Violence as etiological factor on psychopathology of children. impact of intentional and social violence on children up to 12 years old. risk factors: clinical, endocrinological, genetics, brain structure and neuropsychological

Abstract

Childhood abuse is a known risk factor for mental psychopathology, either mental disorders that begun at childhood or at adulthood. Many scientific evidences correlated biological findings with the presence of early life abuse (ELA) among them: hypothalamic-pituitary-adrenal axis dysfunctions, autonomic nervous system dysfunctions, sleep architecture disruption, immunological dysfunction, structural and functional brain alterations, and neuropsychological impairment. Also, some genetic polymorphisms predispose an individual to better or worse resilience for traumas, but these genes could have their expression modulated through affective experiences of continence, and reinforcement. However, many questions remained not unanswered relating to etiopathogenesis of mental disorders associated to traumatic events. Some individual developed mental disorder just after the traumatic event, others carried the risk, which could be associated to biological factors like the ones described above. Some suggest that this psychopathological symptoms, and even the type of mental disorder developed, depend upon the type of abuse, when they happened during the child development, theirs frequency, and who is the perpetrator. The different types of intentional violence (domestic or social) are highly prevalent in Brazil, as the mental disorder related to them, being a public health problem. We intend on this exploratory study to evaluate the impact of intentional traumatic events on different stages of child development, and which are the effect of usual clinical treatments (TAU - treatment as usual: psychopharmacotherapy and psychotherapy according to officials guidelines) on them. We intend to study the impact of traumatic experiences on different stages of child development. We will evaluate 60 consecutively children who presented at the outpatient clinic of the program of treatment and research on violence, of the department of psychiatry-UNIFESP, and present a psychiatric disorder (n=40 case) and 20 children without disorder (n=20 control). All subjects will be submitted to clinical and psychometric evaluation. Saliva samples will collect to dose cortisol, melatonin, and some target genes. A subgroup of 30 children (15 case and 15 control) will be randomically selected to administered neuropsychological testing, they also will be submitted to a brain scan. They will be evaluated at the enrollment and 12 months after. The results could be useful to guide us for future measures on prevention and treatment of psychiatric disorders resulting from violence and abuse suffered by kids from 7 to 12 years old. (AU)