Childhood Stress Subtypes Predict Adult Psychiatric Subtypes


A review of the literature from 2001 to 2011 on child abuse, neglect, and psychiatric disorders finds that early life stress subtypes can predict the development of psychopathology subtypes in adults.  Physical & sexual abuse and unspecified neglect were associated with mood & anxiety disorders.  Emotional abuse was associated with personality disorders and schizophrenia, and physical neglect with personality disorders.  The research appears in the December issue of the Journal of Nervous and Mental Disease.

Article →

Carr, C., Martins, C., Stingel, A., Lemgruber, V., Juruena, M.; The Role of Early Life Stress in Adult Psychiatric Disorders: A Systematic Review According to Childhood Trauma Subtypes. Journal of Nervous and Mental Disease. December, 2013. 201(12) p. 1007-1020 doi: 10.1097/NMD.0000000000000049

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. This is absolutely true, I am a “boarding school survivor”.

    Here is a quote and link to more information.

    “Am I a ‘Boarding School Survivor’?

    A couple of weeks ago my partner emailed me a copy of a short article by the psychotherapist and author Nick Duffell entitled Surviving the Privilege of Boarding School. It can be found here. The article also contains a link to a web site,, which provides access to material supporting and extending its argument.

    Duffell argues that sending children to boarding schools is a bad idea because it damages them. This happens because their “attachment formation and natural development in their family” is interrupted and they are lead to adopt a “drastic survival mode”. The child sent to boarding school “finds himself in an unfamiliar world where the hierarchy of those who have been there longer serves to enforce that he is at the bottom of the pile” and he is denied the opportunity to return at the end of the day to “loving homes…where they can be safe, regress if they need to, talk things through or remain silent, as they wish”. In response the child will construct a “Strategic Survival Personality” (SSP) by “design(ing) a character that keeps the heat off him, in many disguises: a winner is best, but a clown, a pleaser an isolate, even sometimes a victim will do”.

    Duffell sets out a range of consequences for ex-boarders, or, as he calls them, “Boarding School Survivors” (BSSs). They may always feel “as if ‘on the run’”, they may be “ever-ready to perceive a threat where there may be none”…

    Read more

    These links describe some of the effects.

    It was my experience with an abusive boarding school that contributes to the intense resentments I have towards psychiatry after my experience with inpatient and in particular the threats of injection they used in an attempt to coerce me to take anti psychotics for my anxiety they called bipolar mania after I objected to the way they were treating me.

    If they carried out a drug rape on me as a coercion tool I would have come back after it was all over and severely kicked that doctors ass after first retaining a lawyer to deal with the legal systems likely inability to understand justice in its purest form.

    That was my plan in the hospital as I waited to see if they would carry out the injection threat, to not resist and make it worse but to get even for the wrong done to me later outside the hospital on even ground away from there panic buttons and backup. Sadly the only reason I was in the hospital is because I was stupid enough to go there with my own free will asking for help after using to much alcohol for my anxiety, anxiety that resulted from abuse earlier in my life.

    There is nothing worse that to be threatened or assaulted by those you seek help from at a time of crisis, nothing is worse.

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  2. P.S My “Strategic Survival Personality” includes “if you hurt me I hurt you back” thinking, its part of the basic jail house survival skills I learned young in boarding school not jail, the knowledge that weakness draws aggression. This “strategic survival personality” also includes if you got my back I loyally got yours.

    I am hundreds of miles away from that ‘hospital’ but I ever happen to come across that abusive SOB that was doing the coerced intake strip searches the day I came in there is going to be trouble. That guy enjoyed it, I know his type from boarding school, they enjoy power over others in a setting where the victims have little credibility. Of course my reaction to the orders to get naked when I was full of anxiety and didn’t want to and objected were also labelled symptoms of the phony psychiatric illness I was later accused of (bipolar mixed).

    I do have a lawyer and a psychiatric living will just in case someday some tragedy in my life (such a death of a loved one) leads me to the liquor store for relief and I over do it again and find myself face to face with that abuse called help otherwise known as inpatient psychiatry.

    ‘Strategic Survival Personality’ maybe so. Whats wrong with contingency planning ????

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  3. I don’t know why this surprises anyone. But as always, the authors soft soap the real implications – namely, that the concept that there are certain people who will inevitably develop “psychiatric disorder” based on biological and genetic variables is a complete and utter lie. Stress is the most important factor in any “disorder,” and reducing childhood victimization is the most effective tool there is for reducing adult “mental health problems.” But to recognize this would require the adults to take responsibility for screwing up our children, and we’d perhaps have to consider making some big changes in our approach to childhood. It’s much easier to blame the kids and their brains, plus it makes a lot more money. Reducing early childhood risk and harm is not a profitable enterprise.

    —- Steve

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