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The Psychobiology of Maltreatment in Childhood

Authors


*Correspondence concerning this article should be addressed to Michael D. De Bellis MD, MPH, Professor of Psychiatry and Behavioral Sciences, Director, Healthy Childhood Brain Development and Developmental Traumatology Research Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3613, Durham, NC 27710 [e-mail: debel002@mc.duke.edu].

Abstract

The varied maladaptive behavioral, social, medical, and psychiatric outcomes associated with maltreatment in childhood have been extensively documented in the extant empirical literature. In this review, we examine the adverse impact of the stress associated with child maltreatment on the regulation of the neurobiological stress systems, alterations in brain maturation, and neuropsychological outcomes in the developing child. Further, we provide a detailed discussion of the pathway between the psychobiological consequences of trauma and subsequent cognitive, language, and academic deficits that often have a deleterious impact on global functioning. We review neuroimaging techniques and the empirical results of studies utilizing such techniques to examine brain maturation in maltreated children and individuals with posttraumatic stress disorder. We address the practice, research, and policy implications of the psychobiological sequelae of child maltreatment and offer future directions for research.

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