Adverse childhood experiences (ACEs) refer to distressing incidents before the age of 18, such as neglect, abuse, and household dysfunction. ACEs can have enduring consequences on an individual’s cognitive, emotional, and behavioral functioning, as well as their neurodevelopment and physical health. People who have experienced ACEs may be at higher risk of adopting health-risk behaviors (CDC, n.d.). The ACE Pyramid offers a structure for comprehending the diverse levels of impact that ACEs can have on a person’s life.
Impacts of ACEs on Neurodevelopment
ACEs can have a substantial impact on adult life in a variety of ways. ACEs cause changes in brain structure, which can result in an increased stress response, chronic inflammation, cortisol dysregulation, and abnormalities in neuronal connectivity and function. ACEs can disrupt neurodevelopment, making it difficult to cope with stress and control emotions later in life (Makris et al., 2023).
Furthermore, ACEs can lead to delayed development, which can persist into adulthood and produce issues with impulsivity, decision-making, and emotional regulation (Makris et al., 2018). ACEs have been related to diminished grey matter in the hippocampus, amygdala, and prefrontal cortex, to name a few brain locations. Remembering, emotion, and decision-making abilities are all vulnerable to degradation under these conditions (Makris et al., 2018).
Injury to the grey matter of the brain can have long-term effects on cognitive capacities such as learning and memory, as well as emotional regulation, planning, and motor control, which can affect how someone manages their day-to-day life and interacts with others.
Social, Emotional, and Cognitive Impairment Due to Damaged Neurodevelopment
ACEs, or adverse childhood experiences, can harm daily social lives and functioning. Emotional dysregulation is one such effect that can result from the impaired development of emotional regulation and increase the risk of mood disorders, anxiety, and post-traumatic stress disorders (Jowett et al., 2020). Those who have experienced ACEs may face difficulties regulating their emotions, leading to challenges in coping and managing stress, ultimately affecting their daily functioning and overall quality of life.
Cognitive capacities like attention, working memory, and verbal fluency, among others, can be negatively impacted by exposure to ACEs. Performance in school or the workplace may deteriorate if the individual has trouble learning, solving problems, or making decisions due to this handicap (Jowett et al., 2020).
A person’s social skills may suffer if they were exposed to trauma as a child. Those who have trouble in this area frequently have a harder time forming relationships based on empathy, trust, and collaboration, which can increase the risk of aggressiveness, substance misuse, and other bad outcomes (Jowett et al., 2020). Moreover, they may face challenges forming healthy relationships due to trust issues and be at greater risk of engaging in harmful behaviors as a coping mechanism.
Health Risk Behaviors Connected to Experience and Impact of ACEs
ACEs are a significant contributor to a wide range of health risks. These behaviors are more common in children who have experienced ACEs than in adults (Novais et al., 2021). Drug and alcohol abuse is one example of high-risk behavior that is frequently associated with ACEs. Substance abuse is a common coping strategy for people suffering from ACEs, which cause chronic stress and emotional dysregulation. According to Novais et al. (2021), having four or more ACEs increases a person’s likelihood of substance abuse and addiction. Drug abuse has far-reaching consequences, including physical and mental health problems, criminal behavior, and societal breakdown.
Engaging in risky sexual behavior is another health risk activity linked to ACEs. The experiences can make it difficult to form healthy connections and boundaries, leading to an early sexual debut, multiple sexual partners, and risky sexual behavior (Novais et al., 2021). Trauma’s psychological effects, such as sexual dysfunction, low self-esteem, and a negative body image, can all contribute to risky sexual behavior (Novais et al., 2021). Unwanted pregnancies, sexual transmitted infections, and sexual abuse are just a few examples of how unsafe sexual behavior can harm one’s physical and mental health.
ACEs have been linked to a wide range of health risk behaviors, including eating disorders. An unhealthy relationship with food is one way to cope with the emotional dysregulation and stress that ACEs can cause. According to Novais et al. (2021), women who have had ACEs are more likely to develop eating disorders such as anorexia, bulimia, and binge eating. Physical and mental illness, loneliness, and, in the most extreme cases, premature death are among the negative consequences of eating disorders. As a result, it is critical for people who have had ACEs to participate in treatments such as counseling and support groups that target these health risk behaviors in order to learn healthy coping skills and improve their well-being.
ACEs and Effectiveness of Treatment/Services
A variety of barriers can prevent people who have suffered from ACEs from actively participating in their therapy. Emotional responses to trauma, such as fear, mistrust, and avoidance, can lead to resistance and dropout from treatment. Discussing past experiences can make clients feel vulnerable or exposed, leading to shame, guilt, or embarrassment (Barnett et al., 2021). According to Crandall et al. (2019), individuals who have gone through traumatic experiences in childhood, also known as adverse ACEs, may encounter issues with emotional regulation, which can lead to harmful outcomes.
Challenges in controlling and expressing emotions characterize emotional dysregulation, and it is frequently associated with mood swings, intense feelings of anger or sadness, and impulsive behavior. Additionally, people with a history of ACEs may have difficulties identifying and labeling their emotions, resulting in communication and relationship problems. They may also be more vulnerable to the onset of anxiety and despair, as well as to the usage of unhealthy coping techniques like substance addiction and self-harm.
In addition to causing difficulties with emotional control, ACEs have been linked to a decline in social skills and an inability to establish and maintain positive professional connections. In particular, those who have experienced ACEs may have difficulty cultivating empathy, trust, and communication skills, all of which might impede their capacity to form meaningful connections with others (Crandall et al., 2019). They may also have trouble setting appropriate limits in relationships, making them more vulnerable to abuse. They may also be more likely to resort to illegal or antisocial conduct as a means of coping with their trauma (Hoogsteder et al., 2022).
As a result, it is essential that therapeutic methods incorporate tactics for fostering social skills and connecting with others. As a result, they may be better able to express themselves and form meaningful bonds with others, both of which can help them get closer to their own goals.
ACEs’ Impact on Emotions and Behavior of Individuals at Work
One of the impacts of ACEs is emotional dysregulation, a common problem among people who have encountered adverse incidents in their childhood. Mood swings, extreme feelings of despair or rage, and erratic conduct are all symptoms of emotional dysregulation (Crandall et al., 2019). People who have suffered ACEs may have trouble recognizing their feelings, which can impede communication and strain interpersonal relationships. They may have a greater propensity for engaging in risky behaviors like substance misuse or self-harm as a means of coping with their emotional pain.
Secondly, ACEs have been linked to social difficulties and an inability to develop positive working connections. People who have experienced ACEs may have trouble forming meaningful relationships due to difficulties in empathy, trust, and communication (Crandall et al., 2019). It is possible they have trouble setting boundaries and are more likely to end up in unhealthy or abusive relationships as a result. These difficulties can be mitigated through the incorporation of social skills training and relationship-building strategies into treatment plans.
References
Barnett, M. L., Sheldrick, R. C., Liu, S. R., Kia-Keating, M., & Negriff, S. (2021). Implications of adverse childhood experiences screening on behavioral health services: A scoping review and systems modeling analysis. American Psychologist, 76(2), 364.
Centers for Disease Control and Prevention (CDC). (n.d.). CDC-Kaiser ACE study. Web.
Crandall, A., Miller, J. R., Cheung, A., Novilla, L. K., Glade, R., Novilla, M. L. B.,… & Hanson, C. L. (2019). ACEs and counter-ACEs: How positive and negative childhood experiences influence adult health. Child Abuse & Neglect, 96, 104089.
Hoogsteder, L. M., Ten Thije, L., Schippers, E. E., & Stams, G. J. J. (2022). A meta-analysis of the effectiveness of EMDR and TF-CBT in reducing trauma symptoms and externalizing behavior problems in adolescents. International Journal of Offender Therapy and Comparative Criminology, 66(6-7), 735-757.
Jowett, S., Karatzias, T., & Albert, I. (2020). Multiple and interpersonal trauma are risk factors for both post‐traumatic stress disorder and borderline personality disorder: A systematic review on the traumatic backgrounds and clinical characteristics of comorbid post‐traumatic stress disorder/borderline personality disorder groups versus single‐disorder groups. Psychology and Psychotherapy: Theory, Research and Practice, 93(3), 621-638.
Makris, G., Eleftheriades, A., & Pervanidou, P. (2023). Early life stress, hormones, and neurodevelopmental disorders. Hormone Research in Paediatrics, 96(1), 70-77.
Novais, M., Henriques, T., Vidal-Alves, M. J., & Magalhães, T. (2021). When problems only get bigger: the impact of adverse childhood experience on adult health. Frontiers in Psychology, 12, 693420.