ACE Studies: Childhood Abuse and Trauma

According to the ACE (Adverse Childhood Experiences) Study, an important public health study conducted between 1995 and 1997, childhood abuse and trauma is more common than anybody ever imagined. Various forms of trauma affect people from all walks of life, including those who grew up in educated, middle class homes with stable jobs and good health insurance.

The study, conducted in Southern California by the Centers for Disease Control (CDC), and Kaiser Permanente, asked people questions about their exposure to 10 categories of childhood trauma, ranging from physical, sexual, or emotional neglect or abuse, incarceration of a family member, violence, mental illness or addiction within the family, or absence of one or both parents.

The answers were subsequently scored with an ACE score of 0 indicating no exposure to trauma, up to a score of 10 for participants who had been exposed to all categories.

The Results

Two-thirds of the 17,000 participants in the baseline ACE Study had a score of at least 1, with nearly 90 percent scoring more than 1. The study has been repeated in several states across the country, with similar results.

The impact on public health was tremendous, as it became increasingly clear that childhood abuse and trauma is a common place occurrence -- not a rarity.

What it Means: The Consequences of Childhood Trauma

As the study unfolded, it became apparent that higher scores are correlated with an increased risk for physical and psychological problems down the road. The higher the score, the greater the chance of developing diabetes, emphysema, severe obesity, stroke, cancer, headaches, cardiac problems and early death.

The body’s Fight or Flight response helps keep us safe by releasing stress hormones that spur us to respond quickly when danger looms. However, a child who continually lives in fear becomes trapped in the Fight or Flight response as the brain is constantly overloaded with stress hormones.

As a result, trauma takes precedent over all other aspects of life. Children have difficulty trusting adults and developing relationships with their peers. Learning problems are common. Children who live with trauma often act out and because they have trouble regulating emotions, they are often misdiagnosed with ADHD.

Individuals exposed to trauma during childhood are also more likely to engage in behaviors that increase the risk of health problems, including smoking and abuse of drugs and alcohol. They are more likely to end up in various human service systems such as criminal justice, social services or child protective services.

It comes as no surprise to drug and alcohol treatment professionals that people frequently turn to drugs, alcohol, sex, overeating, work, smoking or even extreme sports to escape anger, fear, rage, depression, anxiety and other difficult emotions related to unresolved childhood trauma.

There’s Hope: What the ACE Study Doesn’t Mean

The ACE questions are easy to find online, and anybody is welcome to take the test and determine their own ACE score.

Keep in mind that a high score doesn’t mean you are automatically doomed to experience a difficult, problem-filled life. In spite of the risk factors correlated with a high score, it has also become apparent that children (and adults) can thrive in spite of childhood trauma.

For example, the study doesn’t consider positive influences that mitigate the negatives, such as the presence of one resilient parent, an influential teacher, a beloved family friend or grandparent, or a nurturing, supportive community.

When childhood trauma is balanced with such protective factors, children can learn to regulate their emotions and engage the world in positive ways. Even one safe, stable relationship with an adult can make all the difference in how a child cultivates a sense of purpose. If a child has no buffers, the risk is much greater.

Schools, health care systems and other entities that provide support for parents and children play an important role.

Although it isn’t easy, adults who continue to struggle with the residue of childhood abuse and trauma can learn to develop resilience and move beyond the pain. Counseling is highly effective, especially cognitive behavioral therapy and other techniques that help people address and change negative thought patterns.

Adults who turn to drugs and alcohol to cope with a painful childhood can benefit greatly from drug and alcohol treatment or rehab.

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