ACEs high… and resilience low
The Adverse Childhood Events (ACE) Study began life in 1985 in an obesity clinic in California. Concerned about their weight loss programme’s high drop-out rate, Dr Vincent Felitti noticed the curious fact that that the patients who were dropping out were the ones who were successfully losing weight.
Following up with the former participants, Felitti discovered that the majority had experienced sexual abuse in childhood. He speculated that obesity might, for some people, serve as an unconscious defence formed in childhood in response to difficult circumstances.
Felitti and colleague Robert Anda subsequently established the ACE Study, which reviewed the case histories of more than 17,000 adult patients, asking about their experience of ten different kinds of abuse and adversity. They found a strong correlation between the number of types of childhood trauma a person had suffered, and the incidence in adulthood of many serious physical and mental health problems.
For example, someone with an ACE score of four or higher was found to be
240% more likely to contract hepatitis than someone with a score of 0
260% more likely to have chronic obstructive pulmonary disease
460% more likely to experience depression and
1,220% more likely to attempt suicide.
The idea that exposure to difficult experiences in childhood might lead to health problems is not surprising. It seems intuitive that a child might self-soothe with drugs or food, become dependent or obese, and suffer poor health as a result. But the ACE research uncovers a different kind of connection – a response to stress that is biological rather than purely behavioural, and which can cause serious illness, and is a stronger predictor of coronary heart disease than high blood pressure, high cholesterol, and even smoking.
The 2016 documentary ‘Resilience’ explores the impact of ACEs on people’s lives, and how these findings are being used in the US to support trauma informed interventions to help young people manage difficult life circumstances better, and get their lives back on track. You can see a trailer for the film here, and you might also be interested in paediatrician Nadine Burke Harris’s TED talk on the effects of repeated stress on children’s emotional, cognitive and physical development.