Depression
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Useful Links
What you will find on this page
Introduction
Terminology associated with ACEs
What is an ACE
Take the ace quiz
How do ACEs affect someone
Toxic stress
Aces, Mental health and Prison
What is intergenerational trauma?
What can we do
“Adverse childhood experiences are the main determinant of the health and social well-being of the nation.” (Shaili Jain)
Introduction
We so often hear these phrases “troubled backgrounds” “they had it tough as a kid” “harsh upbringing” and one of my favourites “ he was dragged up", not brought up”. Phrases that are used when describing someone who may be acting recklessly at a young age, someone snared by substance misuse, your local bully who lashes out for no apparent reason or a person you may know who has become entangled in the justice system. But when we use or hear these terms do we understand the full extent to what is commonly referred to as a “difficult childhood”
A child's first years of life, until he/she goes to school, are primarily spent at home where he/she is surrounded by familiar caregivers. Most children are therefore able to form lifelong bonds with their parents and develop strong, healthy attachments. In an ideal world, children would be nurtured, supported, encouraged, and positively reinforced. After leaving home, they will be better prepared to interact with peers, employers, and form healthy relationships. Ideally, this would be the case.
It is likely that some of us have experienced disruption of this process, either through a degree of family dysfunction or an unexpected change like a divorce or a parent's death. Because we had positive buffers such as a supportive relationship with the remaining parent, sibling, aunt or a grandparent we were able to adapt, bounce back, and persevere. “Resilience”
However, for some households, dysfunction, abuse, and neglect are so extreme and relentless that they are traumatic, impacting the health and development of the young children who are exposed to them.
“The greater a child’s terror, and the earlier it is experienced, the harder it becomes to develop a strong and healthy sense of self.”
― Nathaniel Branden, Six Pillars of Self-Esteem
Terminology associated with ACEs
What is an ACE?
An ACE is an “Adverse Childhood Experience” also known as childhood trauma. This term originated from the study created at Kaiser by Dr. Vincent Felitti and Robert Anda of the CDC.
The 10 Adverse Childhood Experiences which appear on the official ACE Questionnaire include:
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Physical Abuse
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Emotional Abuse
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Sexual Abuse
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Physical Neglect
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Emotional Neglect
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Parents divorced or separated
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Domestic Violence
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Parent or caregiver addicted to drugs or alcohol
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Parent or caregiver who is depressed or mentally ill
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Household member ever been in prison
Understanding ourselves as adults often means revisiting our childhoods. The ACE, or adverse childhood experience, test helps you do that. The test asks 10 questions, and at the end will provide you with your score and information on what it may mean for you.
Your answers are confidential.
No identifying information is gathered.
How do ACEs affect children?
ACEs affect a child's brain development and change their body's response to stress. In adulthood, ACEs are associated with chronic health problems, mental illness, and substance abuse.
The study on Adverse Childhood Experiences found a strong link between trauma, adversity, as well as long-term health, mental health, and social consequences. Many studies that have followed since have helped us to understand that trauma has what is known as a ‘dose effect’ – that is, the more trauma and adversity you experience, the more likely you are to suffer consequences.
Study findings from Public Health Wales (2015) found that those who had experienced more than four adverse childhood experiences (which amounted to 14.5% of the population) exhibited the following risk factors in comparison with those who had not had adverse childhood experiences:
• 4x more likely to be high risk drinkers
• 6 x more likely to have had or have caused unintended teenage pregnancy
• 6x more likely to smoke cigarettes or e-cigarettes
• 11x more likely to smoke cannabis
• 14x more likely to have been the victim of violence over the last 12 months
• 15x more likely to have committed violence against others over the last 12 months
• 20x more likely to have been in prison
In addition to the impact on mental health and wellbeing, living through a traumatic event increases the risk of physical health problems (for instance, type II diabetes and heart disease), and also increases the possibility of involvement in the criminal justice system.
Source
Toxic stress
How do ACEs relate to toxic stress?
Jack P. Shonkoff of Harvard University's Center on the Developing Child coined the term toxic stress to describe chronic, excessive stress that exceeds a child's ability to cope, especially in the absence of supportive adult caregiving. The absence of supportive relationships to buffer the effects of a heightened stress response can produce damage and weakening of bodily and brain systems, which can lead to declining physical and mental health throughout an individual's lifespan.
Stressful and adverse experiences over a long period of time can be toxic.
Toxic stress explains how ACEs ”get under the skin” and trigger biological reactions that lead to those outcomes. The National Scientific Council on the Developing Child coined the term “toxic stress” to describe extensive, scientific knowledge about the effects of excessive activation of stress response systems on child development and health. Experiencing ACEs triggers all of these interacting stress response systems. When a child experiences multiple ACEs over time—especially without supportive relationships with adults to provide buffering protection—the experiences will trigger an excessive and long-lasting stress response, which can have a wear-and-tear effect on the body, like revving a car engine for days or weeks at a time.
According to the CDC: ACEs and associated conditions, such as living in under-resourced or racially segregated neighborhoods, frequently moving, and experiencing food insecurity, can cause toxic stress (extended or prolonged stress). Toxic stress and ACEs can change brain development and affect such things as attention, decision-making, learning, and response to stress. This can manifest as emotional and conduct problems in childhood, and risk-taking and criminal behaviours in adulthood. (Levenson et al, 2016)
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Aces, Mental health and Prison
“If you study prison populations as I have, you see a common preponderance of childhood trauma and mental illness. The two go together. So a lot of people are being punished for being mentally ill and they are mentally ill because they were traumatized as kids. So what we have in [prisons] are the most traumatized people in our society.” — Dr. Gabor Mate
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Criminal behavior can be added to the list of negative outcomes associated with high scores on the ACE questionnaire.
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ACEs have been linked to many ‘criminogenic’ risks (factors that increase risk of offending) including substance and alcohol abuse, deprivation, poor educational attainment, and mental health problems. (Centers for Disease Control and Prevention, 2015)
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One-third of all mental disorders worldwide are attributable to exposure to adverse childhood experiences (Green, et al., 2010; Kessler, et al., 2010; McLaughlin, et al., 2012)
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Also research shows that compared to the general population, people in prison are significantly more likely to have experienced adverse events (ACEs) prior to imprisonment which have been linked to the development of mental health issues.
To understand the root causes of why people develop mental health conditions, fall into the snare of crime, substance misuse, and ultimately be convicted and sentenced to prison is key to creating preventive approaches and tailored treatment interventions. A focus on providing frontline workers and professionals working within the criminal justice system with a trauma informed approach is a start, but to decrease the many negative outcomes for survivors of ACEs and reduce criminal recidivism treatment interventions should focus on how early life experiences shape behavior and be more directed at the survivors of trauma. Promotion of adverse childhood experiences and education on the impact these have over the life course is crucial.
What is intergenerational trauma?
Adversity in childhood is related to criminal behavior in adulthood.
Families with dysfunction can bring dysfunction into the lives of their children. We call such a cycle intergenerational trauma. When these children grow up, if their Adverse Childhood Experiences (ACEs) remain unaddressed, they are susceptible to repeating the patterns they learned during their own childhood, and so forth pass down unhealthy traits to their children and so the cycle continues.
What can we do
Become more trauma informed
The majority of individuals seeking treatment in behavioral settings have a history of trauma, but they rarely recognize the significant impact trauma had on their lives; either they do not draw connections between their trauma histories and their presenting problems, or they completely avoid the topic.
“A program, organization, or system that is trauma-informed realizes the widespread impact of trauma and understands potential paths for healing; recognizes the signs and symptoms of trauma in staff, clients, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, practices, and settings.”
(SAMHSA, 2012, p. 4)
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ACE aware programs and literacy courses for people who have experienced the criminal justice system.
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Educate the families/loved ones of those in prison about ACEs and provide trauma informed training. (By just understanding someone has experienced trauma and acknowledging it, that is a step towards being trauma informed)
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Ensure all services connected to those in prisons adopt a trauma informed approach.
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Show more compassion to people with offending backgrounds
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