Childhood Trauma: The ACE Study Overview

Adverse childhood experiences (ACE) can have a wretchedly direct relationship to lifelong troubles inadulthood, troubles that can be best fixed in childhood.

That's one of the result of the ACE study,according to one of its principal investigators, Vincent Felitti, MD, professor at UC San Diego.From a sample of over seventeen thousand adults, the ACE study team asked about the prevalence of tentraumatic childhood events in three categories: abuse, neglect, and household dysfunction. Specificexperiences includes loss of a parent, physical abuse, and mental abuse.

Each of the ten events was weighed equally, and patients were studied based on how many of the tenevents they experienced as children, and what their lives have been since then. Only one third ofadults reported no adverse events.

Of the people with at least one ACE, a whopping 87% of them had at least one addition ACE. A seriesof similar graphs showed that the more ACEs a person underwent, the more likely they were to be, say,an acknowledged adult alcoholic or a pack-a-day smoker. For IV drug use, the statistics were notincremental but exponential.

Adults who suffered ACEs had a higher risk of COPD, and a greater risk of heart disease, althoughsmoking of course may play a role in such a figure. Rape figures increased with ACEs, as didsuicides. "Every internist is seeing two or maybe three of these people every day," Dr. Felitti said.

What can pediatricians do? Dr. Felitti suggested a thorough questionnaire of the child's and theparents' past history of ACEs. If the patient or family did have an ACE, ask how it affected themlater in life. This does not open Pandora's box, he said, though he added that "the answers are oftenremarkably brief."

It may be necessary to ask unconventional questions for certain people - have they been in awar zone, have they been kidnapped, or tortured, or have they had a nervous breakdown. Dealing withsuch issues early can prevent a lifetime of problems. More information on this is available at www.acestudy.org.