Adverse Childhood Experiences (ACEs)

Childhood trauma can lead to physical and mental health issues later in life

Traumatic events that occur during childhood can lead to physical and mental health problems later in life.

These adverse childhood events, or ACEs, can create toxic stress to the growing brain and immune system. This leads to a number of health issues, such as mood and anxiety disorders, addiction, obesity, poor dental health, cardiovascular disease, depression and even cancer.

When people experience unaddressed trauma and neglect during childhood, their immune systems are affected in a way that leads to poor health outcomes in adulthood.

Stress during childhood can be divided into three groups:

  • Positive stress, which is a normal and important stress in the body, often caused by an upcoming test or sports competition
  • Tolerable stress, which is more severe or longer lasting—such as a death in the family—during which the child is supported by loving caregivers
  • Toxic stress, which describes highly stressful situations like abuse, neglect or untreated mental illness, during which a child experiences in the absence of supportive caregiver

Your brain is very sensitive when it comes to experiences. Toxic stress from negative experiences and environments can be just as unhealthy and damaging to the brain as genetic disorders or exposure to toxins. If you were exposed to repeated toxic stress as a child, you can’t develop all the chemical connections in the brain that help you form healthy and stable relationships throughout life.

Your brain develops unhealthy chemical reactions because your fight-or-flight stress responses are regularly activated. You may lack the protection of a safe space.

Unless the cycle is broken, many children impacted by ACEs repeat the same traumatic habits when they raise their own children.

ACEs are seen across all groups of people. According to the Centers for Disease Control and Prevention (CDC), 61% of adults surveyed across 25 states reported they had experienced at least one type of ACE. Nearly one in six reported four or more.

Understanding Adverse Childhood Events (ACEs)

When people experience unaddressed trauma and neglect during childhood, their immune systems are affected in a way that leads to poor health outcomes in adulthood.

Stress during childhood can be divided into three groups:

  • Positive stress, which is a normal and important stress in the body, often caused by an upcoming test or sports competition
  • Tolerable stress, which is more severe or longer lasting—such as a death in the family—during which the child is supported by loving caregivers
  • Toxic stress, which describes highly stressful situations like abuse, neglect or untreated mental illness, during which a child experiences in the absence of supportive caregiver

Your brain is very sensitive when it comes to experiences. Toxic stress from negative experiences and environments can be just as unhealthy and damaging to the brain as genetic disorders or exposure to toxins. If you were exposed to repeated toxic stress as a child, you can’t develop all the chemical connections in the brain that help you form healthy and stable relationships throughout life.

Your brain develops unhealthy chemical reactions because your fight-or-flight stress responses are regularly activated. You may lack the protection of a safe space.

Unless the cycle is broken, many children impacted by ACEs repeat the same traumatic habits when they raise their own children.

ACEs are seen across all groups of people. According to the Centers for Disease Control and Prevention (CDC), 61% of adults surveyed across 25 states reported they had experienced at least one type of ACE. Nearly one in six reported four or more.

Poor health from adverse childhood events can take many forms. Adult patients dealing with addiction, mental health challenges or chronic illness may uncover ACEs during a conversation with a primary care doctor or psychiatrist.

ACE-Q Questionnaire

To determine a patient’s exposure to adverse events during childhood, a doctor may ask questions using an ACE-Q questionnaire. Many adults experience one to three ACEs growing up. However, the accumulation of additional traumas can worsen the damage to a person’s well-being.

When compared with people who report zero ACEs, people with a score of four or more face these increased health risks:

  • 7 times as likely to develop alcohol use disorder
  • 2 times as likely to develop cancer
  • 4 times as likely to develop emphysema
  • 1.6 times as likely to develop diabetes

How are Adverse Childhood Experiences (ACEs) Diagnosed?

Poor health from adverse childhood events can take many forms. Adult patients dealing with addiction, mental health challenges or chronic illness may uncover ACEs during a conversation with a primary care doctor or psychiatrist.

ACE-Q Questionnaire

To determine a patient’s exposure to adverse events during childhood, a doctor may ask questions using an ACE-Q questionnaire. Many adults experience one to three ACEs growing up. However, the accumulation of additional traumas can worsen the damage to a person’s well-being.

When compared with people who report zero ACEs, people with a score of four or more face these increased health risks:

  • 7 times as likely to develop alcohol use disorder
  • 2 times as likely to develop cancer
  • 4 times as likely to develop emphysema
  • 1.6 times as likely to develop diabetes

The buildup of ongoing trauma can cause a number of physical and mental health conditions for adults. Treating these issues begins with identifying the childhood adversity and then healing trauma through a multi-step approach.

The first step of treatment is to remove the trigger of the adverse events. The second step is an intervention that includes both mental healthcare and addiction services. Ideally, this full range of care will be coordinated among the patient’s healthcare providers, such as primary care doctors, obstetricians, psychiatrists and addiction specialists.

While the developing brain is very susceptible to stress, it’s also open to receiving healing. Our team of experts at IU Health use trauma-informed therapy to begin treatments that are effective in increasing connectedness to help heal the brain. By helping you move past toxic stress responses, we can guide patients to safer mental spaces that rely less on fight-or-flight reactions.

Treatment

The buildup of ongoing trauma can cause a number of physical and mental health conditions for adults. Treating these issues begins with identifying the childhood adversity and then healing trauma through a multi-step approach.

The first step of treatment is to remove the trigger of the adverse events. The second step is an intervention that includes both mental healthcare and addiction services. Ideally, this full range of care will be coordinated among the patient’s healthcare providers, such as primary care doctors, obstetricians, psychiatrists and addiction specialists.

While the developing brain is very susceptible to stress, it’s also open to receiving healing. Our team of experts at IU Health use trauma-informed therapy to begin treatments that are effective in increasing connectedness to help heal the brain. By helping you move past toxic stress responses, we can guide patients to safer mental spaces that rely less on fight-or-flight reactions.

As an academic health center, IU Health is actively involved in research studying the biological effects and successful preventions for ACEs.

These developments help caregivers to better understand challenges facing our patients of all ages. The work has included specific research on the genetics of mental illness and the potency of environmental effects of early exposure to abuse and neglect, as well as studies to identify traits among young children that may predict future addiction.

Research

As an academic health center, IU Health is actively involved in research studying the biological effects and successful preventions for ACEs.

These developments help caregivers to better understand challenges facing our patients of all ages. The work has included specific research on the genetics of mental illness and the potency of environmental effects of early exposure to abuse and neglect, as well as studies to identify traits among young children that may predict future addiction.

The CDC estimates that 1.9 million cases of heart disease and 21 million cases of depression potentially could have been avoided by preventing ACEs. IU Health recognizes the role toxic stress plays in children and adults and takes a systematic approach to improve access and quality of services.

Some ways to prevent and treat toxic stress go beyond conventional medicine. This is why IU Health uses social workers, integrated mental health professionals and care coordinators to help patients and families navigate treatment.

Providers at IU Health are encouraged to provide extended hours to help these individuals get the high-quality care they need.

Why IU Health for ACEs Care

The CDC estimates that 1.9 million cases of heart disease and 21 million cases of depression potentially could have been avoided by preventing ACEs. IU Health recognizes the role toxic stress plays in children and adults and takes a systematic approach to improve access and quality of services.

Some ways to prevent and treat toxic stress go beyond conventional medicine. This is why IU Health uses social workers, integrated mental health professionals and care coordinators to help patients and families navigate treatment.

Providers at IU Health are encouraged to provide extended hours to help these individuals get the high-quality care they need.

Patient Stories for Adverse Childhood Experiences (ACEs)