This research found that traumatic experiences were linked with white matter hyperintensities (WMHs), which are lesions in the brain that show up in brain scans and might be an early marker for dementia. Sexual assault was the most reported traumatic experience, at 23%, and the most significantly related to WMHs. As factors that increase the risk for dementia are better understood, public health efforts can further target intervention programs to address them.

The study was conducted with 145 women regarding traumatic events and looked at white matter hyperintensities (WMHs). Researchers found that 68% of participants reported at least one trauma, with sexual assault being the most reported trauma, at a rate of 23%. Results showed that participants with trauma exposure had more WMHs than those without trauma, and the trauma most associated with WMHs was sexual assault, which may be an early marker for dementia. While this research is the first to highlight the link between traumatic experiences and greater WMHs, which may suggest poorer brain health, a limitation of this study is that it only included a sample of women, so it cannot be generalized to other genders.

Women Deserve Safety from Trauma

Licensed clinical psychologist, and co-founder and director of the Center for Cognitive Behavioral Therapy and Mindfulness, Suraji Wagage, PhD, JD, says, “This finding is meaningful in that, while it does not prove a causal relationship, that experiencing sexual assault causes poor brain health, it demonstrates an association that may turn out to be causal. This underscores both the severity and uniqueness of sexual assault.” Wagage explains that therapists who treat trauma are familiar with the fact that sexual trauma is different from other types of trauma in the degree to which it may affect survivors. “It is an incredibly personal, painful violation that often shatters some of our most deeply held beliefs about other people and the world and our safety and ability to trust others,” she says. This study demonstrates the need to take sexual assault seriously as a risk to mental and physical health. Wagage explains, “As a society, we have a tendency to minimize psychological harms compared to physical harms and to treat psychological injury as something one should just get over, and we also have a tendency to minimize harms that primarily affect women.” As an example, Wagage references the criticism of Simone Biles for stepping away from the Olympics for psychological reasons, as she questions whether she would have been criticized had it been due to a physical injury. “We draw sharp distinctions between mind and body, when in fact they are intertwined. Psychological health deeply affects physical health,” she says. Wagage explains. “Whether we as a society consider sexual assault a serious harm matters a great deal: it affects the ways we raise our children, the laws surrounding sexual assault, the ways we treat survivors of sexual assault, the money we spend on resources for survivors and research, etc.”

Trauma Can Impact Brain Health

Psychiatrist and regional medical director for Community Psychiatry + MindPath Care Centers, Leela R. Magavi, MD, says, “We require more data to understand how disparate forms of trauma can affect individuals’ brains.” Magavi explains, “Although women with cardiovascular disease, stroke, or dementia were excluded from this study, it is important for readers to acknowledge that other factors such as brain tumors, vitamin deficiencies, infections, migraines, autoimmune diseases, and demyelinating diseases can be linked to white matter hyperintensities.” In terms of impacts, Magavi highlights how individuals who have endured trauma tend to experience difficulty with processing speed, working memory, and productivity. “Further research could help physicians better diagnose and treat short-term and long-term cognitive changes observed in individuals with posttraumatic stress disorder,” she says.  Magavi explains, “An individual’s age at the time of trauma is extremely important. We need more research to differentiate neurological changes based on whether an individual experienced trauma during childhood versus adulthood. It would also be important to ascertain how different traumatic experiences such as neglect, emotional abuse, physical abuse, and sexual abuse can independently affect the brain.” Trauma can affect individuals in countless ways secondary to neurological changes, as Magavi highlights how it may trigger or exacerbate self-esteem concerns, anxiety, and depression. “Individuals who have endured any form of neglect or abuse are prone to self-gaslighting where they dismiss their emotional responses to situations and contend that they are simply being too sensitive and dramatic,” she says. Magavi explains, “Chronic exposure to trauma and stress could lead to substance use, depression, and various anxiety disorders inclusive of posttraumatic stress disorder. The ability to better link these clinical changes with concurrent neurological changes can change the way we practice medicine and help our patients.”