Chapter 11 - Implications and outcomes of ACEs

Abstract

The researchers behind the CDC-Kaiser Permanente adverse childhood experiences study used what is referred to as the Adverse Childhood Experience (ACE) pyramid as a conceptual framework for their investigation (Centers for Disease Control and Prevention CDC, 2021). The pyramid represents a system of processes involved in the physical and mental health consequences among individuals who suffer from the effects of negative experiences in childhood. In the original ACE study, Felitti et al. (1998) noticed the commonality of child abuse experienced in the early years among adults with physical health problems. It was, therefore, hypothesized that poor physical health in adulthood, such as disease or obesity, may stem from health risk behaviors resulting from internalized and unresolved adverse experiences in childhood. Accordingly, and as the results of the ACE study indicated, health outcomes throughout the lifespan appear to be largely dependent on psychological underpinnings that contribute toward human development. Studies on ACEs have continued to highlight in decades since the original study that these consequences involve the integration of adverse experiences, subsequent toxic stress and trauma, and an inability to cope with stressors (Barnthouse & Jones, 2019). It is important to note that the result of ACEs is not only related to adverse health outcomes; these experiences can also impact many areas of life, such as attachment and relationships (Choi et al., 2020) and economic instability (Kim et al., 2020). The premise of the conceptual framework for ACEs is founded on the link between the exposure to an event that is potentially traumatic and the subsequent impact on psychological and neurological development that, in turn, seemingly drive and motivate human emotions and behavior across the lifespan. Because childhood is a susceptible and critical period of human development, exposure to adverse experiences leaves children highly sensitive to stress and maladaptive coping mechanisms that can perpetuate challenges if left unaddressed.