A World of Contrasts

This alumnus counts the many blessings in his personal life as he strives in his professional life to ease the suffering of abuse victims

Frank Putnam Jr., MD '75, feels he had a charmed childhood growing up in Gainesville, Fla. The son of a college professor, he had a healthy mix of youthful fun activities and constructive educational outlets. As an adult, Dr. Putnam believes he is blessed with two wonderful sons, ages 8 and 12, who epitomize the healthy, happy lifestyle touted as normal for American children.

His older son Philip loves computers, science and woodworking, and is a budding Thomas Edison, although his father says his inventions are more of the Rube Goldberg variety. When not designing devices, such as a contraption using multiple steps to close a door, he is painting and drawing. Brother Will is more of a budding Michael Jordan or Peli with a love of basketball and soccer. He also spends many hours rollerblading or "just moving," his dad says. His artistic vent is music; he plays the piano and has plans to learn the trumpet and then the flute.

All of this contrasts markedly with Dr. Putnam's professional life, where he deals with the painful reality of child abuse and neglect. Referred to as the "Father of Developmental Traumatology," Dr. Putnam has overseen the world's longest running study of sexual abuse in girls. As a practicing adult psychiatrist, Dr. Putnam began to see a correlation between mental health conditions and prior physical and sexual abuse. He also suspected biological abnormalities in adults who were abused as children, but there was no data to substantiate his suspicions. That was about to change.

In 1986, Dr. Putnam changed his career path. Seven years after completing his residency in psychiatry at Yale University School of Medicine he was accepted into a fellowship program in child psychiatry at Children's Hospital National Medical Center in Washington, D.C. At the time he had been employed at the National Institute of Mental Health since 1979, first in the Section on Psychobiology, and later as a staff psychiatrist in the Neuropsychiatry Branch. By 1986, he was a senior clinical investigator in the Laboratory of Developmental Psychology.

That year was a turning point for Dr. Putnam and for the fledgling field of psychobiology as it pertains to victims of child abuse and neglect. He and Penelope Trickett, PhD, a developmental psychologist at University of Southern California, enrolled 186 girls, half of whom had been abused, in a study to determine if biological changes were indeed a result of child sexual abuse. The researchers have since determined that abused girls have higher levels of testosterone, initially higher and later lower levels of cortisol, increases in immune system abnormalities, and abnormal changes in the regulation of their heart rate when stressed in the laboratory.

The study also has produced evidence that sexual abuse affects more than just the psychiatric health of a victim.

"Clearly, we now know it significantly increases the risk for depression, PTSD (post-traumatic stress disorder) and suicide, but adults who were abused or neglected as children also are at greater risk for heart disease, cancer, stroke, emphysema, diabetes and hepatitis," says Dr. Putnam.

There are other indirect social costs related to victims of child abuse and neglect, such as decreased aptitude in school, significantly higher delinquency arrest rates and, as adults, higher rates of criminal activity and lower rates of employment. Seventy percent of people in alcohol rehabilitation have histories of child abuse and neglect.

"It is a huge (unrecognized) public health problem that, at the very least, contributes to many things that are recognized as public health problems," he says.

Since he began researching the biological affects of abuse and neglect, about a half-dozen other researchers across the country have joined the cause. Still, all that remains to be learned led Dr. Putnam to leave his job of twenty years at the NIMH to become director of the Mayerson Center for Safe and Healthy Children and a professor of pediatrics and child psychiatry at Children's Hospital Medical Center in Cincinnati.

"The NIH was not as interested in developing the treatment research piece of the child abuse and neglect problem," he explains. "That became a frustration for me."

As director of the Mayerson Center, Dr. Putnam and a staff of about thirty are creating a national treatment research center on child abuse and neglect. He also oversees a program to promote healthy parenting in eight counties and two states for 1,200 high-risk families, along with continuing his developmental neurobiology research and seeing patients at Children's Hospital.

The transition from adult psychiatry to child psychiatry was a natural one, he says, because he was following a trail of information obtained through his research concerning the long-term effects of child abuse and neglect.

"I have always been following my research problem," he says. "This job also, in many ways, was the next logical step. It involves many of the things I was doing at the NIH, but it also gives me the resources to do what I think I need to do next."

"Next" are additional studies involving prevention models and treatment models - pioneering the next generation of information for those involved with child abuse and neglect victims.

But that's Frank Putnam's daytime job. At the end of the day, he goes home. Then he hugs his kids.