The ACE study


The ACE study originated in the US between 1995 and 1997 to demonstrate the relationship between adverse childhood experiences and obesity. 286 individuals from an obesity clinic took part in the survey and initial results showed a pattern between weight gain and depression, anxiety and fear. This resulted in  further studies which focused on childhood traumatic experiences. Researchers studied over 17000 patient volunteers of which 1/2 were female, 74% Caucasian with an average age of 57. 75% of participants attended college and every participant had good jobs and healthcare and were members of the kaiser health maintenance organisation.

During the study participants were asked about experiences they had during childhood and adverse childhood experiences were listed as; physical abuse sexual abuse emotional abuse physical neglect, emotional neglect, exposed to domestic violence, household substance abuse, household mental illness, parental separation or divorce, incarcerated household member.

The study looked into how frequent these experiences where are and found common ACE's which come together. 40% of the sample reported more than 1 adverse childhood experience. Remember, the sample was compromised of participants from similar cultures and economic backgrounds.

As best study was completed over time , researchers began to identify that a cumulative ACE score, a score involving one or more ACE's, had a relationship to social, behavioral and health issues.

Research found 80% of individuals who reported experiencing one ACE experienced at least one additional ACE.

The adverse childhood experience study also showed that there was a positive correlation between number of ACE's and the number of risky behaviours undertaken such as poor health choices, promiscuity and drug abuse or addictive behaviours.

Startling results were found; individuals with an ACE score of 4 or higher had a 700% increase chance of developing alcoholism and a 3000 percent increase in attempted suicide. Concluding that poor parenting and family dysfunction in children  contributes strongly to health problems which can occur decades later. 

Having been completed within a specific population within the US, it was implied that this would reflect similarly worldwide. However, theorists in trauma argue that it's simplicity causes major issues with regards to cultural and economic backgrounds. Professor Van Der Kolk and Gabor both agree that retesting a larger and differing population could yield different results which would undoubtedly have implications for current trauma research.

The study itself however was a catalyst in the production of numerous articles which investigated the prevalence of adverse childhood experiences and consequences for individual health. The original study was used to develop a 10 point screening system which can aid professionals in obtaining an idea of an individual's childhood experience and how it relates to their current health.

Further testing show higher ACE's being present in urban areas and this prompted validation testing as well as worldwide surveys of adverse childhood experiences.

Recently, ACE's are said to change the development of neuroendocrine systems (Teicher and Martin, 2014) which has a long term effect on your body. The high and constant level of cortisol found in individuals who also had cumulative ACE's leads to the body compromising its immune system. 
This toxic stress includes cortisol and adrenaline production at higher levels: causing chronic wear and tear on the body, leading to disease and illness in future adult life. Understanding this from a chemical perspective could aid professionals when diagnosing possible illnesses and during the prescription process. From personal experience, due to the high cortisol and adrenaline levels; it is not helpful to prescribe me a type of antidepressant that creates noradrenaline (SNRI). I found this out the hard way through unsupportive of doctors and an NHS system which was not fit for purpose.

It was not until 2011 that adverse childhood experiences were recognised in some US health systems and from this we have seen more awareness of the ACE study although it is still relatively not known.

Knowledge of the ACE study would make therapy more trauma informed and would also give patients some understanding of how their childhood experiences currently effect them. It would change the way health and social services screen children and young people - identifying early any possible ACE's and have the ability to put steps in place to prevent future ACE's occurring. This could be groundbreaking for schools, nurseries and child health.

In it's entirety, the study was criticized because the data that it produced did not necessarily equate to early death - so many incidences can happen in adulthood that are never accounted for in this study.

It's not possible to gather 50 children and purposely neglect half and then study the group under lab conditions for 30 years. UK ethics would not approve... 

Of course, the ACE study produced a concept that is worthy of further experimentation but as a society we need to tread carefully on overly relying on a study that is not inclusive of the wider population. At an individual level, it can remove the sense of personal responsibility for your current maladaptive behaviour. 

If you want to get your ACE score you can do so from here;

The ACE score is no way diagnostic, if you have been affected by this post please message a member of the admin team. The ACE score is only there to help you identify the areas which you may have been affected, if you feel like you have been further affected or if this has brought up things that you did not realise please contact your GP or therapy team. 

Much love