Oh man is it hard to write clever opening sentences about child abuse. A new study by the Yale School of Medicine shows that childhood maltreatment—whether it be emotional, sexual, or physical—actually shrinks people’s brains. Well, more specifically, it causes reduced brain volume in certain areas of the hippocampus that control emotion, memory and reward-based learning. And if these individuals go on to develop problems with substance abuse—which many, many do—these same brain deficiencies caused by the abuse can leave them more prone to relapse. In short, it’s a one-two punch.
Funded by the National Institute of Health, this study was based on brain scans of 175 patients, including 79 people in inpatient treatment for addiction and a control group of 89 non-addicts. Both the addicted and non-addicted group contained people who had experienced childhood trauma. All the addicts were receiving inpatient treatment and had been sober for four-to-five weeks at the time of the brain scan. For simplicity’s sake, the study only examined people whose drug of choice was alcohol, cocaine or cannabis. After 90 days, the researchers followed up with the addict group to see who among them had relapsed.
It turned out that the subjects who had self-reported childhood trauma, whether they were addicts or not, all displayed deficits in the same limbic regions of the brain. For addicts, these brain differences led to a tendency to relapse more quickly than those who had experienced little or no childhood trauma. Not only did abuse victims relapse sooner, but their relapses were also more intense, as measured by the number of days they used their first-choice drug during the 90-day window.
The Bad as Well as the Good
This seems like a tough break for addicts. Not only can childhood abuse (which is bad enough in itself, thanks) trigger a lifetime of addiction; it also creates a permanent handicap that makes recovery even more of an uphill battle. The study cites other research which suggests that 40-50% of children who suffer maltreatment go on to develop substance abuse issues, and those who experience it are twice as likely to pick up illegal drugs in adolescence. So are all these kids basically screwed?
The silver lining, if there is one, is that new knowledge always comes with the promise of better solutions. Rajita Sinha, the study’s lead author, hopes that “addressing these trauma-related structural brain changes can help us develop better treatment plans to promote successful recovery from addiction.” If doctors and treatment centers are aware of how their patients’ psychological histories may have affected them down to a cellular level, they can be more attuned to the risks of relapse.
Sinha, who is also the Foundations Fund Professor of Psychiatry and director of the Yale Stress Center, added that “We can begin to think about ways to address the underlying pathology in substance abuse and explore use of exercise and some medications to stimulate new growth and connections in brain cells in these specific brain regions to help restore trauma-related brain atrophy.”