The definition continues: «Traumatic
brain injury applies to open or closed head injuries resulting in
impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem - solving; sensory, perceptual,
and motor abilities; psycho - social
behavior; physical functions; information processing;
and speech.
Typical presenting problems include concerns about attention / ADHD, learning, trauma / PTSD, depression, anxiety, memory, disruptive
behavior, hyperactivity, social interactions / Autism, dementia, neurobehavioral disorders, traumatic
brain injury,
and cognitive
impairments among others.
These toxic stress - induced changes in
brain structure
and function mediate, at least in part, the well - described relationship between adversity
and altered life - course trajectories (see Fig 1).4, 6 A hyper - responsive or chronically activated stress response contributes to the inflammation
and changes in immune function that are seen in those chronic, noncommunicable diseases often associated with childhood adversity, like chronic obstructive pulmonary disease (COPD), cirrhosis, type II diabetes, depression,
and cardiovascular disease.4, 6
Impairments in critical SE, language,
and cognitive skills contribute to the fractured social networks often associated with childhood adversity, like school failure, poverty, divorce, homelessness, violence,
and limited access to healthcare.4, 19,58 — 60 Finally, behavioral allostasis, or the adoption of potentially maladaptive
behaviors to deal or cope with chronic stress, begins to explain the association between childhood adversity
and unhealthy lifestyles, like alcohol, tobacco,
and substance abuse, promiscuity, gambling,
and obesity.4, 6,61 Taken together, these 3 general classes of altered developmental outcomes (unhealthy lifestyles, fractured social networks,
and changes in immune function) contribute to the development of noncommunicable diseases
and encompass many of the morbidities associated epidemiologically with childhood adversity.4, 6