Introduction
Adverse childhood experiences (ACEs) incorporate potentially traumatic occurrences of different nature, including experiencing or witnessing violence, family separation/instability, and indirect encounters with mental health issues and dependencies. The relationship between ACEs and holistic health later in life is a complex health promotion issue. With reference to the previously selected topic, problem, and research questions (RQs), this review demonstrates correlational links between ACEs and health and early screenings’ potential helpfulness.
Literature Review
Problem: ACE and Disease/Mental Health/Substance Abuse Issues
Current research relevant to RQs 1-3 confirms a positive relationship between ACEs and the issues specified in the problem statement without solid evidence to establish causal links. Aside from chronic neglect-caused food insecurity that can promote anemia and vitamin deficiencies, there are some propositions to connect household dysfunction/maltreatment to chronic orthostatic intolerance (Dempster et al., 2021). The biological consequences of ACE-induced stress, including the hyperactive hypothalamic-pituitary-adrenal axis, require further confirmation (Dempster et al., 2021). Regarding mental disease, based on a systematic review of 23 large-scale studies, Bellis et al. (2019) conclude that in North America, ACEs can be attributed to 30% and 40% of anxiety and depressive disorders, respectively. Data on ACEs’ severity and the degree of social dysfunction are, however, absent, which might weaken the link. Scoping review research also suggests a positive association between the history of ACE and the risk of developing substance use disorders, especially severe ones, in adolescence and adulthood (Leza et al., 2021). Despite stating a positive correlation, the available sources possess a limited explanatory value when it comes to the link’s underlying mechanisms and details.
ACE Prevention Interventions
Based on external sources relevant to RQs 4 and 5, early screening endeavors initiated by healthcare providers could be a promising approach to ACE prevention and ceasing the victims’ exposure to it, whereas public education interventions cannot be recommended. In their pilot study of a pediatrician-led ACE screening program, Quizhpi et al. (2019) argue for ACE screenings’ contributions to parental and child resilience. In their literature reviews, Lacey and Minnis (2019) and Rariden et al. (2021) claim that ACE screenings and scores, including those in pediatric, home-based, and school-based settings, are considered feasible by care providers. At the same time, it is possible that families’ perceptions of early screening as invasive and requesting overly personal information can alter the approach’s effectiveness by affecting responses’ sincerity. However, it is logical that ACE screening and communication with young patients can increase the chances of identifying dysfunctional family life patterns or children’s poor quality of life and connecting families to the right resources. Thus, it can be important to continue developing this public health strategy.
Some alternative strategies, including the large-scale promotion of non-violent communication strategies and the inappropriateness of corporal punishment, are unlikely to be as effective as screening. ACE-focused educational materials can imply that the child’s encounters with unpleasant experiences will inevitably cause health issues (Lacey & Minnis, 2019). As shown above, not all ACEs actually result in life-affecting diagnoses, which could make the public teaching approach unfocused. Conclusively, ACE awareness education could be based on a false assumption that ACEs and negative outcomes are linked causally.
Conclusion
Finally, ACEs are positively correlated with mental health and substance use issues in adolescent and adult individuals, with their role in chronic disease remaining unclear. Concerning preventing ACEs, the reports of any interventions’ effectiveness are currently limited, but early screening for ACEs as part of healthcare services could still have some potential in identifying at-risk families. ACEs’ possible mechanisms of promoting barriers to well-being later in life and preventive strategies’ actual influences on at-risk children present questions to be addressed in further research.
References
Bellis, M. A., Hughes, K., Ford, K., Rodriguez, G. R., Sethi, D., & Passmore, J. (2019). Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: A systematic review and meta-analysis.The Lancet Public Health, 4(10), e517-e528.
Dempster, K. S., O’Leary, D. D., MacNeil, A. J., Hodges, G. J., & Wade, T. J. (2021). Linking the hemodynamic consequences of adverse childhood experiences to an altered HPA axis and acute stress response.Brain, Behavior, and Immunity, 93, 254-263.
Lacey, R. E., & Minnis, H. (2020). Practitioner review: Twenty years of research with adverse childhood experience scores. Advantages, disadvantages and applications to practice.Journal of Child Psychology and Psychiatry, 61(2), 116-130.
Leza, L., Siria, S., López-Goñi, J. J., & Fernandez-Montalvo, J. (2021). Adverse childhood experiences (ACEs) and substance use disorder (SUD): A scoping review.Drug and Alcohol Dependence, 221, 1-10.
Quizhpi, C., Schetzina, K., Jaishankar, G., Kwak, H. G., Toliver, R. M., Thibeault, D., Fapo, O., Gibson, J., & Wood, D. (2019). Breaking the cycle of childhood adversity through pediatric primary care screening and interventions: A pilot study.International Journal of Child Health and Human Development, 12(4), 345-354.
Rariden, C., Smith Battle, L., Yoo, J. H., Cibulka, N., & Loman, D. (2021). Screening for adverse childhood experiences: Literature review and practice implications.The Journal for Nurse Practitioners, 17(1), 98-104.