Cells in the hippocampus have an unusually large number of receptors that respond to the stress hormone cortisol.
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Since animal studies show that exposure to high levels of stress hormones like cortisol has toxic effects on the developing hippocampus, this brain region may be adversely affected by severe stress in childhood. Douglas Bremner and his colleagues at Yale Medical School compared magnetic resonance imaging MRI scans of 17 adult survivors of childhood physical or sexual abuse, all of whom had PTSD, with 17 healthy subjects matched for age, sex, race, handedness, years of education, body size, and years of alcohol abuse. Not surprisingly, given the role of the hippocampus in memory, these patients also had lower verbal memory scores than the nonabused group.
Murray Stein and his colleagues also found left hippocampal abnormalities in women who had been sexually abused as children. Fifteen of the 21 sexually abused women had PTSD; 15 had a dissociative disorder. They suffered a reduction in the size of the left hippocampus proportionate to the severity of their symptoms.
The left hemisphere is specialized for perceiving and expressing language, the right hemisphere for processing spatial information and also for processing and expressing negative emotions.
We wondered, then, whether abused children might store their disturbing childhood memories in the right hemisphere, and whether recollecting these memories would activate the right hemisphere more than it is activated in those without such a history. To test this hypothesis, we measured hemispheric activity in adults during recall of a neutral memory, then during recall of an upsetting early memory. Those in the control group had a more integrated bilateral response. Furthermore, in boys, neglect exerted a far greater effect than any other type of maltreatment; physical and sexual abuse exerted relatively minimal effects.
In girls, however, sexual abuse was a more powerful factor, associated with a major reduction in size of the middle portions of the corpus collosum. Building on this work, other scientists discovered that these consequences were less severe if the surrogate mother swung from side to side, a type of movement that may be conveyed to the cerebellum, particularly the part called the cerebellar vermis, located at the back of the brain, just above the brain stem.
Like the hippocampus, this part of the brain develops gradually and continues to create new neurons after birth. It also has an extraordinarily high density of receptors for stress hormone, so exposure to such hormones can markedly affect its development. We have gone from thinking of the entire cerebellum as involved only in motor coordination to believing that it plays an important role in regulating attention and emotion. The cerebellar vermis, in particular, seems to be involved in the control of epilepsy or limbic activation.
Testing this hypothesis, we found that the vermis seems to become activated to control— and quell—electrical irritability in the limbic system. It appears less able to do this in people who have been abused. If, indeed, the vermis is important not only for postural, attentional, and emotional balance, but in compensating for and regulating emotional instability, this latter capacity may be impaired by early trauma. By contrast, stimulation of the vermis through exercise, rocking, and movement may exert additional calming effects, helping to develop the vermis.
By contrast, long isolation produces stress that has a deleterious effect on brain and behavior development. If we assume that lots of attention, licking, and grooming are the natural state of affairs and that lower levels of attention are a form of neglect, we can use this model to explore some of the biological consequences of neglect or abuse in children.
Low rates of maternal attention decrease the production of thyroid hormone by the rat pups. This, in turn, decreases serotonin in the hippocampus and affects the development of receptors for the stress hormone glucocorticoid. Since corticosterone, one of our primary stress hormones, is kept in check by a complicated feedback mechanism that depends on these same stress hormone receptors, their inadequate development increases the risk of an excessive stress hormone response to adversity.
For this and certain other reasons, lack of maternal attention predisposes the animals to have a heightened level of fear and a heightened adrenaline response. These consequences seem consistent with inadequate development of the corpus collosum, which is a highly myelinated structure, and abnormal development of the hippocampus and cerebellum. High levels of cortisol can also hinder development of the cerebral cortex, the extent of vulnerability dependent on how rapidly the brain was growing at the time of the insult.
During the years of rapid language acquisition approximately years of age , the left brain develops more rapidly than the right, making it more vulnerable to the effects of early maltreatment. Finally, diminished maternal attention also appears to be associated with a lifelong decrease in production of the hormone oxytocin in the brain, and enhanced production of the stress hormone vasopressin.
Both hormones may also help control sexual response, with vasopressin enhancing sexual arousal and oxytocin triggering climax and release. In summary, we now know that childhood abuse is linked with excess neuronal irritability, EEG abnormalities, and symptoms suggestive of temporal lobe epilepsy.
It is also associated with diminished development of the left cortex and left hippocampus, reduced size of the corpus callosum, and attenuated activity in the cerebellar vermis. Many disorders are associated with childhood abuse. One is depression or heightened risk for developing it.
Many scientists believe that depression may be a consequence of reduced activity of the left frontal lobes. If so, the stunted development of the left hemisphere related to abuse could easily enhance the risk of developing depression. Similarly, excess electrical irritability in the limbic system, and alterations in development of receptors that modulate anxiety, set the stage for the emergence of panic disorder and increase the risk of post-traumatic stress disorder. Alterations in the neurochemistry of these areas of the brain also heighten the hormonal response to stress, producing a state of hyper vigilance and right-hemisphere activation that colors our view with negativity and suspicion.checkout.midtrans.com/chilln-conocer-chicas.php
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Alterations in the size of the hippocampus, along with limbic abnormalities shown on an EEG, further enhance the risk for developing dissociative symptoms and memory impairments. Very early childhood abuse appears particularly likely to be associated with emergence of ADHD-like behavior problems. Some studies have also found an association between reduced size of the mid portions of the corpus callosum and emergence of ADHD-like symptoms of impulsivity.
Hence, early abuse may produce brain changes that mimic key aspects of ADHD.
With less well integrated hemispheres, borderline patients may shift rapidly from a logical and possibly overvaluing left-hemisphere state to a highly negative, critical, and emotional right hemisphere state. This seems consistent with the theory that early problems of mother-child interaction undercut the integration of right and left hemispheric function.
Very inconsistent behavior of a parent for example, sometimes loving, sometimes abusing might generate an irreconcilable mental image in a young child.
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Instead of reaching an integrated view, the child would form two diametrically opposite views—storing the positive view in the left hemisphere, the negative view in the right. These mental images, and their associated positive and negative world views, may remain unintegrated, and the hemispheres remain autonomous, as the child grows up. Couple this with possible alterations in oxytocin- and vasopressin-mediated sexual arousal, and you see why patients with borderline personality disorder have tumultuous relationships.
The most immediate conclusion from our work, however, is the crucial need for prevention. The costs to society are enormous. Furthermore, childhood maltreatment can be an essential ingredient in the makeup of violent individuals, predisposing them to bouts of irritable aggression. In the meantime, early intervention should be our priority. The brain is more plastic and malleable before puberty, increasing our chances of minimizing or reversing consequences of abuse.
One consequence of childhood maltreatment is limbic irritability, which tends to produce dysphoria chronic low-level unhappiness , aggression, and violence toward oneself or others. Even into adulthood, drugs can be useful in alleviating this set of symptoms. Anticonvulsant agents can help, as can drugs that affect the serotonin system. Abuse also causes alterations in left-right hemisphere integration. Some research suggests that anticonvulsant drugs may facilitate the bilateral transmission of information. Left-right hemisphere integration may also improve through activities that require considerable left-right hemisphere cooperation, such as playing a musical instrument.
Certain existing psychotherapies may be helpful. Cognitive-behavioral psychotherapy, which emphasizes correcting illogical, self-defeating perceptions, may work by strengthening left-hemisphere control over right-hemisphere emotions and impulses. Traditional, dynamic psychotherapy may work by enabling patients to integrate right-hemisphere emotions while maintaining left-hemisphere awareness, strengthening the connection between the two hemispheres.
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A moving visual stimulus is used to produce side-to-side eye movements while a clinician guides the patient through recalling highly disturbing memories. For reasons we do not yet fully understand, patients seem able to tolerate recall during these eye movements and can more effectively integrate and process their disturbing memories.
Society reaps what it sows in nurturing its children. It predisposes the child to have a biological basis for fear, though he may act and pretend otherwise. The brain is programmed to a state of defensive adaptation, enhancing survival in a world of constant danger, but at a terrible price.
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To a brain so tuned, Eden itself would seem to hold its share of dangers; building a secure, stable relationship may later require virtually superhuman personal growth and transformation. At the extreme, the coupling of severe childhood abuse with other neuropsychiatric handicaps for example, low intelligence, head trauma, or psychosis is repeatedly found in cases of explosive violence. Dorothy Otnow Lewis and Jonathan Pincus have analyzed the neurological and psychiatric history of violent adolescents and adults.
In another study, they reviewed the childhood neuropsychiatric records and family histories of incarcerated delinquents. What might have been a tip-off to those who later were arrested for murder? In a follow-up study of 95 formerly incarcerated juvenile delinquents, they found that the combination of intrinsic neuropsychiatric vulnerabilities and a history of childhood abuse or family violence effectively predicted which adolescents would go on to commit violent crimes.
Lewis concludes that child abuse can engender all pivotal factors associated with violent behavior, namely, impulsivity, irritability, hyper vigilance, paranoia which she interprets as an extreme version of hypervigilance , decreased judgment and verbal ability, and diminished recognition of pain in oneself dissociation and others. Those with a history of childhood abuse may know right from wrong, but their brains may be so irritable and the connections from the logical, rational hemisphere so weak that intense negative right-hemisphere emotions may incapacitate their use of logic and reason to control their aggressive impulses.
Is it just to hold people criminally responsible for actions that they lack the neurological capacity to control? Even if the abused person comes to terms with the traumatic memories and chooses for the sake of sanity to forgive the perpetrator, this will not reverse the neurobiological abnormalities. Childhood abuse, age, and neurological impairments can be critical mitigating factors that a just society should not ignore. If we know that the roots of violence are fertilized by childhood abuse, can we make a long-term commitment to reduce violence by focusing on our children rather than our criminals?
What if we set a goal of reducing the cases of childhood abuse and neglect by 50 percent a year? We would have to commit ourselves, seriously, to improving access to quality day care and after-school programs. We might need to educate and support parents so they could know how to nurture their children more effectively. We certainly would need to foster better relationships among peers and siblings. Think of what we could save if we needed fewer prisons and fewer mental health professionals. Our brains are sculpted by our early experiences.
Maltreatment is a chisel that shapes a brain to contend with strife, but at the cost of deep, enduring wounds. Brain-machine interface—once the stuff of science fiction novels—is coming to a computer near you. The question is: How soon?
The silent, often subconscious conversation that is taking place inside us is one of the most vital communications we will ever find ourselves engaged in. Medical care improved the odds somewhat, but new discoveries and therapeutic developments have improved survival rates significantly for spinal muscular atrophy.
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