The subject of childhood trauma (often measured as "Adverse Childhood Experiences (ACEs)") and links to substance abuse, mental illness and crime has been getting a lot of attention in the professional criminal justice, mental health and addictions literature over the past few years. In this series of articles, we'll explain ACEs, look at definitions of "trauma", examine some of the relevant research, and what corrections, mental health and addictions professionals need to know.
WHAT ARE "ADVERSE CHILDHOOD EXPERIENCES" (ACEs)?
Adverse Childhood Experiences are when children experience emotional, physical or sexual abuse, emotional or physical neglect, loss of a parent due to separation, divorce, incarceration, abandonment or death; substance abuse and addiction within the family/household, family dysfunction; depression, mental illness or suicide within the family or household, incarceration of any family/household member, or witnessing violence against their mother or stepmother.
For the complete ACE scoring/assessment tool, see http://www.acestudy.org/yahoo_site_admin/assets/docs/ACE_Calculator-English.127143712.pdf
INITIAL "ACEs" RESEARCH
Adverse Childhood Experiences were first identified in an extensive research initiative by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente in 1995. They studied the connections between childhood maltreatment and family dysfunction and adult health and mental health outcomes among over 17,000 people. This original ACE study drew several conclusions:
• when children are exposed to these "adverse childhood experiences", the stress of this exposure may affect or disrupt the chemical and physical development of the child's brain and nervous system
• when development of a child's brain and nervous system is disrupted, this affects the child's ability to cope with difficult or negative emotions and the child's cognitive and emotional development may be impaired
• over time, the child will develop other coping mechanisms for dealing with negative or difficult emotions – this often plays out during adolescence, when the child may abuse drugs or alcohol as a coping mechanism for the trauma experienced during childhood
RECENT RESEARCH ON CORRELATIONS OF ACE SCORE TO ADDICTION, MENTAL ILLNESS AND CRIME
Additional research over the past 15+ years has found very strong relationships between ACEs and the following substance abuse and behavioral outcomes:
• early initiation of alcohol use (Dube et al, 2006)
• problem drinking behavior into adulthood (Dube et al, 2002)
• prescription drug use (Anda et al, 2008)
• lifetime illicit drug use, drug problems and self-reported addiction (Dube et al, 2003)
• increased risk of suicide attempts, for both men and women, during both adolescence and adulthood (Dube et al, 2004)
• lifetime depressive episodes (Chapman et al, 2004)
• sexual risk behaviors (Hillis et al, 2001)
• Teen pregnancy (Hillis et al, 2004)
• early psychological trauma may actually cause lasting changes in the brain that promote aggressive behavior in adulthood (Sandi et al, 2013)
Future articles on the RMO website will explore other research on ACEs and what service providers and corrections professionals should know about ACEs and working effectively with clients.