The relationship between childhood abuse and post-traumatic stress disorder is clear and indisputable. Even one deeply traumatic incident in your early years can have serious mental health repercussions.

However, what is not always fully appreciated, is the way abuse in childhood can cause PTSD and C-PTSD to appear in adulthood.

There is sometimes an assumption that with the right support and more positive experiences, a child can ‘put the abuse behind them’. When in fact, the imprint of the trauma can manifest in a myriad of different ways.

The individual may have symptoms that appear – or last for – many years after the abuse stops. Prolonged or repeated childhood abuse can also create complex PTSD (or C-PTSD).

This article provides insights on this highly sensitive topic and the way an abusive childhood can cause PTSD in adults.

Understanding what’s meant by childhood abuse

First, it needs to be clarified that the term ‘childhood abuse’ is being used as a collective term for diverse types of trauma; sexual and physical, but also emotional abuse and neglect.

Any of these can cause PTSD and C-PTSD. A caregiver who denies a child their basic needs to comfort, food and a safe living environment can create trauma just as damaging as physical blows or sexual contact.

In fact, there are bodies of opinion that suggest that emotional abuse from a caregiver can be particularly damaging and be even more likely to cause severe PTSD or C-PTSD.

A 2021 study into Child Abuse & Neglect found: “Emotional abuse (rather than any other type of maltreatment) was associated with more severe PTSD symptoms in all symptom clusters.”

How common is PTSD from an abusive childhood?

The likelihood of trauma in childhood is possibly more common than you would imagine.

The U.S. Department of Health & Human Services reported that over two-thirds of children experience one traumatic event by the time they are 16. This is not always abuse of course but includes witnessing acts of violence, accidents or deaths, and the sudden loss of a significant family member.

Accurate figures on child abuse in the UK are impossible to find, as so much of it goes unreported. In many cases, the child is unaware that they have been abused, particularly if abusive behaviours are commonplace in their lives.

According to a 1999 study into PTSD and child victimisation: “Slightly more than a third of the childhood victims of sexual abuse (37.5%), 32.7% of those physically abused, and 30.6% of victims of childhood neglect met DSM-III-R criteria for lifetime PTSD.”

How PTSD manifests in children

PTSD symptoms displayed by abused children and young people include learning difficulties, poor behaviour at school, depression and anxiety, aggression, risk-taking and criminal behaviours, emotional numbness, and a range of physical issues including poor sleep and headaches.

Diagnosing PTSD in children requires a professional mental health evaluation. Treatment plans would be similar to adults with post-traumatic stress, including Cognitive Behaviour Therapy, and counselling, as well as practical steps to make them feel safer and supported.

One of the important things to dismantle is the shame and guilt that can be interwoven with childhood abuse. Also, children don’t have as many cognitive resources to draw on as adults do. Leading them to possibly rationalise their traumatic experiences or display a “fawn’ response, seeking to please their abuser and win favour.

Family support plays an important role in helping children recover from PTSD. So, when a parent is responsible for the trauma, it makes recovery a more complex and longer-term process.

Childhood abuse and adult PTSD

Some of the effects of childhood abuse outlined above linger into adulthood or don’t even become apparent until later in life.

Children and young people who are abused can become emotionally numb to their trauma, or bury it deep in their psyche. The adaptive or protective mechanisms they use can ask the long-lasting damage.

Undiagnosed and untreated PTSD could make victims of abusive childhoods prone to self-harming, depression, substance abuse and anxiety. Or their symptoms could be difficulties in maintaining healthy relationships, trust issues, poor self-confidence or disassociation (being emotionally distant or shut-down).

The attachment issues associated with the abuse at an early age are categorised as:

• Dismissive-Avoidant Attachment – being highly independent, self-sufficient and focused on avoiding being rejected (as they were in childhood).
• Fearful-Avoidant Attachment – avoiding intimacy and closeness, as they associate these with their childhood abuse and don’t want to give someone ‘power’ to hurt them.
• Anxious-Preoccupied Attachment – someone clingy and needy, who demands constant validation to balance out inherent feelings of insecurity and ‘not being enough’.

Some people go for years without clear symptoms that their childhood abuse is affecting them but an event or experience triggers mental health issues. For some, this includes the birth of their own child, which reawakens their own fractured relationship with a caregiver. There is also evidence that pregnancy and childbirth can stimulate “risk behaviours” due to “sudden memories of sexual abuse situations.”

The brain, abuse and complex PTSD

The way PTSD can linger into adulthood – or be diagnosed many years after childhood abuse – is partially due to the way trauma causes physical changes to the human brain. Neglect and all other forms of childhood abuse, occur at key stages in the development of the brain, altering the formation and function of the amygdala, hippocampus and prefrontal cortex.

Once a diagnosis of PTSD or C-PTSD is received, the individual can receive treatment that includes overcoming both the physiological and psychological effects.

The important thing is that you need to accept that your earliest experiences in life can – and do – lead to serious mental disorders in adults.

As one researcher into the neurobiological effects of childhood mistreatment said: “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. Childhood abuse isn’t something you ‘get over.’

NICE guidance updated in 2018 recommends the use of trauma focused psychological treatments for Post Traumatic Stress Disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing (EMDR) and trauma focused cognitive behavioural therapy (CBT).

Please remember, these aren’t meant to be medical recommendations. Be sure to work with a professional to find the best methods for you.

For direct support for Child Abuse, please see the resources below:

• Help for Adult Victims of Child Abuse (HAVOCA) provide information and support for adults who have experienced any type of childhood abuse, run by survivors. havoca.org
• The National Association for People Abused in Childhood (NAPAC) supports adult survivors of any form of childhood abuse. Offers a helpline, email support and local services. Call them on 0808 801 0331 napac.org.uk
• Childline provides support for children and young people in the UK, including a free helpline and 1-2-1 online chats with counsellors. You can call them on 0800 1111 childline.org.uk
• YoungMinds are committed to improving the mental health of babies, children and young people, including support for parents and carers. Call the parents helpline on 0808 802 5544 or Young People can contact the crisis messenger by texting the letter YM to 85258 
• Respond provide services for people with a learning disability, autism or both, who have experienced abuse or trauma. Call them on 0207 383 0700 respond.org.uk