By Lester Long: Written June 5, 2022
ACE: An Overview
One of the most horrific and traumatic events that an individual can endure in our society is Adverse Childhood Experiences (ACE). ACE includes such things as emotional and psychological abuse or neglect, physical abuse, sexual abuse, verbal abuse or neglect, and exposer to violence and domestic abuse or neglect. Individuals who have experienced Adverse Childhood Experiences (A.C.E.) endured a stressor and/or trauma that has a significant impact on their lives. Many of these traumas and/or stressors may take a lifetime to address in a healthy manner or overcome. Unfortunately, some never, or only partially overcome these challenges. These challenges, while being endured, often leaves an impact on the way ACE individuals believe and respond to life situations related to events in the future. Many of these individuals become angry, non-trusting, paranoid, fearful, depressed, anxious, and resentful. Their belief system often takes on a different more cynical view of the world. All these issues affect such things as impulse control and decision making. James (2022) points out that many of the social problems that may develop from the impact of ACE is a heighten sensitive to stress during decisions making as well as issues with impulse control. Research also demonstrates that early relationships and attachment style carries over into adulthood.
In addition to the above issues, the effects of ACE causes changes in the brain and brain chemicals. These changes may also affect physical and biological changes. The Center on the Developing Child (2022) of Harvard University explains that ACE has an affect on both the body and the brain. They point out that the excesses of “toxic stress” on the brain causes long lasting effects. They go on to posit that this toxic stress affects, not only the child’s developing brain but their “immune system, metabolic system, and cardiovascular system” (p.1). These issues and others affect the quality and quantity of life as Individuals who experiences ACE. Research shows that it tends to shorten their lifespan. The Center on the Developing Child (2022) also explains that the more a child experiences ACE, the greater the possibility that he or she will have poor academic achievement and issues with substance abuse. Children often develop conduct disorder and experience situations related to problems with the law. As adults, there tends to be issues with anti-social behaviors and their behaviors are often can be classified as demonstrating borderline personality disorder. The implications of these behaviors are often the results of the toxic stress.
ACE: The Continual Implications
Many children who have experiences ACE grew up in a household where substance abuse and mental illness was evident. As a result, and in addition to the resulting stress, many of these children often see this as normal behaviors and mimic them as both children and adults. This is the most difficult aspect that must be overcome: ACE children being able to understand that anti-social behaviors and mental health dysfunctions are not normal and acceptable ways of society. The Center for Disease Control and Prevention (2019) explains that many individuals with ACE grow up in families with both mental health and substance use disorders and as a result they themselves have these issues in adulthood.
One of the major mental health illnesses that contribute to both poor mental health outcome and substance use is depression. Not only does depression contribute to a life struggle with self-esteem, self-worth, self-confidence, and self-efficacy but all these can be contributed to one’s approach to substance use. Often individuals that have experienced ACE spend a lifetime wrestling with depression. This battle is one of the leading causes of both the high morbidity and mortality rates among these individuals. The National Center for Biotechnology Information (2017) point out that depression is a large contributor to both chronic illnesses and shorter lifespans for persons who have experienced adversity in childhood. It points out that 11.4 % of Americans ages 12 to 17 and 6.6 of adults eighteen and older have reported major depressive episodes. These issues become even greater issues if there is no intervention.
ACE and Interventions
One of the most important ways to counteract the effects of ACE is the implementation of interventions. The most preferred would-be prevention. Preventing ACE that a child experience would go a long way helping to reduce the ill effects that it has on individuals and society. Unfortunately getting to parents and guardians in the early upbringings of a child is not always possible or even probable. However, once these issues are identified in childhood or an adult finding the right therapeutic approach is especially important in preventing further damage. One of the most advocated forms of intervention is Trauma Informed Care. This is a process that requires professions to recognize that certain forms of treatment and processes may trigger negative responses on the part of the patient or client and that certain steps are necessary to counteract the effects of ACE. Cognitive Behavioral Therapy has had good success in treating patience with ACE but only if implemented as a Trauma-Focus process. Factsheet (2018) explain that “Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based treatment approach shown to helping children, adolescents, and their parents (or other caregivers1) overcome trauma-related difficulties. It is designed to reduce negative emotional and behavioral responses following trauma, including child sexual abuse and other maltreatment” (p.1). Factsheet (2018) goes on to explain that the value of this kind of treatment is that it addresses distorted beliefs about the traumatic events as well as false attributions. This treatment endorses a supportive and nurturing environment for children and to teach them skills that further help them with triggers that may cause depression and anxiety. When it comes to the non-abusive parents, TB-Cognitive Behavioral Therapy helps them understand the effects of the trauma on their children and teaches them skills that provide support. TB-Cognitive Behavioral Therapy has proven to be an extremely effective method to help those affected by ACE and has shown that those who want to meet their challenges can develop resilience and not let their past dictate their future.
Resilience and Post-Traumatic Growth
Resilience is defined as the ability to bounce back after traumatic and toxic stressful event. Some children that experience ACE without a doubt experience unbelievable stressors at times. These experiences cause, as mentioned above, a great deal of pain and suffering for the victims. So, for one to overcome and meet these challenges requires a great deal of resiliency. Have resilience requires a person to accept the situation with the ability to restructure their perspective. They must believe that despite the experience there can be a brighter more hopeful time. Collier (2018) however explains that there are those on the other hand, that have a tough time bouncing back. In some cases, traumatic event challenges his or her core beliefs and as a result they endure psychological struggles but eventually find personal growth. This is known as Post-Traumatic Growth (PTG). This differs from resilience in that a person who is resilient, when trauma occurs, isn’t severely affect to their core by the event and doesn’t have to seek a “new belief system” (p.1). Tedeschi and Calhoun (2004) point out that someone with who experiences post-traumatic growth must develop a new belief system and learn how to do the following:
- Learn to have an Appreciate of life
- Develop more positive relationships with others
- See that there are new possibilities in life
- Develop Personal Strength
- Make a Spiritual Change
As to how many individuals experience (PTG), It is estimated that one-half to two-thirds that experience ACE experience PTG.
This paper has shown that many individuals who have endured ACE can recovery if the right therapeutic process is applied. It has shown that despite the often-hopeless state that many people feel, through a process of Post-Traumatic Growth, they can gander the strength necessary to overcome their challenges. ACE treated with Trauma Informed Care can reduce the long term affects and help individuals recover. The National Center for Biotechnology Information (2019) explains that this is the most effective way to assist those affected by ACE to feel safe and secure in their environment. They go on to point out that “Trauma-informed practices, including services, programs, organizations, or systems that take in to account the following which has referred to as the “4Rs 1) a realization that trauma has a significant impact on the person but that there are multiple pathways to recovery; 2) a recognition that trauma may result in signs and symptoms of significant disruption; 3) a comprehensive and integrative response to the person exposed to trauma; and 4) minimizing the likelihood of re-traumatization” (p.1). These are the keys to helping those still suffering from ACE.
Collier, L. (2018) Growth After Trauma: Why Are Some People More Resilient Than Others-and Can It Be Taught. Retrieved June 5, 2022, from https://www.apa.org
Factsheet (2018), Trauma-Focused Cognitive Behavioral Therapy: A Primer for Child Welfare Professionals. Retrieved June 5, 2022, from https://www.childwelfare.gov
James, A. (2022), 4 Ways that Adverse Childhood Experiences Affect Adults. Retrieved June 5, 2022, from https://www.betterhelp.com
The Center for Disease Control and Prevention (2019), Adult Childhood Experiences: Preventing Early Trauma to Improve Adulthood. Retrieved June 5, 2022, from https://www.cdc.gov
The Center for Biotechnology Information (2017), Unpacking the Impact of Adverse Childhood Experiences on Adult Mental Health. Journal on Child Abuse Neglect (69): pp.10- 19.
The Center for Biotechnology Information (2019), A Community’s Response to Adverse Childhood Experiences (ACEs): Building a Resilient, Trauma-Informed Community.
Am J Community Psychol. 4(3-4): 451–466.
The Center on the Developing Child (2022), ACE’s and Toxic Stress: Frequently Asked Questions. Retrieved June 5, 2022, from https://developingchild.harvard.edu
Tedeschi, R. and Calhoun, L. (2004) Post-Traumatic Growth: Conceptual foundations and Empirical Review. Retrieved June 5, 2022, from https://www.jstor.org