Our childhood experiences have a powerful influence on the rest of our lives. When those early years are marked by abuse, neglect, or trauma, it can have a negative lasting impact with serious consequences. In fact, adverse childhood experiences, or ACEs, can set the stage for long-term physical and mental health problems.
A 2024 neuroimaging study published in Frontiers in Psychiatry and conducted at Amen Clinics confirms that having more ACEs is closely associated with heightened risk of mental health conditions, such as anxiety, depression, post-traumatic stress disorder (PTSD), and substance use disorders.
In this blog, you’ll learn more about adverse childhood experiences, how they impact brain development as well as physical and mental health in adulthood, and how to overcome childhood trauma for better brain health and mental wellness.
WHAT ARE ADVERSE CHILDHOOD EXPERIENCES (ACEs)?
For decades, researchers have been looking into the many possible consequences of adverse childhood experiences. Experts have been studying how traumatic events in childhood impact people not only during their early years but also in adulthood.
Research shows that ACEs are very stressful and traumatic and can interfere with normal developmental processes. They also increase the risk for health problems and psychiatric disorders.
In 1995, the Centers for Disease Control (CDC) and Kaiser Permanente undertook a large-scale study to identify the extent of ACEs in a group of 17,337 adult participants. This study also looked at the long-term effects of ACEs.
Adverse childhood experiences were surveyed using eight specific questions that covered neglect, abuse, and household dysfunction, such as witnessing domestic violence.
The results of this research found that nearly 25% of those in the study had been exposed to three or more of the eight ACEs that were being studied at that time. The fact that the participants were primarily middle-class Caucasian adults was a clear indication that ACEs can happen in almost any household.
However, it is now well-known that chronic poverty, community violence, and racism can also negatively impact a child’s physical and mental health and development.
WHAT IS THE ACEs QUESTIONNAIRE?
Since the time of that groundbreaking study, the ACEs questionnaire has had some minor modifications. The latest version is comprised of 10 questions that cover adverse and traumatic experiences a child could be subjected to or witness while growing up. The categories include:
The scores on the ACE questionnaire range from 0 to 10, with zero meaning no exposure and 10 indicating a person was subjected to significant—if not profound—levels of trauma before age 18. The higher the score, the higher the long-term health consequences a person can be at risk for.
Of note, the ACE questionnaire is not a stand-alone diagnostic assessment. It specifically addresses only negative experiences, not positive ones. It’s not necessarily predictive of future problems, although those correlations exist.
Rather, it’s intended to be used as a guide for clinicians and community health workers to identify services that can benefit the child and family.
For a deeper understanding of the ACEs questionnaire, tune in to the Change Your Brain Every Day podcast, where hosts Dr. Daniel Amen and his wife Tana Amen break down each question.
HOW CHILDHOOD TRAUMA IMPACT THE DEVELOPING BRAIN
The development of a child’s brain is very sensitive to the environment in which they are raised. A loving, supportive, and predictable home environment bodes well for the brain to organize and function in developmentally appropriate ways as the child grows up.
However, for children who are repeatedly subjected to trauma, chaos, abuse, and/or neglect, healthy brain development is often obstructed. When a child is chronically exposed to adverse and traumatic experiences, the brain’s stress activation system—which impacts immune, metabolic, and cardiovascular functioning—is constantly in overdrive.
As the brain develops, the delicate balance of neurotransmitters (brain chemicals) that are necessary for healthy brain function can be disrupted due to the constant flood of stress hormones. This process can also stunt the development of certain areas of the brain, such as the hippocampus, which is important for memory formation.
When enduring toxic levels of stress, it’s as though the child’s brain is stuck in fight-or-flight mode. This can lead to problems with self-regulation, learning, and social interactions, as well as trouble controlling emotions, aggression, and nightmares. Another long-term consequence involves difficulty forming and maintaining healthy attachments later in life.
The negative effects of the adverse experiences can even alter a child’s genes and be passed along to the next generation.
In a fascinating episode of the Change Your Brain Every Day podcast, Dr. Amen talks in detail about the results of the Amen Clinics study mentioned earlier. The largest brain-imaging study ever conducted on ACEs, it involved over 7,000 participants and used brain SPECT imaging and clinical evaluations to map how childhood trauma affects brain activity.
As he reveals on the episode, the results indicate that higher ACE scores are tightly linked to an increased risk of mental health conditions. The study underscores the importance of brain-focused treatment approaches to mitigate the long-term effects of ACEs.
ADVERSE CHILDHOOD EXPERIENCES: IMPACTS ON PHYSICAL AND MENTAL HEALTH
Not everyone with a high ACE score will develop health problems later in life. Some children have natural strengths that can help them navigate the turmoil that surrounds them in a way that other children may not be able to.
In addition, having a close relationship with one or more caring adults can help buffer the adversity at home. For example, a teacher may provide extra support for the child. In other instances, a loving relative who cares for the child may provide a temporary refuge from the trauma. These adults can promote a sense of safety that helps the child become more resilient.
However, adults who had multiple ACEs and did not have healthy connections to people around them—nor strengths that were nurtured—can be at an increased risk for physical and mental health problems in adulthood, including:
The connection between high ACE scores and substance abuse is especially strong. In fact, more than 25% of people with addictions report childhood trauma, according to a 2022 study in General Psychiatry. This study also found that higher levels of ACEs was associated with greater severity of mental health disorders.
ADVERSE CHILDHOOD EXPERIENCES (ACEs) AND EMOTIONAL BIAS
Neuropsychological testing also shows that individuals who have experienced high levels of childhood trauma have difficulty with emotional awareness and emotional bias.
Emotional awareness and emotional bias tests involve having a person look at images of facial expressions and categorize them as happy, neutral, angry, or disgusted. On these tests, people with high scores on the ACE Questionnaire typically respond slower to happy faces and more quickly to disgusted faces. They also identify fewer neutral faces correctly while recognizing more angry faces correctly.
This contributes to an emotional bias known as a conscious negativity bias. Ultimately, this means people with higher levels of adverse childhood experiences are more likely to have a negative view of the world.
TREATING ADVERSE CHILDHOOD EXPERIENCES (ACEs)
Fortunately, certain mental health therapies and lifestyle changes can help mitigate the onset or reduce the severity of ACEs consequences, such as:
- Address the adverse childhood experiences with a trained psychotherapist to help work through the emotional trauma.
- Consider Eye Movement Desensitization and Reprocessing (EMDR), which is a powerful treatment for trauma survivors.
- Seek treatment for alcohol, drug, and/or food addiction.
- Switch to a healthier diet with lots of fresh produce and omit fried foods, sugar products (including soda), and ultra-processed foods.
- Exercise regularly and spend less time on the couch.
- Volunteer in your community to build positive social connections.
On the Change Your Brain Every Day podcast episode about ACEs, Dr. Amen and Tana discuss several other beneficial strategies to help overcome childhood trauma for better mental health.
If you’re an adult who endured the trauma of adverse childhood experiences, start taking good care of yourself now. Incorporating healthier habits and seeking treatment for your physical and mental health issues can open up greater possibilities for your life as you go forward.
