Adverse Childhood Experiences (ACEs)

The American Psychologist February-March 2021 issue dealt extensively with Adverse Childhood Experiences (ACEs). Portwood, Lawler, & Roberts address implications of ACEs for science, practice, and policy. They note that:

Since its introduction, the term ACEs has entered popular usage to refer to a wide range of potentially stressful and traumatic experiences, including not only those in the original ACEs study measure (Felliti et al., 1998) – physical, sexual, and emotional abuse; physical and emotional neglect; exposure to adult incarceration, mental illness, substance abuse, or violence in the household; and parental separation or divorce – but also poverty, exposure to community violence, bullying, racial discrimination, and most recently, separation from immigrant parents (Cronholm et al., 2015; Finkelhor et al. 2015). (p.183)

The prevalence of ACEs is also alarming. Portwood et al. note a study of samples from 25 states found 60.9% of adults reporting at least one ACE, 15.6% four or more ACEs. Not surprisingly, the pandemic has led to increases in reported ACEs. One of appeals of the ACEs approach is its multidisciplinary origin, since ACEs relate to such medical outcomes as heart disease as well as mental and behavioral disorders, with up to one-third of these latter attributed to ACEs.

The emerging consensus, according to Portwood et al., is that ACEs should be seen as risk factors, in that many can have different outcomes. They cite divorce as an example of an event that can be experienced as positive or negative to varying degrees. Moving forward, we need to more closely examine the cumulative effect of ACEs, the effects of age of exposure, and the effects of protective factors (e.g., culture).