauma in infancy
Trauma can be broadly defined as experiences that threaten the individual’s
psychological or physical well-being or physical existence and that overwhelm
the individual’s coping mechanisms. Chronic or enduring stressors are likely to
result in attempts at adaptation and will produce significant organisational
change at both psychological and neurobiological levels.
In infants, traumatic experiences are frequently related to threats to their
attachment relationships and sense of security. Infants can experience significant
indirect trauma such as witnessing harm or threat to their mother, usually the
primary attachment figure, or threats of abandonment.
Infants may experience a range of inadequate, inappropriate and inconsistent
caretaking and communication. Such environments do not allow the infant to
develop secure attachment relationships with their parents.
In situations of traumatising care involving maltreatment, abuse and neglect,
infants show features of disorganised attachment (as discussed in Chapter 2).
These infants show poor capacity to self-regulate, modulate anxiety and process
emotional information. They show high levels of arousal and a persistent stress
response. This category of attachment is a predictor for ongoing developmental
difficulties and behavioural and emotional disturbances.

Extreme trauma in infancy involves direct and indirect maltreatment and
abuse. Traumatic experiences and interactions are directly inscribed in the fabric
of the developing brain as they influence development of particular pathways.
Perry, Pollard, Blakely, Baker and Vigilante (1995) describe this as the brain
‘organising’ itself around traumatic experiences. Extreme or chronic trauma
results in long-term dysregulation of stress and emotional systems and brain
structure and functioning may be permanently altered.
This chapter will discuss the basic processes of brain development in infancy
and a model of brain–environment interaction. It will highlight the importance
of the caretaking and affective environment for optimal neurobiological
development and the adverse effects of trauma, maltreatment and neglect on
brain development. The implications of early trauma for later mental health will
be discussed.

Tags: infancy, syndromes, trauma