• Neurobiology
• ETHICS (see Medical Ethics)
• MENTAL HEALTH

The extensive, long-term consequences of childhood trauma on brain development and the resulting implications for military recruitment and service are the subject of a review submitted to the Australian Royal Commission into Defence and Veteran Suicide, which began in 2021.1

Evidence presented to the Defence Select Committee’s inquiry, Mental Health and the Armed Forces, Part One: The Scale of Mental Health Issues, published in 2018,2 has shown that the youngest recruits from socioeconomically disadvantaged backgrounds are the group in the British Armed Forces at greatest risk of mental health problems. The developing nervous system is more vulnerable than that of the adult to adverse and stressful events, and this has a knock-on effect on the susceptibility to mental health problems later in life, including post-traumatic stress disorder (PTSD).

Although considerable plasticity occurs during normal brain development, a wide range of neuropathological events can affect developmental trajectories, thus altering fundamental patterns of brain organisation. The immature brain adapts to the effects of neural insults, but adaptation is not always benign and can produce long-term, possibly lifelong, adverse consequences. For example, untreated pain in infancy has the potential to inflict lasting damage on the developing nervous system,3 predisposing to chronic pain problems later in life.4

Evidence suggests that there is substantial overlap between brain circuits that involve physiological threat, including pain, and those that mediate the emotional distress seen in PTSD. Structural reorganisation and altered functional activity combine to decrease inhibition and …