How many ACEs do you have? Unlike in poker where a four-of-a-kind of aces the best hand, when it comes to ACEs, adverse childhood events, the fewer the better. The term “adverse childhood events” sounds so mild but what it is assessing is childhood trauma. It turns out that ACE scores correlate highly with a person’s mental and physical health as an adult.
The original ACEs study looked at people’s exposure to abuse, neglect, and household dysfunction up to the age of 18. The result were stunning. Two-thirds of the study group of more than 17,000 people had experienced at least one ACE, and of those people 87% had experienced at least two. This initial study was conducted by Kaiser Permanente and the subjects of this study were people who had Kaiser Permanente insurance and was primarily comprised of middle-class, white people—not the inner city population you might have assumed from the results. This initial study led to at least 70 other studies (including the CDC’s own study and 36 states which studied the issue) and all found similar results.
Researchers eventually came to realize that the common denominator was chronic stress. When the developing brain is bathed in stress hormones from chronic, ongoing stress, the brain is changed. Adverse childhood experiences have the greatest impact on the developing brain in early childhood, up to the age of five. Researchers have found that chronic stress in childhood changes a person’s epigenetics. Epigenetics is the change in how genes are expressed and may turn some genes on and others off. Chronic stress changes some gene function and these changed gene functions are passed down to a person’s children. This means that if you had a childhood of chronic stress, your children are born already primed to deal with stress differently than those of children born to people who did not experience chronic stress as children.
The findings from the ACEs study were striking. We learned that, unfortunately, childhood trauma or chronic stress in childhood, is quite common. (Remember that 67% of people have at least one ACE). We also learned that outcomes as adults is dose dependent. That is, the more ACEs a person has, the more likely they are to have serious mental and physical health issues. A score of 4 or more greatly increases the likelihood of severe outcomes. Outcomes linked to ACEs include: cancer, diabetes, alcohol and drug abuse, unintended pregnancy, traumatic brain injury, depression, anxiety, suicide, PTSD, and reduced education and income. A score of six or more was found to result in a life expectancy that is 20 years shorter than that of someone whose ACE score is zero.
The effects of childhood chronic stress in adulthood is not always obvious. For example, a person with an ACE score above zero is more likely to be a victim of rape and that likelihood increases dramatically as the ACE score increases. Another example: ACE scores higher than zero are linked to COPD and an earlier onset of multiple sclerosis among people who develop it. ACEs have been shown to be associated with obesity and overweight in adults.
Are you interested in knowing your ACE score? Click here and answer 10 quick questions. I want to note that you’ll find that some traumas, such as being bullied, are not on this assessment. That doesn’t mean those childhood traumas don’t affect people as adults; the original study looked at only the top 10 most common types of trauma, which is why some traumas are not represented on this assessment.
Once you know your ACE score, then what? Are you doomed if it’s not zero? No, you aren’t doomed. The higher the number, the greater the likelihood that we can see evidence of it in your life, such as if you have anxiety or depression, a substance use problem, have been in an abusive relationship, or are overweight. However, we also have learned in recent decades that the brain has neuroplasticity, meaning the brain is capable of changing. We can actually change the structure of our brains as adults. For example, a study of mindfulness meditation showed structural changes in the brain after just a few short weeks of meditation practice. So while you may indeed be living a life that reflects the ACEs in your past, you can work to counteract that through therapy as an adult and through being intentional in engaging in healthy practices and self-care.
Are you a perfectionist? Are you struggling with depression or shame? These are all common outcomes of traumatic events such as abuse, neglect (including emotional neglect), bullying and other events causing severe and chronic stress. I invite you to call or text me at 816-226-4678 to set up a free 30-minute consultation with me to see what we can do to empower you.