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The Impact of Childhood Trauma on Adult Functioning

Increased risks for comorbid psychiatric diagnosis, fibromyalgia, and more.

Key points

  • Adult survivors of complex childhood trauma can struggle with processing what they survived which can lead to emotional and physical symptoms.
  • One of the largest impacts on adult functioning after surviving chronic childhood trauma includes feelings of anxiety and depression.
  • Existing research finds that adults with histories of childhood trauma are at an increased risk of developing fibromyalgia.
  • When a person’s basic needs are not met in childhood, these can create maladaptive patterns that are acted out in adult romantic relationships.

The effects of childhood trauma are often longstanding and chronic. Adult survivors of complex childhood trauma can struggle with processing what they survived in childhood, which can lead to a host of emotional, psychological, and physical symptoms. Equally common are histories of toxic romantic relationships, poor choices in friends, and patterns of self-sabotage based on shame and guilt for what they survived.

Four common patterns seen in adults with histories of childhood trauma include:

Misdiagnosis and Comorbidity

One of the largest impacts on adult functioning after surviving chronic childhood trauma includes feelings of anxiety and depression. Many with histories of significant attachment and developmental traumas struggle with symptoms associated with dysregulated affect (mood disorders, including bipolar disorder or major depression), generalized anxiety, social anxiety, post-traumatic symptoms, or obsessions and compulsive behaviors. Some may receive an incorrect diagnosis, while others may receive comorbid diagnoses.

Yet, symptoms of depression and anxiety also mirror core symptoms found in Borderline Personality Disorder (BPD), in which existing research supports as caused by a combination of biology and environment, including severe and chronic childhood neglect and abuse (Erkoreka, et al., 2021; Harned, et al., 2013; and. Scott, 2017). However, because of social stigma that often surrounds BPD, many with histories of complex childhood trauma may go without a proper diagnosis or intervention required for healing. Others may receive a prescription for an antidepressant or an antianxiety medication which may numb troublesome symptoms, but cannot provide full support or treatment.

Chronic Pain

Existing research has found that adults with histories of childhood trauma, specifically physical abuse, are at an increased risk for developing chronic pain, including back and neck pain, headaches and migraines, gastrointestinal and pelvic issues, rheumatoid arthritis, and fibromyalgia. Trauma, especially chronic trauma early in life may lead to permanent changes in the Central Nervous System (CNS), which may make a person more vulnerable to developing depression, anxiety, chronic pain, and autoimmune diseases.

Similarly, existing research suggests higher correlations between attachment style and development of chronic pain, specifically those with an anxious attachment style as having an increased risk for allostatic load. According to Widom, et al (2019) anxious attachment style in adults predicted higher levels of allostatic load, which may be a predictor of later development of chronic pain.

Pathological “Love Addicted” Behavior

If a person has experienced profound attachment trauma, how they approach adult romantic relationships may include a “dance” of pulling towards or pushing away out of survival mode. When a child’s basic needs for safety, consistency, predictability, love, nurturance, and support are not met in childhood, or are only met intermittently, these can create maladaptive patterns of behavior that are learned and acted out in romantic relationships, in order to get their needs met.

While “love addiction” is not a formal diagnosis in the DSM-V-TR (2022), the symptoms mirror unprocessed attachment trauma, including an intense “need” to be in a relationship for external validation, a shaky sense of self-identity or “mirroring” their partner, high levels of control or manipulation, a need to “fix” or be “saved”, and patterns that are associated with unmet basic needs, including to feel safe, seen, heard, and unconditionally accepted.

Codependency and Self-Betrayal

Childhood abuse can include invalidation, which is sometimes known as “silent abuse” because it can be difficult to spot and identify. Common patterns seen in invalidation include: ignoring, dismissing, minimizing, or rejecting a child’s feelings, needs, or opinions. Children who experience invalidation can become depressed, or believe something is “wrong” with them.

When a child has their reality denied, it often conditions a pattern of trying harder to gain their caregiver’s approval or validation, which can breed enmeshment and codependency and self-betrayal for the sake of trying to be loved. Fast-forward into their adult lives, and many have histories of choosing partners who silence, shame, belittle, mock, or dismiss their feelings and needs. Instead of leaving an abusive relationship, those who struggle with codependency also belief that if they try harder to meet their partner’s needs, their partner would see their value and worth, which often leads to developing a pattern of self-betrayal.

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Edwards R. R., et al. (2016). The role of psychosocial processes in the development and maintenance of chronic pain. J Pain, 17, 9, 70-92.

Erkoreka, L., et al. (2021). Attachment anxiety as a mediator of the relationship between childhood trauma and personality dysfunction in borderline personality disorder. Clinical Psychology & Psychotherapy, 6, 501-511.

Gunduz, N., et al. (2018). Psychiatric comorbidity and childhood trauma in fibromyalgia syndrome. Turk J Phys Med Rehab, 64(2), 91–99.

Harned, M. S., et al. (2013). Treatment of borderline personality disorder and co-occurring anxiety disorders. PubMed, 5, 15, 1 -6.

Lahousen, T., et al. (2019). Psychobiology of attachment style and trauma: Some general remarks from a clinical perspective. Frontiers in Psychoogy, doi: 10.3389/fpsyt.2019.00914

Linehan, M. (1993). Cognitive-Behavioral Treatment Of Borderline Personality Disorder. New York: Guilford Publications.

Scott, N. P. (2017). Misdiagnosis or comorbidity: Borderline personality disorder in a patient diagnosed with bipolar disorder. The American Journal of Psychiatry Residents’ Journal, doi:

Stickley A., et al. (2015). Childhood adversities and adult-onset chronic pain: results from the World Mental Health Survey. Japan. Eur J Pain, 19(10), 1418-1427.

Widom, C. S., et al. (2019). Does adult attachment style mediate the relationship between childhood maltreatment and mental and physical health outcomes? Child Abuse & Neglect, 76, 533-545.

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