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Adverse Childhood Experiences and Trauma

Adverse Childhood Experiences and Trauma

Update: 2021-01-202
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Objectives

~ Explore the relationship between ACEs and trauma

~ Identify the impact of ACEs and traumatic injury on mental, physical and interpersonal health in adults

~ Explore risk factors for ACEs and subsequent prevention and intervention measures.


Overview of LTE of ACEs

~ Adverse childhood experiences (ACEs) are stressful or traumatic events that children experience before age 18 years. Studies have linked exposure to ACEs and negative health, and developmental and behavioral outcomes.

~ Traumatic Event: Direct or indirect exposure to an event that involved the possibility of death or serious injury

~ Traumatic Injury: Psychological consequences sometimes experienced after a trauma.

~ 61% of adults surveyed across 25 states reported that they had experienced at least one type of ACE, and nearly 1 in 6 reported they had experienced four or more types of ACEs.

~ Over 50% of adolescents have been exposed to ACEs which can have detrimental effects on learning and behavior and is associated with increased suicidal ideation in adolescents

~ 68.1% of people who reported homelessness in childhood also reported experiencing four or more ACEs. Only 16.3% of people were never homeless in childhood reported experiencing four or more ACEs

~ ACEs have a different impact on the brain based upon the age of exposure, individual factors and microsystem protective factors

~ Strongest impacts are found for younger children (ages 2-5) and those living in households with incomes below 200% of the federal poverty level

~ ACEs contribute to disturbances in cognitive and affective processing including

~ Heightened attention toward threatening stimuli

~ Increased experience of loneliness

~ Increased HPA-Axis dysregulation / reduced impulse control

~ Functional alterations in key stress–and emotion associated brain regions particularly the anterior cingulate cortex [ACC], amygdala and hippocampus (shrinkage)

~ Initial increase in amygdala volume after ACEs, followed by a decrease in volume due to persistent distress in later life

~ These brain regions are particularly susceptible to damage from trauma/HPA-Axis hyperactivation due to the high density of glucorticoid receptors

~ Exposure to specific types of ACEs selectively affect the sensory systems which were involved in perceiving the trauma

~ Mental disorders in individuals with ACE exposure tend to have more severe symptomatology, increased risk of comorbidity and are less likely to respond to standard treatments (why?)

~ In adults, ACE exposure is associated with

~ A wide range of physical disorders including obesity, dysregulation of the immune system, autoimmune disorders and abnormal pain perception with and without underlying causes

~ Stress itself can sensitize nociceptive neurons in the spinal cord which result in comparable changes in pain-perception and related behavior.

~ Increased levels of pro-inflammatory cytokines

~ Disruptions in intestinal microbiota and the mucosal immune system

~ 200-400% increased risk of heart disease, cancer, chronic lung disease, skeletal fractures, depression, diabetes and prediabetes, liver disease


Summary

~ More than 60% of people have experienced ACEs

~ It is believed the rate of exposure to ACEs has increased significantly during COVID

~ Not everyone who experiences ACEs will develop traumatic injury

~ Injuries related to ACE trauma include:

~ Borderline and antisocial personality disorder

~ Mood disorders

~ PTSD

~ Addictions

~ Autoimmune issues including IBS, Chron’s, Diabetes

~ Heart disease, cancer, chronic lung disease, liver disease

~ Increased difficulty in interpersonal relationships due to above issues

~ Increased risk to become a perpetrator of ACEs

#traumainformedcare #adversechildhoodexpoeriences #aces #mentalhealth

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Adverse Childhood Experiences and Trauma

Adverse Childhood Experiences and Trauma

Charles Snipes