What are Adverse Childhood Experiences and How Do They Impact on Adult Life?
I often reflect on my life, as have many of us, wondering how my prior experiences have influenced my life, my psychology, work choices, relationships, parenting skills, children’s development and health.
My personal and professional research into this concept has led me to understand more about ACE’s (Adverse Childhood Experiences) and I've realised that no one is immune, we have all sustained ACES in some shape or form and some more than others.
The experiences we have early in our lives and particularly in our early childhoods have a huge impact on how we grow and develop, our physical and mental health, and our thoughts, feelings and behaviour.
Trauma is not just experienced it can also be inherited. This happens when trauma has been passed from one individual or generation to another. It often manifests as inter-generational trauma. Whereas collective trauma is the effect shared by a group after witnessing traumatic events where they’ve been targeted.
Recent research in the UK indicates that one in five adults have experienced at least one ACE, before the age of 16 years. Females and minority groups are at greater risk of experiencing four or more ACEs.
General population studies of Adverse Childhood Experiences have also observed a relationship between exposure to Adverse Childhood Experiences and future violence, whether as a victim, a perpetrator, or often both. A nationally representative study of almost 4,000 participants in England found that respondents with four or more Adverse Childhood Experiences were seven times more likely to have been a victim of violence in the past year, and were eight times more likely to have committed a violent act than those with no Adverse Childhood Experiences. In Wales these figures were more pronounced, as those who had experienced four or more Adverse Childhood Experiences were 14 times more likely to have been a victim of violence in the past year, and 15 times more likely to have been the perpetrator of a violent incident. Little is known about the long term impact of ACEs, however what we do know is that the issue is complex and multifaceted.
What Counts as an Adverse Childhood Experience?
Adverse Childhood Experiences (ACEs) are traumatic events that children can be exposed to while growing up.
ACEs can be direct and indirect, including neglect, physical, emotional and sexual abuse, divorce substance misuse, violence, mental illness, domestic violence, disability and social factors such as financial hardship, homelessness, discrimination and low-level educational attainment.
The impact of ACEs
Experiencing ACEs can have a huge impact on physical and mental health in adulthood compared to the general population.
Trauma survivors are:
3x more likely to suffer from a heart attack
5x more likely to suffer from mental health problems, such as anxiety, depression, and complex post-traumatic stress disorder
14x more likely to die by suicide
11x more likely to have drug and alcohol addiction issues
35x more likely to experience intimate partner violence
The longer individuals experience an ACE and the more ACEs someone experiences, the bigger the impact it will have on brain development and how threats are perceived. When faced with a threat, our bodies naturally produce cortisol, the stress hormone which helps us respond in a natural and healthy way to protect us and keep us safe from harm. Cortisol is responsible for the fight, flight and freeze response. Recent research demonstrates that adults who have sustained childhood trauma have elevated cortisol production leading to cortisol suppression. In layman’s terms this means that trauma survivors live in a constant heightened state of flight or flight.
Exposure to ACEs can also impact on:
The ability to recognise and manage different emotions.
The capacity to make and keep healthy friendships and other relationships.
The ability to maintain employment.
Healthy development of problem-solving skills
While everyone's reaction to trauma is unique, there are some common reactions. Knowing and understanding the formulation of trauma is key to learning to not only survive but also thrive.
What Needs to Change
We need to start from the beginning. We have seen the same approach or small variances to tackling complex social problems time and time again. Rather than making the necessary but difficult societal reforms that would lower the probability of abuse happening, we wait for horror stories to happen and then try to alleviate their effects - what Geoffrey Rose referred to as a ‘focused rescue mission for vulnerable individuals’.
In the case of ACEs, this means that the prevention strategy is often too late to implement as the damage has been done. It takes a survivor of trauma approximately ten years to come forward and ask for help.
A new narrative needs to be introduced on how people think about the causes of ACEs and who can help prevent them, shifting the focus from individual responsibility to community-based solutions. We need to stop vilifying those who are seek help with parenting challenges or for substance misuse, depression, and suicidal thoughts.
When trauma has not been preventable, training in trauma-informed care is essential for mental and physical health-care providers, police and ambulance staff. Universal screening and assessing for ACEs, especially in regard to determining how trauma affects healthy functioning is critical to developing person centred, needs led care plans.
A trauma-informed care approach should be used with all trauma survivors, this approach actively engages those with a history of trauma whilst recognising the presence of trauma symptoms. The approach acknowledges the role that trauma has played in survivors’ life as well as validating that they are doing the best that they can with the skills they have learned.
Paula Edwards: Mental Health Therapist