Adverse childhood experiences (ACEs) are difficult things that sometimes happen to people before the age of 18. ACEs assessments can be a tool for predicting unwanted outcomes later in life and also for preventing poor outcomes. But what do ACEs mean for post-traumatic stress disorder (PTSD)? At Highland Hospital Behavioral Health in Charleston, West Virginia, we are happy to answer your questions about ACEs and PTSD.
Some Background About ACEs
Researchers have been studying ACEs and their impact on people who endure them since 1995. Some examples of ACEs include:
- Abuse: Mental, physical, or sexual
- Neglect: Emotional or Physical
- Untreated parental mental illness or substance misuse
- Witnessing violence such as domestic or in the community
- Loss of a parent or close loved one due to death, incarceration, placement in foster care, or divorce
There are free online assessments people can take to determine their “ACEs Score”. Most people experienced one or more of the adverse experiences included in the ACEs assessment prior to reaching adulthood, but a score of four or more is correlated with many undesired outcomes later in life, which include:
- Addiction
- Lack of physical activity, leading to obesity, diabetes, or heart disease
- Poor school and work engagement
- Risky sexual behavior and increased risk of being sexually trafficked, leading to a higher risk of sexually transmitted infections
- Depression and suicide attempts
- Strokes
- Cancer
- COPD and asthma
Are ACEs the Same as Trauma?
Trauma is different for every person, and two people can survive the exact same event with completely different results. How resilient a person is, the coping skills a person has, how their support system responds, and the overall situation around a difficult experience can all influence whether or not an event is traumatic for the person who endures it. While ACEs can definitely be traumatic, trauma may not always result from a specific event that meets the criteria to be called an adverse childhood experience.
Imagine a scenario with two cousins, whose grandmother recently died. One of the children lived with their grandmother because their parents were not able to care for them. This child watched her die very suddenly and violently, while their cousin, who lives further away, was not present for her death and only saw her a couple of times per year before her passing. The first cousin ends up in foster care, as a result of their caregiver dying, while the other child remains with their parents, who have a healthy marriage, stable jobs, safe housing, and consistent income. Both children experience loss and miss their grandmother, but there are differences in how the event impacted their lives. It is more likely that the child who lived with their grandmother, witnessed her passing, and then lost the ability to remain with family, would have a traumatic experience from her death.
Do ACEs Cause PTSD?
This is a complicated question. Saying that ACEs cause PTSD isn’t fully clear or accurate because:
- Some people who experience ACEs do find them traumatic
- Some people also navigate ACEs without experiencing trauma
- People can experience trauma without developing PTSD, which is a clinical diagnosis that has a specific set of symptoms
- Some people also experience trauma later in life, which leads them to develop PTSD
Preventing PTSD from ACEs
Recognizing that ACEs can contribute to PTSD can help us to take steps that prevent the risk of a person developing PTSD. These include:
- Assessing young people for ACEs and educating parents about ACEs
- Providing family, community, and professional support for young people who have had an adverse experience
- Teaching young people skills that will make them more resilient
- Implementing trauma-informed practices in schools, medical settings, social services, mental health, and public policy
- Taking steps to reduce the number of ACEs a young person will endure by addressing domestic violence, childhood maltreatment, violence in communities, parental mental and chemical health, childhood poverty, and disproportionate incarceration of minorities.
- Recognizing that high ACEs scores can also increase the risk of PTSD developing when a young person experiences trauma later in life
At Highland Hospital Behavioral Health, we treat children, adolescents, and adults with serious behavioral health needs that require a high level of care. Many of the patients we serve have experienced a large number of ACEs and/or traumatic events in their lives. We offer trauma-informed services in our state-of-the-art facilities in Charleston, West Virginia.
