Positive relationships can buffer childhood trauma and toxic stress, researchers say

 ·  Kay Lazar, The Boston Globe   ·   Link to Article

Traumatic events and toxic relationships during childhood can cast long shadows, often damaging mental health well into adulthood.

But a growing body of research suggests sustained, positive relationships with caring adults can help mitigate the harmful effects of childhood trauma. And specialists say pediatricians, social workers, and others who work with kids should take steps to monitor and encourage those healthy relationships — just as they’re careful to screen for abuse and neglect.

Otherwise, “we will miss attempts to help people recover or heal,” said Dr. Robert Sege, a pediatrician and researcher at Floating Hospital for Children at Tufts Medical Center.

In the latest contribution to this research, a study recently published in JAMA Pediatrics, Sege and his coauthors found that supportive childhood relationships dramatically reduced the likelihood of developing depression and other mental health problems in adults. The researchers studied several types of relationships, including bonds within families, among friends, and those in the community.

In a phone survey of more than 6,000 Wisconsin adults, the researchers found that those who reported at least six caring relationships when they were young were 72 percent less likely to have poor mental health as adults, compared with those who recalled only two or fewer such relationships.

Even when respondents reported multiple negative childhood experiences, such as abuse, neglect, or severe family dysfunction, if they could also count several supportive relationships, those connections often mitigated long-term mental health problems, the researchers found.

The survey included seven specific questions to measure how nurturing those sustained relationships were. Respondents were asked how often as a child they felt able to talk to their family about feelings, felt their family stood by them in difficult times, enjoyed participating in community traditions, felt a sense of belonging in high school, felt supported by friends, had at least two nonparent adults who took genuine interest in them, and felt safe and protected by an adult in their home.

“All of those things are key to developing resilient children,” Sege said.

As logical as the findings might seem, the research underscores an overlooked but basic point: A support system matters.

This thinking is catching on, said Dr. Andrew Garner, a pediatrician at University Hospitals of Cleveland. In 2012, Garner cowrote a seminal American Academy of Pediatrics policy statement that recommended doctors pay closer attention to early childhood adversity and toxic stress. Now, based on mounting evidence of long-term health benefits from supportive relationships, he is working on an update, recommending that pediatricians also seek information about nurturing relationships in a child’s life.

“These positive experiences may give kids a flashlight to shine into the future,” Garner said.

Dr. Renee Boynton-Jarrett, a pediatrician at Boston Medical Center, said the growing recognition of the power of positive relationships to foster resilience will help busy physicians remember to ask about promising family, school, and community relationships. Armed with that information, a pediatrician can make more useful recommendations, she said. For instance, Boynton-Jarrett said, some families facing particularly challenging episodes might be open to the suggestion that they reach out to relatives or friends for help.

“Maybe mom has a significant mental health condition, but that child has two aunts who are very engaged, and a grandmother who is also very engaged,” she said.

If a child seems to lack solid relationships with adult relatives, doctors might suggest parents or guardians look outside the family for support systems that can take root.

Boynton-Jarrett, for example, is founding director of Vital Village Network, a program at Boston Medical Center that encourages collaboration between community groups and families to help children.

Caregivers who help kids find these supportive relationships can often see children reap the benefits in real time.

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