While I was in a pain rehabilitation hospital for my fibromyalgia, my provider had me take an assessment called the Adverse Childhood Experiences (ACEs) Questionnaire, which consists of 10 questions relating to childhood traumatic events prior to your 18th birthday. This was my first time ever hearing about ACEs; with a personal score of 10, I decided to do some investigating.
Adverse Childhood Experiences Study
The Adverse Childhood Experiences Study, conducted by the Centers for Disease Control (CDC) and Kaiser Permanente in the late 1990s, involved 17,000 Kaiser patients. The questionnaire was completed by these patients and compared against their medical histories and research.
The results of the study were crystal clear. ACES can have long lasting effects on health outcomes, including well-being; social, emotional, and cognitive function; development of disease and disability, such as fibromyalgia; and mental and physical health. ACEs can even result in early death. In turn, these outcomes can have negative effects on education and employment (1).
One of my resources from rehab was How Childhood Trauma Affects Health Across a Lifetime |Nadine Burke Harris | TED on YouTube. I remember sitting down on my couch, stunned and shocked after watching the TED Talk. Notably, Nadine Burke Harris shared that “the CDC and Kaiser Permanente discovered an exposure that dramatically increased the risk for 7 out of 10 of the leading causes of death in the United States.”
Examples of ACEs
Many different kinds of childhood traumas can be ACES. ACEs include the following:
- Physical and emotional abuse
- Neglect or abandonment
- Losing a family member to suicide or having a family member attempt suicide
- Substance abuse or alcoholism in the household
- Mental health problems in the household
- Household members being in jail or prison
- Witnessing violence in your home or community
- Not having enough food to eat
- Unstable housing or homelessness
- Experiencing discrimination
What’s Your Score?
Don’t fret: ACEs are common. Several distinct racial and ethnic minority groups are at a heightened risk for having four or more ACEs. But they can have lasting effects on your health, behavior, and life potential, so knowing your score is crucial. Here are the questionnaires for adults, teens, and children; these assessments are also available in Spanish on the website. Every question answered “yes” equals one point. The higher your ACEs score, the higher your risk of health, social, and economic problems. The most common resulting diagnosis in adulthood is Complex-PTSD.
You Can Counter the Effects of Your ACEs
You can reduce the long-term effects of your ACEs through the following avenues:
Primary Care: Primary care providers can screen you for ACEs, make referrals to intervention services, and assess risk of ACES for children. Assessments for adults can identify ACEs for better treatment outcomes.
Victim-Centered Services: Those affected by violence can tap into a number of resources, such as hotlines and crisis intervention, advocacy, and housing services. Services for children include recreation, education, emotional support, and material aid.
Holistic Mitigation: People with ACEs can take advantage of a number of programs, such as parent training, childcare, children’s services, medical and nutrition services, education, employment assistance, and aftercare. Many of these programs can be administered in residential or outpatient facilities.
Treatment for Mental Health and Substance Use Disorders: Combining treatments such as medication-assisted therapy and trauma-focused cognitive behavioral therapy can improve the symptoms of substance use disorders, post-traumatic stress disorder, and depression and help resolve behavioral problems (2). Cognitive behavioral intervention for trauma in schools may help children with limited access to treatment.
Crime and Violence-Centered Care: Effective treatments like multi-systemic therapy (MST) have shown that both long- and short-term care can help reduce the effects of ACEs and help strengthen protective factors (2). MST has numerous advantageous effects on various aspects, including family dynamics, parental approaches, juvenile substance abuse, social interactions with peers, academic achievements, psychological well-being, and prevention of gang participation and sibling delinquency.
Integrated Programs: These comprehensive programs enhance the development of children and promote positive emotional and behavioral functioning (2). Additional advantages consist of improved maternal psychological well-being, enhanced birth results, strengthened parent-child bonding, and favorable parenting practices.
Reducing ACEs for Everyone
Do what you can to educate youth and adults about ACEs to improve their outcomes. Be a cushion against ACES, connect to positive activities, build resources for schools, and address difficulties at home and negative influences (CDC, 2019).
“1 in 6 adults experienced four or more types of ACEs.” — Centers for Disease Control
“Preventing ACEs could reduce the number of adults with depression by as much as 44%.” — Centers for Disease Control
References
- CDC Adverse Childhood Experiences (ACEs), National Center for Injury Prevention and Control, Division of Violence Prevention, June 29,2023.
- Adverse Childhood Experiences Prevention Resource for Action Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, 2019.
- CDC Vital Signs Adverse Childhood Experiences (ACEs) Preventing Early Trauma to Improve Adult Health, Centers for Disease Control and Prevention, November 5, 2019.
- What are Adverse Childhood Experiences (ACEs) Very-well Mind, Wendy Wisner, February 24,2022.
- How Childhood Trauma Affects Health Across a Lifetime | Nadine Burke Harris | TED, TED, February 17, 2015.
- Aces Aware Screen. Treat. Heal. ACE Fundamentals Screening Tools For children and Adolescents and Adults May 5, 2020
Gabrielle (Gabby) Mancha is currently enrolled in the Nickerson Institute’s Integrative Health Coaching Program and plans to graduate in April 2024. Gabby has worked as an Assistant in the insurance and finance industry for the past 8 years. After losing her best friend, who also suffered from fibromyalgia, to suicide in 2023, she set out to help others on their own journey to healing.
Along the way, Gabby became a Twitch streamer to meet others who struggled with their own mental and physical health, and she has created her own community around mental health and gaming. Gabby will continue to help others in her mental health coaching practice.
