Neglect: Part II

Extensive research indicates that experiencing mistreatment during childhood, regardless of one’s developmental stage, can lead to enduring repercussions that significantly elevate the likelihood of developing both psychiatric and medical disorders. There is increasing awareness of the correlation between neglect and diagnoses like narcissistic personality disorder, post-traumatic stress disorder, attention deficit and hyperactivity disorder, as well as a number of eating disorders.

Long Term Mental Health Consequences of Neglect 

In addition to the direct physical harm that children may endure due to mistreatment, a child’s responses to abuse or neglect can cast a long shadow, potentially spanning across generations. Childhood maltreatment is intricately connected to subsequent physical, psychological, and behavioral ramifications, with children who have experienced child abuse or neglect being four times more likely to develop a serious mental illness.

Narcissistic Personality Disorder (NPD)

Narcissistic Personality Disorder (NPD) is a complex and deeply ingrained mental health condition characterized by an exaggerated sense of self-importance, a constant need for excessive attention and admiration, and a lack of empathy for others. Understanding the link between NPD and neglect involves delving into the early developmental stages of an individual’s life.

Neglect in childhood, whether it’s emotional, physical, or psychological, can significantly impact the development of an individual’s personality and self-perception.  Especially during critical formative years, it can have a profound impact on a child’s emotional and psychological development. Children who experience neglect often lack consistent and nurturing caregiving, which leaves them yearning for validation and attention. This early deficit can lead children who experience neglect to grow up feeling invisible, unworthy, or unimportant, which can ultimately drive them to seek validation and recognition externally, as they lack it internally.

Neglect can also hinder the development of healthy emotional connections and empathy, which are crucial aspects of normal social functioning. Consequently, individuals with NPD may struggle with genuine empathy and often resort to manipulative behaviors to fulfill their desires for attention and validation.

Neglect can also instill deep-seated insecurities and fears of abandonment, which can drive individuals to adopt narcissistic traits as a coping mechanism. NPD serves as a defense mechanism to shield oneself from the painful emotional repercussions of neglect, which creates a facade of grandiosity and superiority to compensate for the feelings of unworthiness.

Post-Traumatic Stress Disorder

Neglect, whether in childhood or adulthood, can profoundly influence the onset and severity of Post-Traumatic Stress Disorder (PTSD). Trauma resulting from neglect can manifest as a significant risk factor for the development of PTSD. When individuals experience neglect, whether emotional, physical, or psychological, they are subjected to chronic stressors that disrupt their sense of safety and stability. These traumatic experiences can erode an individual’s ability to cope with subsequent stressors.

Neglect during crucial developmental stages can alter brain function and structure, which impacts the individual’s ability to regulate emotions and process threatening situations. When a person with a history of neglect encounters a traumatic event, their response may be intensified due to the prior trauma and lead to a heightened risk of developing PTSD. 

Attention Deficit and Hyperactivity Disorder

When children experience neglect, they often lack the necessary emotional and cognitive stimulation needed for healthy brain development. This deprivation can disrupt neural pathways and neurotransmitter functions and potentially contribute to ADHD symptoms.

Children subjected to neglect may exhibit inattentiveness, impulsivity, and hyperactivity, which are characteristic traits of ADHD. The chaotic and unpredictable environment resulting from neglect can also exacerbate these symptoms. Additionally, neglect can hinder the development of self-regulation skills, making it challenging for these children to manage impulses and maintain focus.

Neglect also elevates stress levels, which alters brain development and often causes behaviors akin to ADHD in children. Early life stressors alter brain structure and neurotransmitter systems, which impacts attention, impulse control, and emotional regulation—key aspects affected in ADHD. Chronic stress during critical brain development stages disrupts the prefrontal cortex, which is crucial for executive functions. Neurobiological alterations from early trauma can lead to imbalances in neurotransmitters like dopamine and norepinephrine, which are also observed in individuals with ADHD.

Moreover, neglect and trauma can induce hypervigilance and sensory processing issues, which affect attention and concentration. While genetics play a significant role in ADHD, environmental factors, like neglect, also contribute, and it is important that psychological and biological perspectives are integrated to achieve a comprehensive understanding of ADHD.

Eating Disorders (EDs)

Neglect and eating disorders are intertwined, often creating a perilous cycle of physical and emotional harm. Neglect, whether it’s emotional, physical, or psychological, can play a significant role in the development and exacerbation of eating disorders. When individuals experience neglect, whether from family, peers, or society, they may turn to food as a coping mechanism to fill the void left by the lack of attention, care, or support. This can manifest as emotional overeating, binge-eating, or anorexic behaviors as a desperate attempt to gain control over their lives when other aspects are chaotic or unfulfilled.

Conversely, the presence of an eating disorder can lead to further neglect as individuals isolate themselves, hide their struggles, or face stigma and misunderstanding from those around them. This isolation can intensify feelings of neglect and fuel the unhealthy behaviors associated with eating disorders. Breaking this cycle requires comprehensive support, understanding, and intervention that address both the underlying neglect and the eating disorder itself. Professional help, a supportive social network, and the fostering of a culture of empathy and open communication are vital steps toward recovery and healing for those grappling with the devastating effects of neglect and eating disorders.

Healing from the Complex Effects of Neglect

Healing from the impact of neglect requires multifaceted intervention and acknowledging its link to mental health issues like NPD, PTSD, ADHD, and eating disorders. Addressing the roots of neglect is crucial for recovery.

For those struggling with NPD, acknowledging the roots of neglect in their early developmental stages is crucial. Healing involves reevaluating self-perception, fostering genuine empathy, and dismantling defensive facades constructed to compensate for past feelings of unworthiness.

In the case of PTSD, addressing the trauma resulting from neglect is vital. Comprehensive therapy and the development of effective coping mechanisms can help individuals regulate emotions and navigate traumatic experiences, ultimately breaking free from the cycle of emotional distress.

In the context of ADHD, integrating psychological and biological perspectives is essential. Combining therapeutic strategies with supportive environments can aid in rewiring disrupted neural pathways and empowering individuals to develop essential self-regulation skills.

To combat the cycle of neglect and eating disorders, a holistic approach is essential. A nurturing support network, professional help, and promotion of open communication can empower individuals to reclaim control over their lives, find healthier coping mechanisms, and embark on a path of recovery. Breaking this cycle requires resilience, understanding, and a commitment to restoring the inherent worth and dignity of those affected by neglect and its far-reaching consequences.

Trauma-focused therapy, such as Eye Movement Desensitization and Reprocessing (EMDR), helps process traumatic experiences and reduce their emotional charge. Cognitive-Behavioral Therapy (CBT) targets distorted thought patterns and behaviors, thereby fostering healthier coping strategies. Dialectical Behavior Therapy (DBT) enhances emotional regulation and interpersonal skills. Additionally, interpersonal therapy and psychodynamic approaches delve into relationship dynamics and early experiences to promote healing. Group therapy and support networks offer a sense of belonging and validation, complementing individualized treatments for a comprehensive healing process.


[1]  Chandan JS, Thomas T, Gokhale KM, Bandyopadhyay S, Taylor J, Nirantharakumar K. The burden of mental ill health associated with childhood maltreatment in the UK, using The Health Improvement Network database: a population-based retrospective cohort study. Lancet Psychiatry. 2019 Nov;6(11):926-934. doi: 10.1016/S2215-0366(19)30369-4. Epub 2019 Sep 26. PMID: 31564467.

[2] Vrijsen JN, Tendolkar I, Onnink M, Hoogman M, Schene AH, Fernández G, van Oostrom I, Franke B. ADHD symptoms in healthy adults are associated with stressful life events and negative memory bias. Atten Defic Hyperact Disord. 2018 Jun;10(2):151-160. doi: 10.1007/s12402-017-0241-x. Epub 2017 Oct 28. PMID: 29081022; PMCID: PMC5973996.

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