Childhood is a time of great physical and emotional development. Adverse experiences that occur during this time can significantly impact the child’s life well into adulthood. Exactly what are the connection and long-term consequences of Adverse Childhood Experiences on overall health and well-being?
A study in 19981 analyzed the relationship of childhood abuse and dysfunction in the home to many of the leading causes of death in adults. More than 17,000 adult patients completed questionnaires while waiting to see their doctor.
Tallying the data
The survey asked about 10 different types of childhood trauma:
- Physical abuse
- Emotional abuse
- Sexual abuse
- Physical neglect
- Emotional neglect
- Witnessing violence against their mother
- Living with household members who were substance abusers
- Mental illness in the household
- An imprisoned member from the household
- Loss of a parent through death, divorce or abandonment
The person taking the survey received one point for each type of exposure they experienced as a child, and points were added to calculate their overall ACE score.
The results indicated that ACEs are quite common, even among this group of primarily Caucasian, upper middle-class and college-educated adults, with over eighty percent of respondents reporting more than one type of ACE. The researchers found that the higher the ACE score, the greater the likelihood of a mental health problem, health risk behavior or medical illness. These findings have been replicated over the past two decades.
Although it was expected that childhood trauma would be associated with mental health issues like depression and substance abuse, the connection to poor physical health outcomes such as heart disease, cancer, chronic lung disease, liver disease and broken bones was surprising. ACEs also correlate to sexual decision-making and health. The higher their ACE score, the more likely a person is to perpetrate or become a victim of domestic violence, have multiple sexual partners, be diagnosed with a sexually transmitted disease or experience a teen pregnancy.
Compared to someone with an ACE score of 0, a person with an ACE score of 4 had a four to 12-fold increased risk for alcoholism, drug abuse and suicide attempts. They also had a two to four-fold increased risk for smoking and poor health, and almost twice the risk for physical inactivity and severe obesity. The more ACEs a person experienced, the higher their chance of poor health care decision making and development of diseases. ACES are also associated with earlier death. Compared to a person with an ACE score of 0, a person with an ACE score of 6 has, on average, a 20-year shorter life expectancy.
The data support that child abuse and neglect are among our greatest health problems and preventing family dysfunction is a goal with potential significant benefits to the mental and physical health of our citizens. As ACEs negatively impact a large population, they pose a threat to our public health which in turn carries an economic toll.
Resilience, or the ability to bounce back from life’s stresses, is the antidote to childhood trauma. Feeling loved, secure and safe are the foundations of resilience. This may be difficult if you experienced childhood trauma, but there are ways to increase your own resilience by taking care of yourself. Exercise regularly, don’t smoke, get an education and practice self-care. If you’re experiencing symptoms that cause you distress or interfere with your ability to function, counseling can help.
Nurturing strong children and families
Parents also have an important role in helping children develop resilience. Strong families create resilient kids, supporting them through life’s difficulties and disappointments. Building secure attachments to your children increases their resilience and protects them from multiple mental health disorders.
Take time to play with your kids and talk with them about their day. Family dinners are a great time for a daily check-in. Insist kids (and parents!) put away cell phones and electronic devices during this time together. Coach them in effective social communication and help them build strong friendships. Teach them self-care with healthy food, regular exercise and daily routines, and avoid overscheduling.
Discipline with love and avoid physical punishment as spanking has been found to increase anger and anxiety in children. Controlling your temper when a child exhibits challenging behavior can be difficult, however calmly disciplining your child communicates your affection even when you are displeased with their actions. Parents also need to handle disagreements with each other positively and without yelling. Discuss sensitive issues privately if you are concerned about handling them well.
It’s also helpful for parents to model daily relaxation and positive coping skills. Download mindfulness apps and practice using them with your children. The guided meditations on Mindfulness for Teens are great for both teens and adults. Belly Breathe with Elmo and Melting on Go Noodle are helpful stress busters for younger children.
Investigate your own ACES and take a companion resilience survey to examine the protective factors in your life. This ACEs Connection site also features news and a blog including tips, research, books, webinars and websites to increase your knowledge about ACEs and resilience.
The American Academy of Pediatrics also offers tips and resources for building resilience in your child and family.
If you have concerns about your child’s experiences and need some assistance helping them build resilience, call Virginia Treatment Center for Children at (804) 828-3129 to request an evaluation with a mental health expert.
By Susan Jones, MD, child and adolescent psychiatrist, Virginia Treatment Center for Children
Medical executive editor for mental health blog series: Bela Sood, MD
1 The Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults, by Drs. Vincent Felitti and Robert Anda in the American Journal of Preventive Medicine