The High Cost of ACES

In this post, I would like to introduce the concept of ACES. What are ACES? The acronym stands for “Adverse Childhood Experiences” and the term comes from a landmark 1998 study that found a surprising relationship between early childhood exposures to adversity and later health risks.  If you were exposed to adversity as a child, or if you have children that have been exposed to adverse events, you should understand the potential consequences of those exposures. The graphic above depicts the basic steps of early exposures to adversity that result in later health effects and early mortality.

There are several points that you should remember about ACES. The first is that ACES are divided into 2 categories; abuse (such as physical, sexual, or emotional abuse) and household dysfunction (such as having an incarcerated parent, or having a mentally ill person living in the house), to differentiate between direct and indirect sources of traumatic exposure. The second point is that exposures to more than one form of trauma increases one’s ACE “score”, thereby multiplying the total expected, physical and mental health effects. A third point to remember is that the effects of ACES are compounded. In other words, additional exposures are not additive, they are multiplicative, in terms of risk. These risks correlate with the expected course of lifespan development, first contributing to social and emotional deficits, which translate into riskier behaviors, which result in chronic and acute health problems and, eventually, in premature death.

​A fourth point to remember is that the negative health effects of exposure to ACES can be reduced and even eliminated with appropriate mental health treatment. This is accomplished by engaging in a systematic, individualized program that accounts for the unique circumstances and experiences of the person that has been exposed. The downside of ACES is that trauma exposures take a toll on all aspects of health. The upside is that treatment offers a more hopeful future for those suffering from past exposure.

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