Posted Sunday March 27, 2011 by Shannon Georgecink

Insights from the ACE Study

It has become increasingly evident that childhood abuse and neglect are major factors in the development of virtually all types of mental health problems, ranging from post-traumatic stress disorder to depression to anxiety to some psychotic disorders. But what you may not know is that childhood trauma is also a major factor in the development of leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study is an ongoing collaboration between the Centers for Disease Control (CDC) and Kaiser Permanente that analyzes types of childhood trauma and physical and mental health consequences later in life. The participants include over 17,000 adults from the Kaiser Permanente Department of Preventative Care in San Diego. The study looked at ten types of potentially traumatic or highly stressful experiences before the age of 18. These include: (1) recurrent physical abuse; (2) recurrent emotional abuse; (3) contact sexual abuse; (4) an addict in the home; (5) an incarcerated member of the household; (6) a household member who was chronically depressed, mentally ill, institutionalized, or suicidal; (7) domestic violence in the home; (8) one or no parents due to divorce or death; (9) emotional neglect, and (10) physical neglect. The study showed amazing correlations: the more types of experiences an individual reported, the more at risk for major health problems, including heart, lung, and liver diseases, fractures and serious injuries, obesity, HIV/AIDS, sexually transmitted diseases, high risk teen pregnancy, fetal death, addictions of all types, migraines, autoimmune disorders, and certain types of cancer. The risk of smoking, alcohol and drug abuse, eating disorders, sexual promiscuity, and other high risk health behaviors increased as the number of types of childhood stressors increased. And of course, the risk for all types of mental health problems grew with more traumatic experiences, including serious depression, hallucinations, memory problems, and suicidality.

The researchers found that even in the relatively well educated and middle class sample, less than a third had an ACE score of 0, and more than 15% of women and 9% of men had four or more types of major stressors.

What is the relationship between childhood trauma and health? It’s complicated, but we know that stress affects the body, and chronic stress affects the body in more chronic ways. A child whose developing brain is exposed to chronic stress has significant changes in both the structure and function of the brain, which of course, regulates the rest of the body. Chronic stress responses in the brain then adversely affect the body. And children who have been abused or neglected often do not take good care of themselves as they grow up, and are more likely to engage in risky behaviors that have consequences on their health.

If you would like to know your own ACE score, simply give yourself one point for each of the 10 types of adverse childhood experiences (ACEs) listed above and add them up for a total score. Thus, scores may range from 0 (no adverse experiences) to 10 (all adverse experiences). Then, to read more about your risk for mental and health problems related to your score, go to any of the CDC  link below to read articles that discuss specific scores. Of course, a risk for problems does not necessarily mean you will have problems. However, if you experienced 4 or more types of ACEs (that is, have a score of 4 or greater), you might want to consider getting a thorough physical exam, work on improving your health behaviors, and see a therapist if you have any emotional difficulties. Prevention can go a long way to calming and healing your body and your mind!

Click here for CDC website for ACE