Neurodevelopmental Biology Associated with Childhood Sexual Abuse

Abstract

Child maltreatment appears to be the single most preventable cause of mental illness and behavioral dysfunction in the United States. Few published studies examine the developmental and the psychobiological consequences of sexual abuse. There are multiple mechanisms through which sexual abuse can cause post-traumatic stress disorder, activate biological stress response systems, and contribute to adverse brain development. This article will critically review the psychiatric problems associated with maltreatment and the emerging biologic stress system research with a special emphasis on what is known about victimization by sexual abuse.

Keywords:

• sexual abuse
• maltreatment
• developmental traumatology
• biological stress systems
• brain development

Acknowledgments

This article was completed with grant support from NIMH RO1-MH63407 MINH/NIMDS RO1-MH61744, K24 MH071434 and NIAAA RO1-AA12479 (principal investigator: Michael D. De Bellis, MD) and 1K23MH0641 11-01 (principal investigator: Eve G. Spratt, MD).

Additional information

Notes on contributors

Michael D. De Bellis

Michael D. De Bellis, MD MPH, is a licensed child psychiatrist in the state of North Carolina with specialty training in child maltreatment, pediatric brain imaging, postraumatic stress disorder and depression, and neuroendocrinelogy. Dr. DeBellis is director of the Duke University Healthy Childhood Brain Development and Developmental Traumatology Program in the Department of Psychiatry, where he is a tenured professor. He has published several seminal papers on the psychobiology of child abuse and maltreatment related postraumatic stress disorder. Dr. DeBellis is the recipient of several NIH and private foundation awards and national awards for his research including the 1998 A. E. Bennett Neuropsychiatric Research Foundation Award for Original Investigation in Clinical Science, for the paper “Developmental Traumatology: Biological Stress Systems and Brain Development in Maltreated Children with PTSD” from the Society of Biological Psychiatry and the 1999 Chaim Danieli Young Professional Award from the International Society of Traumatic Stress Studies for Outstanding and Fundamental Contribution to the Field of Traumatic Stress Studies.

Eve G. Spratt

Eve G. Spratt, MD, MSCR, is a child psychiatrist and pediatrician with special expertise in neurobiology and clinical interventions associated with childhood adversity and psychiatric illness. She is a professor in the Departments of Pediatrics and Psychiatry and Behavioral Sciences at the Medical University of South Carolina. She is the director of Pediatric Psychiatry within the Division of Developmental and Behavioral Pediatrics and director of Special Pediatric Projects in the Office of Academic Affairs. She has worked collaboratively with local and national colleagues, researchers and primary care providers to educate and implement interventions to reduce stress associated with childhood maltreatment, developmental disabilities and adjustment to illness.

Stephen R. Hooper

Stephen R. Hooper, PhD, is a licensed psychologist in the state of North Carolina with specialty training in child/pediatric neuropsychology. He is a tenured professor in the Department of Psychiatry at University of North Carolina School of Medicine, and holds additional appointments as: clinical professor in the Department of Pediatrics; research professor in the Department of Psychology; clinical professor in the School of Education; Fellow at Frank Porter Graham Child Development Institute; and adjunct professor in the Department of Psychiatry and Behavioral Sciences at Duke University Medical School. He is the director of Education and Training at the Carolina Institute for Developmental Disabilities (CIDD) where he also is the director of the Child and Adolescent Neuropsychology Consultation Service at the CIDD. Over the last 25 years, Dr. Hooper has developed an international reputation in the field of child neuropsychology with a focus on neurologically-based disorders—including childhood maltreatment, and he has worked collaboratively with the Duke University Healthy Childhood Brain Development and Developmental Traumatology Program for the past seven years.