The Lifelong Reach of Adverse Childhood Experiences

SAN FRANCISCO—Adverse Childhood Experiences (ACEs) can have a profound effect across the lifetime, and higher numbers of adverse experiences are correlated with larger effects later in life, Elevate by Psych Congress 2017 attendees learned.

ACEs include physical, emotional, and sexual abuse, living with an alcohol or drug abuser, domestic violence, and emotional and physical neglect.

In his presentation titled “Childhood Trauma and Its Effect Across the Lifetime,” Eric C. Arauz, MLER, President, Trauma Institute of New Jersey, presented data showing that ACEs increase the prevalence of heart disease risk factors, the rate of antidepressant usage, and the likelihood of suicide and intravenous drug use. In each case, the effect size rose along with the number of ACEs.

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Having 4 or more ACEs makes a person 4.6 times more likely to have depression, 7.4 times more likely to have alcohol use disorder, 10.3 times to use drugs intravenously, and 12.2 times more likely to attempt suicide, according to research Arauz presented.

ACEs are also correlated with physical illnesses such as hepatitis, sexually transmitted infections, and chronic obstructive pulmonary disease (COPD). Having 6 or more ACES lowers life expectancy by 20 years, Arauz said.

Arauz, who is also Adjunct Faculty Instructor, Department of Psychiatry, Rutgers University, Robert Wood Johnson Medical School, New Brunswick, New Jersey, said it is important that mental health clinicians know which ACEs their patients had. Oftentimes, patients are not asked about them, even if they had a high number of ACEs, he said.

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Arauz recommended that clinicians use the ACE Questionnaire with their patients. The questionnaire, which Arauz describes as a measurement of a patient’s visceral reactivity, tallies the number of ACES a person had, from 0 to 10.

“This is the type of thing you can bring into your practice almost immediately” to aid in making diagnoses and formulating treatment plans, he said.

—Terri Airov

References

“Childhood Trauma and Its Effect Across the Lifetime.” Presented at Elevate by Psych Congress 2017; March 5, 2017; San Francisco, CA.