What Are Adverse Childhood Experiences (ACEs)?
ACEs are negative or traumatic experiences that happen during childhood, usually defined as before the age of 18. Unfortunately, these events are common. A 2019 study by the Centers for Disease Control and Prevention (CDC) found that over 60% of adults surveyed reported experiencing at least one ACE. The study also showed that ACEs are associated with negative mental and physical health consequences—a finding long substantiated by research. Below, we explore examples of ACEs and their impacts, plus how to heal from childhood trauma.
What are the most common causes of adverse childhood experiences?
ACEs can happen at home or in a community, and they often co-occur, meaning a child may experience multiple ACEs simultaneously, increasing the risk of negative outcomes later in life. Some of the most common causes of ACEs include:
Child abuse, including emotional, verbal, sexual, or physical abuse
Neglect, including a lack of emotional support or physical needs not being met
Loss of a parent or primary caregiver due to death, divorce, or incarceration
Witnessing violence inside or outside the home
Growing up in a home with people struggling with substance abuse and/or mental health conditions
Other forms of toxic stress or adversity faced during childhood in the home or community
Who is at risk of having an adverse childhood experience?
ACEs can affect any child, regardless of their background. However, the CDC found that the historical, social, and economic inequities that some families face can elevate the risks of a child experiencing ACEs. While growing up in a household with violence, substance use issues, or mental health problems is still linked with ACEs, the CDC finding suggests that interventions on a systemic level are among the most effective in preventing ACEs.
Adverse childhood experiences and negative health outcomes
Research consistently shows that children who have a history of ACEs are more likely to have problems into adulthood. In other words, childhood trauma can take a toll on well-being, leading to negative physical and mental health outcomes. Below are some of the key health consequences associated with ACEs.
Mental health conditions
Behavioral health issues
Physical health issues
Life opportunities
Mental health conditions
ACEs are strongly linked to mental health conditions, including depression, anxiety, and post-traumatic stress disorder (PTSD). For example, one national study of nearly 35,000 Americans ages 20 and older found that adults who faced childhood adversity have higher chances of experiencing mood, anxiety, and personality disorders. Also, the more types of ACEs someone has experienced, the higher the likelihood of personality disorders and somewhat higher chances of anxiety disorders, the study found.
Behavioral health issues
Engaging in risky behaviors, like sexual risk-taking and problematic drug and alcohol use, is linked with ACEs, research shows. An analysis of nearly 40 studies on ACEs found that adults who faced childhood adversity (especially those who experienced multiple ACEs) were at risk of adverse outcomes such as drug use, strong sexual risk-taking, and violence against themselves and others.
Physical health issues
That same study found that people with multiple ACEs are at a higher risk for physical health conditions, including cancer, heart disease, and respiratory diseases. These findings substantiated existing research that ACEs can negatively affect people’s well-being, including their physical health.
Life opportunities
ACEs may negatively impact adult life, including education, work, and income. A study analyzing data from across the United States found that those exposed to ACEs were more likely not to finish high school, be unemployed, and live in poverty.
How are adverse childhood experiences treated?
Although ACEs can have serious consequences, with proper treatment and intervention, adverse health outcomes are not inevitable. Research and public health fields have long emphasized that ACEs are preventable. In other words, one of the best ways to treat the adverse effects of ACEs is by preventing them altogether.
For those children and adults who have endured ACEs, psychosocial interventions, like therapy, have proven to be an effective form of treatment. An analysis of 99 studies on ACE treatment found that cognitive behavioral therapy (CBT) demonstrates the strongest evidence in improving mental health and reducing health-risk behaviors. Expressive writing and mindfulness-based therapies also show promise, according to the analysis.
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