Adverse childhood experiences and adult functioning
I have been writing about adverse childhood experiences (ACEs) since the very beginning of this blog. Here, I look at research on adults. First, Turgoose & Murphy (2024) published “Adverse Childhood Experiences in a Clinical Sample of U.K. Military Veterans” in Traumatology. Here’s a highly edited summary:
Adverse childhood experiences (ACEs) are consistently linked with poorer psychosocial and mental health outcomes, including in military veterans. Military veterans are an at-risk group because of the combined risk factors of ACEs and being more likely to experience high stress and trauma in adulthood. This study aimed to report rates of self-reported ACEs in a clinical sample of U.K. military veterans, and to test for associations between high levels of ACEs and psychosocial variables. Participants were a clinical sample of military veterans who were seeking treatment for mental health issues at a U.K. veterans mental health charity. Participants completed surveys relating to their experiences of ACEs and their current mental health and well-being. Associations were tested using regression analyses. Military veterans are at high risk for experiencing multiple ACEs which may leave them more likely to develop to mental health difficulties in adulthood. Additionally, those with high ACEs may require additional help in accessing social support as this is a key risk/protective factor in mental health issues such as posttraumatic stress disorder.
A large proportion (34.2%) of the sample reported experiencing four or more ACEs, which is the accepted cutoff for being high risk (Felitti et al., 1998). This represents a very large number of military veterans reporting a high number of ACEs compared with the general population, where rates of people reporting four or more ACEs have been 12.5% in the original ACEs study (Felitti et al., 1998). A more recent study reported that 12.7% of people from the most deprived backgrounds reported four or more ACEs (Bellis et al., 2014). In the United States, similar figures are reported for the general, nonmilitary population (12.9%), with 27.3% of a nonclinical military sample reporting 4+ ACEs (Blosnich et al., 2014). Together, this demonstrates that this clinical sample of veterans appears to be more likely to report high ACEs that nonclinical samples of veterans and the wider general public. It is important to understand and be aware of the likelihood of military veterans experiencing high levels of early adversity, because ACEs are strongly linked to poorer health and well-being outcomes in military populations. Clinicians treating military veterans for mental health therefore ought to routinely screen for ACEs given they are a known risk factor.
The present study reports a significant link between high ACEs and low levels of social support. This has not been reported previously in literature pertaining to military personnel. Low perceived social support has been frequently reported as an important pretrauma risk factor for mental health difficulties in general and military samples, as well as being a possible moderating factor between ACEs and mental health difficulties. Low levels of social support have been linked to increased risk of developing PTSD with the perception of a common, shared experience and supportive social networks thought to be protective in cases where individuals experience trauma.
One of the implications of the present findings is in reiterating the high rates of early life adversity reported by military veterans. Understanding pretrauma risk factors for those serving in the military can help to raise awareness of potential vulnerability as well as informing treatment programs and other sources of support. The fact that ACEs were associated with low social support, and that both ACEs and social support have been strongly linked in past research to poorer health outcomes, is of significance. Interventions which aim to increase social and peer support networks among clinical samples of military veterans have reported successful outcomes and could be a useful avenue for further exploration in research and treatment approaches.
I like this study because it identifies the potential impact of ACEs on veterans, via poor social support. This may be an important finding for those who work with veterans and other workers in high risk settings (e.g., police, emergency workers, etc.). The next study looks at another stressful situation. Chasson & Taubman - Ben-Ari (2024) published “Paths from Adverse and Benevolent Childhood Experiences to Personal Growth after Childbirth: The role of psychological distress, social support, and self-compassion” in Psychological Trauma: Theory, Research, Practice, and Policy. Here are the edited abstract and impact statements:
Dealing with the difficulties and demands of the postpartum period may be distressing for the mother, but it is also an opportunity for her to experience personal growth. One factor that may contribute to this growth is the mother’s childhood experiences. Using a prospective study design, and based on Belsky’s parenting model and personal growth theory, we examined the direct and indirect contribution of mothers’ adverse and benevolent childhood experiences and their current psychological distress, self-compassion, and social support to their personal growth following childbirth and motherhood. A convenience sample of 392 women was recruited through social media and participated in the study about 16 weeks after childbirth (Phase 1) and again 6–10 months postpartum (Phase 2). The direct effects of adverse and benevolent childhood experiences on personal growth were not significant. However, multiple significant paths of indirect associations were found through psychological distress, self-compassion, and social support. To understand the roots of the mother’s personal growth, researchers and clinicians alike should not only explore her personal resources, but also the primary processes that contribute to the creation of those resources, that is, childhood experiences. Addressing the mother’s childhood experiences may help her to better understand the connections between the past and the present, and to identify the implications of her “ghosts and angels” for her mental state, personal resources, and experience of personal growth. The findings suggest that while adverse and benevolent childhood experiences may not have a direct effect on personal growth, they can indirectly impact personal growth through psychological distress, self-compassion, and social support. Therefore, addressing a mother’s childhood experiences may aid in improving her mental state, personal resources, and experience of personal growth during the postpartum period.
I love the idea of looking for the “ghosts and angels” that impact adult functioning in a variety of settings. The next study offers an intervention. Taghavi & Kia-Keating (2022) published “Adverse Childhood Experiences and Yoga as ‘a practice of liberation’.” in Psychological Trauma: Theory, Research, Practice, and Policy. Here’s the edited information:
The long-term negative health consequences of adverse childhood experiences (ACEs) pose a significant public health concern. Effective and engaging interventions that simultaneously address physical, mental, and socio-emotional health and mitigate the negative sequelae related to ACEs are needed. Promising evidence points to the impact of yoga and mindfulness on physiological and emotional health outcomes. Yet, little is known about those who have experienced multiple ACEs and their perspectives on the influence of yoga and mindfulness on their lives. The current study examines the phenomenological experiences of adults with high ACEs who engage in yoga practice. Twelve adults participated in in-depth, semistructured interviews. These included nine cisgender women, two cisgender men, and one gender nonbinary individual; 66.8% White, 16.6% multiracial, 8.3% Black/African American, and 8.3% Asian American/Pacific Islander. Participants were aged 20–63 years and endorsed four or more ACEs. They practiced yoga at least once a week for at least 6 months. Themes that emerged included: healing from trauma-related symptoms, integration of the whole self in mind–body practice, corrective experiences through yoga and mindfulness, and healing beyond talk therapy. Individuals with ACEs may experience yoga as a potentially valuable method for promoting healing through an integrative approach.
The current study advances the understanding of the role of yoga and mindfulness in buffering the negative sequelae of adverse childhood experiences (ACEs) and improving mental, physical, social, and emotional health of adults who engage in a regular practice. The study highlights key mechanisms of change that participants drew from yoga and applied to their healing processes.
Here, I love the idea of an intervention that is not very expensive relative to “talk therapy” which is both expensive and less accessible. It is the kind of mindfulness experience that can potentially benefit a range of clients.