Physical or sexual abuse during childhood has been associated with the development of an array of psychiatric disorders including multiple personality disorder,' borderline personality and refractory psychosis! Childhood physical abuse may also sensitize patients to the later development of posttraumatic stress disorder (PTSD).S We postulated that early deprivation or abuse could result in neurobiological abnormalities responsible for subsequent psychiatric disorders." Green et al.' found that soft neurological signs and nonspecific EEG abnormalities were more common in abused children. Greens proposed that this was an additional source of trauma amplifying the impact of the abusive environment. Davies9 reported that 17 of 22 sampled survivors of childhood incest had abnormal EEGs, and 36% had clinical seizures.He postulated that this handicap was a risk factor for being sexually abused and exploited by family members. Recently, we hypothesized that early childhood abuse or trauma could affect the development of the cerebral cortex and limbic ~y s t e m .~. '~'~
WLNERABLE NEUROBIOLOGICAL TARGETSThe brain is a plastic organ whose final form and function are guided by genes but sculpted by early experience. Although early stress and trauma could conceivably have an impact on all known aspects of postnatal brain development, we postulated that some brain regions and functions may be particularly v~1nerable.l~ These targets include the hippocampus, amygdala, prefrontal cortex, and corpus callosum.
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