In this post, you will learn more about the ACE Study. Childhood Trauma can have a direct, lasting impact on physical health, mental health, and ability to function in society.
But we didn’t have any idea how much impact it had until the late 1990’s, when a curious doctor made a groundbreaking discovery.
The ACE Study
Dr. Felitti led an obesity clinic at Kaiser Permanente. In the late 1980s, he observed a strange phenomenon: many patients who successfully lost weight quickly regained it. Some even dropped out of the program despite their success.
Curious about this pattern, Dr. Felitti started interviewing patients to understand why they regained the weight. During these interviews, he uncovered that a significant number of these patients had a history of childhood trauma and abuse. He started to wonder if obesity might be a coping mechanism for dealing with unresolved trauma.
So Dr. Felitti collaborated with the CDC to ask over 17,000 adults about their exposure to various types of childhood trauma. These are called Adverse Childhood Experiences (or ACEs for short). The original ACEs study identified ten categories of these experiences, which can be grouped into three broad categories.
Abuse: Physical abuse, Emotional Abuse, and Sexual Abuse
Neglect: Physical and Emotional Neglect
Household Dysfunction: Domestic Violence, Substance Abuse, Untreated Mental Illness, Parental separation or Divorce, or Parental Incarceration
The original study did not explore other forms of Adversity like environmental violence (war, gang violence, or crime), relocation (moving, asylum seeking, or divorce), grief and loss, racism, prejudice, and poverty. But even just with their limited study, they had 2 findings that changed our understanding of childhood trauma forever.
- They found that a huge number of people have experienced at least one Adverse Childhood Experience (64%) and 17% or 1 in 6 children experience at least 4 ACES. And more specifically, 28% of women and 16% of men reported being sexually abused during their childhoods. And this study was done with mostly middle class white folk, but the rates are actually higher with other demographics. So that was the first finding, childhood trauma is way too pervasive.
- And Two- Dr. Felitti found that this trauma is directly correlated with a wide range of negative health outcomes in adulthood, including chronic diseases, mental health issues, substance abuse, and early death.
- So let’s talk about the impact on physical health– ACE’s increase your chances of autoimmune conditions, heart disease, diabetes, or obesity. With 6 ACES you’re twice as likely to have cancer and 15% more likely to have a chronic disease like heart, lung or liver disease.
- ACE’s fuel behavioral problems like substance abuse, smoking, risky sexual behavior, and criminal activity.
- With 4 or more ACEs, you’re 17X’s more likely to struggle in school, and 7 times more likely to be an alcoholic,
And of course- Childhood trauma massively impacts mental health. People who didn’t experience ACE’s as a child have a 12% chance of experiencing depression, compared to 35% of men and 66% of women who did experience Adverse Childhood experiences. . With an ACE score of 6 there’s a 5000% increase likelihood of suicide attempt. Adverse childhood experiences increase your chances of PTSD, anxiety and most other mental health concerns. And ACEs are directly related to at least ⅓ of mental health conditions in adulthood.
By helping kids grow up in safer homes, we could reduce the rate of depression by a whopping 44%!!
The ACEs study was one of the first to demonstrate how childhood trauma could have long-lasting effects on physical and mental health. Childhood trauma can impact almost every aspect of your life. The ACEs study showed that it affects our ability to form healthy relationships or perform at work.
I think just about everyone experiences something in childhood that they would consider traumatic, and the study found that two thirds of people experienced one of the events on the ACEs list. When we have supportive adults in our lives, most of us have the capability to process through a traumatic experience. Sadly, though, ⅓ of the kids with an ACE had at least four ACEs, which means they were living with recurring trauma that permeated multiple aspects of their life, often coming from the people who were supposed to be supporting them. The ACEs study found that the more ACEs a person experiences, the higher their risk for these negative impacts in their adult years.
In addition to the individual suffering caused by childhood trauma, it’s also costly for our society- The Journal of the American Medical Association (JAMA) recently published a new study that found that ACEs cost our nation a staggering $14.1 trillion annually because of related adult health conditions, including direct medical spending and lost productivity.
This isn’t all bad news though. Understanding ACEs has led to the development of trauma-informed care, which aims to recognize and respond to the effects of trauma in both children and adults.
So first, let’s explore why trauma can be so harmful to physical health, and then we’ll explore what we can do about it.
So how does trauma increase the risk of disease?
Chronic exposure to stress during childhood can lead to long-lasting changes in how the body and brain react to stress, which can contribute to various health problems later in life.
1. The Stress-Response System
The body’s stress-response system, also known as the hypothalamic-pituitary-adrenal (HPA) axis, is responsible for managing how the body reacts to stress. When faced with a stressful situation, the HPA axis triggers the release of stress hormones like cortisol and adrenaline. These hormones prepare the body for a “fight or flight” response, increasing heart rate, blood pressure, and blood sugar levels, among other physiological changes.
Now adversity isn’t inherently bad. When a child faces adversity, has caring adults to support them, and access to resources to recover and restore their sense of safety, they can develop a healthy response to stress, where their parasympathetic response, the calming response in the nervous system kicks on. And adversity with support can make them more resilient, confident and capable.
But when a child is isolated, or threatened by their own caregivers, or exposed to repeated stressors, they never get a chance to restore that sense of safety. This creates chronic stress, which can interfere with the body’s natural ability to regulate. The HPA axis can become dysregulated and can get stuck in one of two states.
- Hyperarousal: The stress response may become overactive, leading to consistently high levels of cortisol and other stress hormones. This chronic state of high alert can damage various bodily systems over time, including the cardiovascular, immune, and digestive systems.
- Hypoarousal: In some cases, the HPA axis may become underactive, leading to an insufficient release of cortisol. This is essentially getting stuck in the Freeze State or a Shutdown state. This can make it difficult for the body to respond appropriately to stress, leaving an individual feeling overwhelmed or unable to cope with challenges.
Brain Changes and Stress Regulation
ACEs can also cause structural and functional changes in key brain areas involved in stress regulation, including:
- The amygdala, which plays a crucial role in processing fear and emotional responses, can become hyperactive due to ACEs. This can make individuals more sensitive to perceived threats, leading to heightened anxiety and fear responses.
- The prefrontal cortex, responsible for executive functions like decision-making and impulse control, may become less effective in regulating emotional responses. This can make it harder for individuals to manage stress and make rational decisions under pressure.
- Changes to the hippocampus can impair memory and cognitive function, and also reduce the ability to properly assess and respond to stressful situations.
Treatment
So, Can it be treated afterwards?
As we learn how trauma impacts mental and physical health, better treatments for trauma have been developed. Schools, workplaces, and doctors are implementing trauma-informed care. And individuals can get support through various types of therapy, education, and experiences. I’ll be exploring some of these treatments in upcoming videos, so keep checking back here.
I really do believe that we humans have a massive potential for post-traumatic growth and we have the ability to heal, to learn to regulate our nervous systems and to improve our brain and body’s ability to regulate stress. Most people have just never been taught how to do so.
If you want to learn more, there’s a ton of resources out there. I’m making a document to put as many good ones as I can find in one place, and of course you can take my free grounding skills course to learn the basics of how to regulate your nervous system. I’ll link those down below.
If you’re interested in whether Adverse Childhood Experiences might be affecting you now, you can take an ACEs quiz over at NPR. I’ll put a link in the description.
So yes, trauma can be treated, but even more importantly-
Can it be prevented?
We don’t just want to have an ambulance at the bottom of the cliff, picking up the kids who fall off the cliff. We want to build a fence at the top of the cliff, preventing them from getting hurt in the first place.
I really believe that we can prevent ACES, and a large study by the CDC has explored how. I’m going to share some lists, but what it really comes down to is building up community support for families, strengthening marriages and supporting parents, and helping people learn the skills to function better in work and school and build financial security.
This can be as simple as helping families connect to free parenting resources, volunteering in your local school, or being a “big brother or big sister”. It makes a difference if you connect with your neighbors, or support community programs, and even just working on your own healing process can help break the chain of generational trauma.
When children have a handful of supportive people in their lives, that can make all the difference, adversity can become a resilience factor instead of leading to PTSD.
I’m feeling really fired up about this right now. I seriously believe that we- you people watching my videos, can take active steps to stop passing down generational trauma, whether that’s just by taking small steps to improve your own mental health, strengthening your family, or reaching out and supporting your community.
So, comment below, what’s one small step you’re going to take this week?
Thanks for watching and take care.
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