Indications of abnormal cortical and limbic system10 development come from symptom self-reports by adults with past sexual or physical abuse (Teicher et al., 1993). The symptom findings were followed up with EEG studies which found that children hospitalized from physical or sexual abuse had left hemisphere deficits (Ito et al., 1998; Ito et al., 1993). The significance of these findings is unclear, but researchers speculate that early abuse may impede hemispheric integration and the establishment of normal left cortical dominance.
Through brain imaging studies, maltreated children with PTSD were found to have smaller intracranial and cerebral volumes compared with matched controls. Corpus callosum area was smaller, and the size of lateral ventricles was larger (after adjustment for intracranial volume). The reductions in brain volume were positively correlated with age of trauma onset and inversely correlated with duration of abuse (De Bellis et al., 1999b). The size of the hippocampus was slightly increased, in contrast to findings in adults. Adult hippocampal volume is reduced in cases of past physical or sexual abuse (Bremner et al., 1997; Stein et al., 1997). Disparate findings between adults and children may be attributed to differences in methodology, co-morbid substance use, or neuroplasticity (De Bellis et al., 1999b). Finally, preliminary work with MRS spectroscopy suggests that maltreated children with PTSD have heightened neuron metabolism and loss (De Bellis et al., 2000).
The psychosocial and behavioral consequences of childhood trauma can be severe. Apart from later effects on psychopathology or suicidal behavior, research has established a spectrum of more immediate effects, ranging from low self-esteem to substance use and delinquent behavior (for reviews, see Cicchetti and Toth, 1995; Cicchetti et al., 2000; Margolin and Gordis, 2000; NRC, 1993; Trickett and Putnam, 1998). Most of the research literature deals with maltreatment. Yet maltreatment often occurs within the context of many other childhood traumas, such as parental psychopathology, violence (domestic and community), and household substance abuse. Researchers have gravitated to the view that it is very difficult to disentangle the effects of one trauma from another (Margolin and Gordis, 2000). Overall, studies have found that multiple, rather than individual, traumas are tied to a broad range of difficulties in childhood