TL;DR:
Medically reviewed by Steven Storage, MD, Amen Clinics.
Many adults struggle with anxiety, depression, or substance use without fully understanding why. If this sounds familiar, your past may hold important clues. A growing body of research is helping answer a powerful question: can childhood trauma be seen on a brain scan?
At Amen Clinics, a large study of adult patients found that higher levels of adverse childhood experiences (ACEs), such as abuse, neglect, or household dysfunction, were linked to clear, measurable patterns in brain function on SPECT imaging. These brain changes were also associated with a greater likelihood of conditions like anxiety, depression, and substance use disorders.
In this article, you’ll learn what ACEs are, what brain SPECT scans reveal about the lasting impact of childhood trauma, and why these findings offer new hope for healing and personalized treatment.
Having a high number of adverse childhood experiences (ACEs) increases your risk for mental health issues. Although your past may help explain your struggles, it doesn’t have to limit your future.
Adverse childhood experiences (ACEs) are potentially traumatic events that occur before the age of 18. These early experiences can shape how your brain develops, how you respond to stress, and how you relate to others later in life.
Understanding ACEs is an important first step in recognizing how your past may still be influencing your present, and how healing is possible.
Related: The Long-Term Impact of Adverse Childhood Experiences
ACEs generally fall into three main categories: abuse, neglect, and household challenges.
These experiences don’t just affect emotions in the moment. They can influence how the brain develops and functions over time.
Researchers often measure ACEs using a simple score based on how many of these experiences a person has had. The higher your ACE score, the greater the potential impact on your long-term health.
Decades of research, including the latest findings from Amen Clinics, show that higher ACE scores are associated with increased rates of mental health conditions like anxiety, depression, and substance use disorders.
One study on twins found that individuals who were exposed to more ACEs had a higher risk of mental disorders compared with their twin who had lower ACE scores.
Studies show that higher ACE scores are also linked to a higher risk of physical health problems, from heart disease to chronic inflammation.
The new research builds on this foundation by showing that these early experiences are not just psychological, but they are also reflected in measurable patterns of brain function.
It’s important to be clear: ACEs increase risk, but they do not determine your destiny.
Even though the study found strong associations between higher ACE scores, brain changes, and mental health challenges, these findings are not a life sentence. Your brain has the ability to change and heal. This concept is known as neuroplasticity.
With the right support, targeted treatment, and brain-healthy habits, you can improve how your brain functions and how you feel. Your past may help explain your struggles, but it doesn’t have to limit your future.
Video: Overcoming the Lasting Impact of Childhood Trauma: ACE Scores & EMDR Therapy
Brain scan findings are important, but what matters most is how they connect to real life. This study helps bridge that gap by showing how early adversity is linked not only to brain patterns, but also to increased risk for common mental health challenges.
The study found that higher ACE scores were associated with increased rates of anxiety-related disorders.
This aligns with what many people experience, such as chronic worry, heightened stress responses, or feeling on edge. The brain patterns identified in the scans may help explain why individuals with a history of childhood adversity are more prone to anxiety later in life.
In addition to anxiety, higher ACE scores were also linked to greater rates of depression-related diagnoses.
These findings are consistent with prior research showing that early life stress can affect mood regulation, motivation, and emotional resilience. The changes observed in brain function may contribute to symptoms such as low mood, lack of energy, and difficulty experiencing pleasure.
The study also found that as ACE scores increased, so did the risk for addictions. This included associations with substance abuse, substance dependence, alcohol-related disorders, and nicotine-related disorders.
For some individuals, substances may become a way to cope with emotional pain, regulate stress, or temporarily quiet an overactive mind.
Not all childhood experiences affect the brain in the same way. One of the most useful insights from this study is that different types of adversity were linked to different adult mental health outcomes. This adds a more personalized understanding of risk.
The study found that exposure to substance abuse in the household during childhood was specifically associated with a higher likelihood of substance-related diagnoses in adulthood.
This includes patterns such as substance abuse, dependence, and alcohol- or nicotine-related disorders. Early exposure may shape how the brain responds to reward, stress, and coping, potentially increasing vulnerability to similar behaviors later in life.
The findings also showed that psychological abuse and growing up in a household with mental illness were linked to higher rates of depression-related diagnoses.
These types of experiences may have a strong impact on emotional development, self-perception, and stress regulation, which can carry forward into adulthood as persistent low mood, negative thinking patterns, or reduced resilience.
For many people, trauma can feel invisible, something that lives only in memories or emotions. But growing research is helping answer an important question: can childhood trauma be seen on a brain scan? The answer is increasingly clear: yes, it can.
In one of the largest adult clinical cohorts of its kind, researchers at Amen Clinics used brain SPECT imaging to examine how early life experiences relate to adult brain function.
SPECT (single-photon emission computed tomography) measures blood flow and activity patterns in the brain, offering insights into how different regions are working.
In this study, scans were taken under both resting conditions and during concentration tasks, providing a more complete picture of brain function in everyday life.
By combining brain imaging data with patients’ ACE scores, researchers were able to explore how childhood adversity may be reflected in the adult brain.
The results showed a clear pattern: higher ACE scores were associated with distinct differences in brain perfusion (blood flow) across several key brain systems.
These patterns were not random. Instead, they appeared in areas involved in:
In other words, early adversity wasn’t just linked to how people felt, it was connected to how their brains functioned. The findings suggest that childhood trauma may leave measurable, lasting signatures in the brain that persist into adulthood.
These findings are powerful because they validate something many people have long felt but couldn’t explain.
If you’ve struggled with anxiety, depression, or impulsivity, it is not a personal failing. It may reflect how your brain adapted to early stress. Brain imaging shows that these challenges can have a biological basis, not just an emotional one.
That shift in understanding matters. It reduces stigma and self-blame, supports more accurate diagnosis, and opens the door to targeted, brain-based treatments that focus on healing root causes.
2024 Study on ACEs: Key Findings at a Glance
Finding | Brain Areas Involved | What It May Mean in Real Life |
Higher ACE scores were linked to more activity | Cognitive control network and default mode network | May reflect increased internal focus, overthinking, or difficulty regulating thoughts and emotions—patterns often seen in anxiety and rumination |
Higher ACE scores were linked to less activity | Dorsal striatum and cerebellum | May be associated with challenges in motivation, decision-making, coordination, and follow-through |
Higher ACE scores were linked to increased mental health risk | Whole-brain patterns affecting emotional and cognitive systems | Higher likelihood of anxiety disorders, depression, and substance use disorders |
When you read research like this, it’s easy to jump to conclusions. This section helps clarify what the findings actually show, and just as importantly, what they don’t.
The study identified patterns across a large group of people, not a single outcome that applies to everyone.
Higher ACE scores were linked to certain brain activity patterns, but individual brains vary widely.
Genetics, environment, resilience factors, and lifestyle all play a role in how the brain develops and adapts. Two people with similar childhood experiences may have very different brain patterns and life outcomes.
Although the study found increased risk for anxiety, depression, and substance use, this does not mean these outcomes are guaranteed.
Risk is not destiny. Many people with high ACE scores never develop mental health conditions, especially when they have protective factors such as supportive relationships, healthy habits, and access to effective care.
What the study does show, clearly and consistently, is that early adversity can be linked to lasting changes in how the brain functions.
These effects are measurable using tools like SPECT imaging, and they help explain why some people may feel more vulnerable to stress, emotional challenges, or certain behaviors later in life.
Understanding how childhood adversity affects the brain can shift the way we think about mental health — from blame and guesswork to clarity and personalized care.
Two people can have similar symptoms, such as anxiety, low mood, or trouble focusing, but very different underlying brain patterns.
Without looking at the brain, it’s easy to assume the same treatment will work for everyone. But symptoms are only part of the picture. They don’t always reveal what’s happening in the brain systems driving those experiences.
This is where functional imaging, like SPECT, may offer additional insight. By measuring blood flow and activity, it can help identify which brain regions are overactive, underactive, or not working efficiently.
When clinicians have a clearer understanding of how a person’s brain is functioning, it may support more personalized and effective care.
Rather than relying solely on symptom checklists, treatment can be tailored to the individual’s specific brain patterns, history, and needs.
While more research is always needed, this approach reflects a growing shift toward precision mental health, where better information leads to better outcomes.
If childhood trauma can leave lasting effects on the brain, the next question is just as important: can those effects be improved? The encouraging answer is that the brain is capable of change, especially when the right strategies are in place.
The findings from this study point toward the value of personalized care. Rather than taking a one-size-fits-all approach, this type of care considers your history, symptoms, and brain function together. This more comprehensive view may help guide more precise and meaningful interventions.
The study’s discussion highlights several approaches that may be helpful as part of a personalized care plan. These include trauma-informed therapies as well as brain-based interventions, such as:
These approaches are not guarantees, but they reflect promising directions that aim to support both emotional healing and healthier brain function. The goal is to help the brain become more balanced, flexible, and resilient over time.
Understanding the impact of trauma is only part of the story. What truly matters is how that information is used to help people heal. At Amen Clinics, the focus is on looking deeper, at the brain itself, to guide more effective care.
At Amen Clinics, we believe mental health is brain health. Instead of relying solely on symptom checklists, our approach focuses on evaluating and treating the organ involved: the brain.
This brain-based perspective helps shift the conversation away from labels and toward understanding what may actually be happening beneath the surface.
When we have more complete information about your brain, your history, and your symptoms, we can create a more targeted plan for healing.
At Amen Clinics, this means combining brain imaging with a comprehensive evaluation of biological, psychological, and lifestyle factors. The goal is to develop personalized care plans that support the health of your brain, body, and mind—because no two people are exactly alike.
This research offers a clearer picture of how early life experiences can shape the brain in lasting ways. Higher ACE scores were linked to measurable differences in adult brain activity, especially in systems involved in:
These patterns were also associated with a higher risk for anxiety-related disorders, depression, and substance use.
At the same time, these findings are not a life sentence. Perhaps the most important takeaway is this: your brain is not fixed. Even if you experienced significant adversity early in life, change is possible. With the right support, healthy habits, and targeted interventions, many people see meaningful improvements in how they think, feel, and function.
Your past may help explain your struggles, but it doesn’t have to define your future.
This study suggests that higher adverse childhood experiences (ACE scores) are associated with measurable blood flow and activity patterns in adult brain function on SPECT imaging. These patterns reflect differences in how certain brain systems are working, rather than structural “damage.”
The study found that higher ACE scores were linked to more activity in cognitive control and default mode networks, less activity in the dorsal striatum and cerebellum, and higher risk for anxiety-related disorders, depression, and substance use.
No. The study identified increased risk of mental health problems, not certainty. Many people with high ACE scores do not develop mental health conditions, especially with the right support and protective factors.
An ACE score is a measure of adverse childhood experiences, including abuse, neglect, and household instability. It reflects how many of these experiences a person had before age 18.
Yes, the brain can heal. The study’s discussion supports personalized, trauma-informed approaches to care and monitoring brain function over time. This suggests the effects of early adversity are worth addressing and may improve with the right interventions, rather than being fixed or unchangeable.
Emotional trauma, anxiety, depression, and other mental health conditions can’t wait. At Amen Clinics, we practice precision medicine—using brain SPECT imaging and comprehensive evaluations to understand what’s really happening in your brain, not just your symptoms. Our whole-body approach to holistic psychiatry combines cutting-edge neuroscience with natural ways to treat mental health conditions, including targeted nutrition, supplements, lifestyle strategies, therapy, and medications (when necessary). Every treatment plan is personalized to address the root causes of your struggles and support the health of your brain, body, and mind. Don’t settle for guesswork. You deserve answers—and a plan built specifically for you. Speak with a Brain Health Advisor today at 888-288-9834 or visit our contact page to get started.
About the Reviewer
Dr. Steven Storage is a child, adolescent, and adult psychiatrist at Amen Clinics Los Angeles Metro Area. He earned his medical degree from the UCLA School of Medicine, completed his general psychiatry residency at Stanford Hospital & Clinics, and finished his child/adolescent psychiatry fellowship at the University of Southern California, where he served as Chief Fellow. Dr. Storage is board certified in both adult psychiatry and child/adolescent psychiatry and serves as Adjunct Clinical Professor of Psychiatry at USC. His clinical expertise includes ADHD, autism spectrum disorders, anxiety, depression, bipolar disorders, OCD, PTSD, traumatic brain injury, and psychiatric symptoms in medically complex patients.
Keator DB, Salgado F, Madigan C, Murray S, Norris S, Amen D. Adverse Childhood Experiences, Brain Function, and Psychiatric Diagnoses in a Large Adult Clinical Cohort. Frontiers in Psychiatry. 2024 Oct 14;15:1401745. doi: 10.3389/fpsyt.2024.1401745
Daníelsdóttir, Hilda Björk et al. Adverse Childhood Experiences and Adult Mental Health Outcomes. JAMA Psychiatry vol. 81,6 (2024): 586-594. doi:10.1001/jamapsychiatry.2024.0039
Ross, N et al. Adverse childhood experiences: Assessing the Impact on Physical and Psychosocial Health in Adulthood and the Mitigating Role of Resilience. Child Abuse & Neglect, Volume 103, May 2020, 104440. https://doi.org/10.1016/j.chiabu.2020.104440
