Mental Childhood Psychology

Adults are shaped by the world around them – the household they grow up in, the people they meet, the relationships they form, and the way they are taught to cope with the challenges that life presents. The topic of this essay is applicable to all of us, no matter our backgrounds or upbringing; I may not have a mental illness, but I can certainly look back on my childhood and reflect on the experiences which I feel have made an impact on the way I think and behave today, as an adult.
In the context of psychiatry, we were taught, on the very first day of our rotation, the correct format for taking a psychiatric history from a patient, a specific skill we had not yet acquired during our medical training. An important aspect was the inclusion

These include abuse and its subtypes – physical, emotional, sexual – violence towards the mother or primary caregiver, and living in a household with substance misusers, those with mental illness or suicidality, and those with a history of imprisonment. A notable landmark in epidemiological research in this area was the ACES study carried out by Dr. Vincent Felitti, an internist in San Diego, California. Dr. Felitti is an international expert on childhood trauma and was at the forefront of this study which analysed 17,000 patients over a 2 year period under the seven headings of Adverse Childhood Events (ACEs) mentioned above. The study found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviours and diseases that were studied. Patients with 4 or more categories of exposure had 4- 12 fold increased health risks of alcoholism, drug abuse, depression and suicide attempt. It made for very interesting reading, as not only did it show a link between these events and psychiatric illness, it also made me realise that they have an enormous impact on the physical health of the adult in later

The HPA axis is a network regulating hypothalamic secretion of corticotrophin-releasing hormone (CRH), anterior pituitary secretion of adrenocorticotrophic hormone (ACTH), and adrenal cortical secretion of cortisol, which then provides feedback at the hypothalamus and pituitary (as well as other brain structures such as the hippocampus) and has downstream effects on other organs and physiologic systems. It is believed that dysregulation of these hormones is potentially responsible for psychiatric malfunctions. For example, according to Shah and Malla, 2015, the HPA axis enters a hyperactive state during the early phase of psychotic illness. Stressors that precipitate psychosis give rise to a high, flat diurnal profile of cortisol release resulting in a high overall level of daily cortisol release. I believe this shows a causal link between environmental factors and the pathophysiology of psychiatric illness. It is certainly an area that requires further investigation, as we currently know so little about the aetiology of many mental