Adverse childhood experiences (ACEs)
Adverse childhood experiences (ACEs) refer to various traumatic events that occur during childhood, including physical, sexual, or emotional abuse, neglect, and exposure to domestic violence or parental incarceration. These experiences can lead to toxic stress, significantly impacting a child's neurodevelopment and overall well-being. Research indicates a strong correlation between ACEs and the development of numerous health and behavioral issues in adulthood, such as substance abuse, depression, and chronic diseases. ACEs affect individuals across all demographics, but prevalence can be higher among those in poverty and marginalized communities. The impact of ACEs can be profound, often leading to intergenerational cycles of trauma. To assess an individual’s exposure to ACEs, psychologists may use an ACE questionnaire, which helps identify risk factors associated with various health problems. Addressing the effects of ACEs typically involves fostering resilience through supportive relationships, therapy, and healthy lifestyle practices. Increasing global awareness and providing resources for prevention and intervention are key initiatives aimed at mitigating the long-term repercussions of ACEs.
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Adverse childhood experiences (ACEs)
Adverse childhood experiences (ACEs) are stressful, traumatic events such as physical, sexual, or emotional abuse and physical and emotional neglect. ACEs can also include witnessing violence against a parent or having an incarcerated parent. Researchers have discovered a link between ACEs and health and behavioral problems and conditions in adulthood such as alcohol and drug abuse, depression, and heart disease. The more ACEs children experience, the more likely they are to have such problems. ACEs occur among individuals of all races and in all geographical regions and economic classes. However, more ACEs occur among children living in poverty.
Background
Experts categorize children’s stress as being positive, tolerable, or toxic. Children need some stress to grow mentally and physically. This is positive stress. Examples include the stress a child will feel if introduced to a new caregiver or environment, such as preschool. A child experiencing positive stress will have a brief increase in heart rate and hormone elevation.
Tolerable stress is more severe and long-lasting but usually not harmful. This is especially true if trusted adults are present to help a child overcome the stress. Examples of tolerable stress include an injury or a move to a new home.
Toxic stress, on the other hand, is much more serious. This type of stress results from a trauma such as physical abuse. Toxic stress is often long-lasting and so severe that it disrupts the growth of the child’s brain and other organs. Children who experience toxic stress often do not have trusted adults present to help them recover. The body’s response to toxic stress can be detrimental to a child’s physical and mental health and last a lifetime.
Overview
Adverse childhood experiences (ACEs) are those that cause an individual to suffer toxic stress. An ACE is beyond a child’s control and its effects linger into adulthood. ACEs occur before the age of eighteen, and individuals begin experiencing their effects in adolescence or the early teens.
ACEs include the following:
- Physical, sexual, or emotional abuse
- Physical or emotional neglect
- Violence at home against a parent or sibling
- Substance abuse in the household
- Parental separation or divorce
- Parental incarceration
- Parental death
- Mental illness within the household
The chronic, toxic stress children suffer from ACEs can harm them in two main ways. First, such stress may lower a child’s immunity to disease, which makes it more likely that they will develop physical health problems that may result in premature death. Second, such stress can cause a disruption in the child’s neurodevelopment. This can affect the child’s ability to cope with negative life events. As a teen, the individual may develop negative coping mechanisms, such as smoking and drinking, which can lead to physical health problems.
Research shows a strong link between ACEs and the development of the following health problems and conditions:
- Substance abuse and smoking
- Depression
- Heart, lung, or liver disease
- Violence against a partner
- Unintended pregnancies
- Sleep disorders
- Attempted suicides
An ACE can happen to any child, regardless of the child’s race, community, and economic class. However, studies often indicated discrepancies in prevalence between groups based on factors such as income and racial and ethnic marginalization. A study published in the journal World Psychiatry in 2023 aggregated 206 studies of over 546,000 participants from twenty-two countries conducted between 1998 and 2021. This review found that 22.4 percent of adult participants reported one ACE, 13 percent reported two ACEs, 8.7 percent reported three ACEs, and 16.1 percent reported four or more ACEs.
ACEs are often passed on to succeeding generations. Adults who experience ACEs tend to be parents experiencing poverty and are less able to respond to stress in a healthy way. The mental and physical problems they developed because of their own ACEs may cause their offspring to have ACEs as well.
To determine the number of ACEs a person has had and their risk factors of behavioral problems and health conditions, psychologists often administer an ACE questionnaire to determine an “ACE Score.” The questionnaire measures the types and numbers of ACEs an individual has had. Scores can range from 0 to 5 or higher. The higher an individual’s score, the more likely they are to have problems. For example, it is believed that those with a score of 4 have double the normal risk of developing heart disease or cancer and are 700 percent more likely to become alcoholics.
In terms of treatment, experts recommend fostering resilience in children who have had one or more ACEs. This can involve therapy but also support from trusted adults. Deep breathing, regular exercise, good nutrition, adequate sleep, and healthy social interactions can help a child replace toxic stress with resilience. Similar treatments are administered to adults but may also include treating the individual’s behavioral and health problems. Additionally, by the beginning of the 2020s organizations worldwide had worked to increase awareness of the prevalence of ACEs and provide information about identifying, responding to, and even potentially preventing their occurrence or inheritance.
Bibliography
Adverse Childhood Experience and the Lifelong Consequences of Trauma. American Academy of Pediatrics, 2014, cdn.ymaws.com/www.ncpeds.org/resource/collection/69DEAA33-A258-493B-A63F-E0BFAB6BD2CB/ttb‗aces‗consequences.pdf. Accessed 29 July 2024.
Bergland, Christopher. “5 Factors Linked to Higher Risk of Early Life Adversity.” Psychology Today, 18 Sept. 2018, www.psychologytoday.com/us/blog/the-athletes-way/201809/5-factors-linked-higher-risk-early-life-adversity. Accessed 16 Oct. 2018.
Frederiksen, Lisa. “The Developing Brain & Adverse Childhood Experiences.” ACEs Connection, 26 Apr, 2018, www.acesconnection.com/blog/the-developing-brain-and-adverse-childhood-experiences-aces?reply=476303634588520707. Accessed 16 Oct. 2018.
King, Robert L. PhD. “Adverse Childhood Experience.” Psychology Today, 22 June 2018, www.psychologytoday.com/us/blog/hive-mind/201806/adverse-childhood-experience. Accessed 16 Oct. 2018.
Madigan, Sheri, et al. "Adverse Childhood Experiences: A Meta-Analysis of Prevalence and Moderators among Half a Million Adults in 206 Studies." World Psychiatry, 15 Sept. 2023, doi:10.1002/wps.21122. Accessed 29 July 2024.