Mental Health Monday - Adverse Childhood Experiences

An important study of more than 17,000 individuals in southern California is changing the way psychologists and medical doctors alike approach the treatment of traumatized individuals. Drs. Vincent Felitti and Robert Anda investigated the relationships between adverse childhood experiences (ACEs) and the development of psychological and health problems in later life. The overall conclusion of the study was not really very surprising: childhood experiences are powerful determinants of adult behavior. What was rather surprising, though, was the extent or magnitude of the impact of ACEs on the physical and emotional health of adults.

The researchers identified major categories of ACEs: recurrent emotion abuse, physical abuse, sexual abuse and neglect were the primary categories, but the researchers also considered the following behaviors of adult family members as ACEs: substance abuse, contentious or bitter parental separation/divorce, chronic depression, suicidal ideation, domestic violence, incarceration, and the death of a parent.

Of the 17,000 participants, 25% were exposed to two of the ACEs categories; 1 in 16 was exposed to four categories, 22% were sexually abused as children, and 66% of the women experienced abuse or violence in childhood. Across the board, the higher the ACEs scores the greater the likelihood of problems in adulthood, including:

• Depression (460% more likely among adults with an ACE score of 4 or higher)
• Suicide attempts (3000% more likely among adults with an ACE score of 7 or more; 5100% more likely among children and adolescents with an ACE score of 7 or more)
• Domestic violence (women with an ACE score of 4 or more are 500% more likely to become victims of domestic violence. Should the victims’ children become aware of this violence, the children’s ACE score will rise. And the cycle continues…)

You may be familiar with the phrase “Correlation, not causation,” which is to say these statistics describe relationships but do not prove that exposure to adverse experiences in childhood cause depression or suicide attempts later in life. However, Dr. Anda—one of the primary investigators—describes relationships of this magnitude as significant and rare in epidemiology.

A growing trend is underway among mental health professionals to become more proactive about recognizing and treating the effects of traumatic experiences. Trauma-informed practitioners are now beginning to ask “What happened to this person?” instead of “What’s wrong with this person?” Adults who were traumatized in any number of ways can begin working through their adverse childhood experiences today with the help of a trained professional. Children and teenagers who are currently experiencing ACEs need not suffer from the effects of these traumas the rest of their lives…but the professionals need your help. Break the silence and tell the person who’s treating you everything you can about the pain you experienced early in life. It’s not easy to do, it’s definitely not fun to do, but it can completely change your life for the better.