Domestic violence in pregnancy: the consequences from the point of view of neuroscience
Abstract
The intervention proposes to highlight how violence suffered by pregnant women can affect children even before birth and that it can be the cause of changes in the mother's stress response systems, increasing cortisol hormone levels, which in turn could increase cortisol levels in the fetus, determining cognitive and neurological alterations.
The early changes in brain structures, in fact, could explain why children whose mothers experience high levels of stress due to trauma and domestic violence during pregnancy, have greater chances of developing learning disorders, relational disorders and psychological and/or psychiatric problems in childhood or elder age.
In light of this it becomes fundamental and necessary to act quickly in order to help women escape violence in pregnancy, being an effective way to support a healthy brain development in the unborn child and reduce the risk of relational, psychological and psychiatric problems.
The period of pregnancy is spoken as of imprinting and gestation not only in a physical conception but also psychic, precisely because of the effect that emotions of the mother have on the fetus and, allegedly, even on the character of the child once born. Problematic situations experienced by mothers in the period of gestation, like traumatic events, abuse and violence, are factors that increase in the unborn child the risk of meeting relational and psychological difficulties, learning disorders and psychopathologies. A small dose of stress during pregnancy is to be considered completely normal and does not involve significant consequences. A condition of chronic stress determines an excessive stimulation of the hypothalamic-pituitary-legal axis with a consequent greater secretion of cortisol, a hormone that, in large quantities, could have negative effects on the pregnancy and health of the unborn child and could lead to neurophysiological alterations of the sympathetic and parasimpatic system.
From more in-depth studies, it emerged that domestic violence can affect children even before they are born and that it may be the cause of changes in mother's stress response systems, increasing cortisol hormone levels, which in turn could increase cortisol levels in the fetus. Cortisol, being a neurotoxic substance, has harmful effects on the brain when it reaches excessive levels. This mechanism could be the basis of the emotional problems that are found after birth in children whose mothers have had a traumatic and violent experience, and it could also represent the beginning of psychological and emotional problems experienced by the children themselves once they have become teenagers. Furthermore, this situation could create a form of mother/son insecurity or even cause changes in the child's neurophysiological functioning (Michigan State University, 2014).
Domestic violence against women during pregnancy can also have a significant impact on the brain development of the unborn child and a neuro-psycho-postural alteration. Hiscox et al. (2023) analyzed the brain scans of 143 South African babies whose mothers had been victims of violence from intimate partner (IPV) during pregnancy. The violence of the intimate partner includes emotional, physical and/or sexual abuses or aggressions. The MRI scans of the brain were performed when infants were only 3 weeks old on average, so all the observed changes were likely to have developed inside the uterus (Hiscox et al., 2023).
The effects of exposure to violence by the partner (IPV) may vary according to the sex of the child. For girls, the mother's exposure to the IPV during pregnancy was associated with a smaller amigdala, a brain area involved in emotional and social development. For boys, exposure to the IPV was instead associated with a larger caudate nucleus, a brain area involved in multiple functions, including the execution of movement, learning, memory, reward and motivation (Hiscox et al., 2023).
The early changes in brain structures could explain why children, whose mothers experience high levels of stress due to trauma during pregnancy, are more likely to develop psychological and/or psychiatric problems in childhood or old age. These changes could also partially explain the development of neurodevelopment disorders and other psychiatric pathologies. In the future, these adult psychiatric patients could be presented a possibility of recognizing a correlation with problems developed in the neurophysiological-positive and psychological-emotional fields, recalling delinquent behaviors (such as pathological addictions) and crimes, degenerating the functioning of the locus coperuleus, a cerebral nucleus involved, when dysfunctional, in neurodegenerative diseases, in the control of the limbic system (related to memory, attention, concentration, control of anxiety and depression). This nucleus is responsible directly or indirectly of the production of major neurotransmitters. Acetylcholine and norepinephrine are produced on site, serotonin and melatonin by the pineal gland following the cerulean stimulation; dopamine originates from the Nigra substanzia always following cerulean stimulation.
The current scientific literature provides evidence that the sensomotor activity of the trigeminal associated with chewing can influence excitement, attention and cognitive performance. These effects may be due to widespread connections of the trigeminal system to the ascending activation reticular system (Aras), to which the Noradrenergic neurons of the Locus Coeruleus (LC) belong. LC neurons contain projections to the entire brain and it is known that their rush varies with the size of the pupil. The LC activation is necessary to excite the midriasis related to the task. If the effects of chewing performance are mediated by the LC, it is reasonable to expect that changes in cognitive performance are related to changes in the mydriasis related to the task, determining a cognitive side with negative effects on different aspects (Fantozzi et al., 2019).
A well-sided child, in fact, presents precise directional reference points; a poorly lateralized or contrasted one, on the other hand, loses these points of reference with negative consequences on socio-affective and intellectual maturation and, in general, on learning. When learning reading and writing, non-well-shed subjects can develop dyslexia and highlight difficulties that are often characterized also in specific aspects, such as confusion of similar letters by shape, reversal of letters and figures, inversions of letters throughout the word. Furthermore, in children who have no structured lateralization well, the movement of the eyeball is unstable: it goes back and forth on the sheet without being able to dominate space-parol, thus generating inversions.
In addition, the activation of different areas of cortical afference contribute, once again, to a different analysis of visual information; The backbone, or magnocellular, is responsible for the recognition of space functions, meaning "where" the objects are located; it is also involved in visual attention, visual research, eye movements and integration of information from the central and peripheral visual field. The ventral way, or parvincellular, is used for the recognition of objects; it is sensitive to the shape of the images, their orientation and their margins, thanks to the high resolutive power. The visual hypothesis assumes that a malfunction of the Magnocellular pathway would lead to visual elaboration disorders and, through the rear parietal cortex, to a binocular insecability and to a visual-staining ability deficit.
In 1999 the professors Halata and Baumann discovered the presence, precisely at the point where the tongue contacts the palate during the physiological swallowing act, of a huge amount of receptors previously related only with postural information given their presence in the feet. These are all five types of the major foreign of the body. On the palate they send their information through the second branch of the trigeminal. The information, through a complex path, reaches the Locus Coeruleus. If there had been studies of what causes the reduction or lack of neurotransmitters directly or indirectly secreted by the LC (such as acetylcholine, norepinephrine, serotonin, melatonin and dopamine) in the brain and in the whole organism, perhaps the swallowing dysfunction in the genesis of DSA and various of its derivatives such as ADHD and Dyslexia could have been hypothesized. These processes determine the alteration of almost all receptors, with consequences also on a psychological and psychiatric level.
If these difficulties are not tempestively noted and acted on with a targeted approach, there’s a risk of creating frustration and anger in the child. It is vital to specify, in fact, that children who present learning disorders can also manifest opposition reactions, characterized by apathy, disinterest, inhibition, sometimes also mutism or on the contrary aggression, jealousies, anxiety, characterized by an excessive concern for school work. In this way, relational, psychological and/or psychiatric disorders can be developed over time. In particular, correlation with personality disorders have been traced, such as antisocial, characterized by social irresponsibility, contempt for others, dishonesty and manipulation of others for personal gain. The borderline would be characterized by inner void, fear of abandonment in interpersonal relationships, unstable relationships, problems of controlling emotions and impulsive behavior, but also with cluster C disorders, which include avoidant, dependent and obsessive-compulsive disorder. From the study of Gillespie et al (2019), conducted on 73 adult male prisoners with stories of serious sexual or violent crimes, lead to results in terms of psychopathy: an association between psychopathy and inability to recognize facial emotions was detected. The study used pupillometry techniques to measure changes in the dilation response of the pupil, a measure of the autonomous excitement of the sympathetic system to emotional stimuli. Moreover, it was discovered that the characteristics of insensitivity due to psychopathy were related to the compromised recognition of frightened faces. The study shows that an increase in the ability was associated with a reduction in the dilation response of the pupil and that this was pervasive in different emotional expressions. The results of the study highlight a potential role of the Locus Coeruleus-norepinephrine system in the pathophysiology of psychopathy and demonstrate the potential of the pupillary response as a technique to understand the attention-emotion interactions in psychopathy.
That's why working on the causes becomes fundamental and necessary for the future of new generations. Starting from this evidence, it is vital to first act on mothers victims of violence, subtract them from the stress situation, focusing rehabilitation interventions on the ability to know how to recognize, respond and report domestic violence. Preventing or acting quickly to help women escape domestic violence can be an effective way to support healthy brain development in their children and prevent the consequences of the violence suffered by mothers from creating negative effects also on children’s lives.
prof. Raffaele Zinno - Dr. Hamida Ouled Slimane
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