Maybe the Kids Aren't Fine - Resilience to Childhood Trauma is More Complicated

"Kids are resilient."

This is a refrain often repeated as a source of comfort after an incident in childhood. But what if it just isn't aways true?

Research from University of Vermont scientists suggests resilience to childhood trauma is more complicatedthan previously understood. William Copeland, Ph.D. '03, professor of psychiatry at UVM's Larner College of Medicine, has studied youth mental health and behavior across the lifespan for two decades. He wants to correct the narrative that children are inherently resilient beings-that they can recover from tragedy or difficulties with ease and without consequence.

Most kids do well in response to adversity, he says. "The challenge is when they experience multiple traumas."

Experiencing trauma is rare at a single point in time, but when you add up exposures over the years that figure increases-ultimately about 60 percent of people will experience some form of trauma by age 16, Copeland explains. "It's normative … We all have to cope."

He is the principal investigator for the Great Smoky Mountains Study, which has tracked the mental and physical outcomes of a cohort of North Carolina residents since 1992. When scientists analyzed data in the early 2000s, they found that 10 percent of children exposed to multiple traumas seemed to emerge unscathed. But two decades later, with study participants now in their 40s, a 2022 study uncovered a different story-a significant portion who appeared resilient earlier in their life developed anxiety and depression as adults.

"Even though they looked like super-copers in childhood there was still a cost," Copeland says. "I wasn't unhappy with shattering this notion of the resilient individual."

Instead, he says, we should take a public health approach to trauma and try to reduce potential exposures from the beginning.

Longitudinal health studies allow scientists to follow individuals over time and examine what factors and experiences affect health outcomes. Hundreds of papers have come from the Great Smoky Mountains Study as investigators routinely check in with participants with hefty questionnaires that screen for exposure to trauma and sample their blood for biomarkers of stress.

"Few studies do what this does and for as long," Copeland says. "The continuous asking the same questions over time is a really powerful design." It allows researchers to see effects of interventions or events in childhood that may not have been obvious at first.

"What are the experiences from childhood that do last?" Copeland asks.

Clues are emerging. Decades of research have shown that one of the strongest predictors of a person's health is socioeconomic status. Children living in poverty are more likely to be poor as adults and to develop physical and cognitive ailments. That is intergenerational poverty at work. New evidence from Copeland's team strengthens support for a policy that could break that cycle: cash transfers to parents. Simply put, it means giving people money to use as they see fit.

The findings emerged after a natural experiment unfolded in 1996 when the Eastern Band of Cherokee opened a casino and began gifting enrolled members of the tribe about $5,000 annually, enabling researchers to examine what happens when parents are provided with a windfall of cash. In 2003, the team first demonstrated the benefit of direct cash transfersto parents.

"It can make a big difference being in poverty or not," says Copeland.

The researchers found that for American Indian families bumped above the poverty line, there was improvement in the psychiatric symptoms of their children. (This finding is what prompted Copeland to join the study as a postdoctoral fellow in psychiatric epidemiology at Duke University Medical Center in 2004.)

A follow up study Copeland led in 2022 found that adults whose parents received financial support not only had lower levels of anxiety but were also more likely to report having better physical and financial health. Evidence for direct cash transfers was further strengthened last year in a study published in Nature , when Copeland's team found these benefits persisted across generations. Researchers found the reading and math scores of third graders whose mothers received a decade of funds during childhood had the equivalent of half a year of additional learning over their peers who didn't received payments.

"I keep expecting the effects to dissipate but it hasn't," Copeland says.

He argues the findings support policies such as a child tax credit similar to the one enacted in 2021, which gave some families up to $3,600 for each child under age 6.

"I do think giving money to parents is a good thing," Copeland says. "Parents make choices that are in the best interest of their kids."

Over the years, the focus of the Great Smoky Mountain Study has shifted from examining the psychiatric health of rural youth to health across the participants' lifespans. The participants were 9 to 13 when first enrolled and many now have children of their own, and many of those children are now part of the study.

"I love puzzles," Copeland says. "I want to understand what makes a difference. … What keeps me up at night is I have been given this amazing dataset-what if we don't squeeze out all that we could? There are only so many ways we can study humans. This is how we learn."

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