Trauma

The ACE Study Results

MORE COMING SOON!

The ACE Study found a strong correlation between the occurrence of childhood adversity and issues with mental and physical health in adults.

Higher ACE scores showed increased instances long-term health effects, including:

gastrointestinal problems (e.g. IBS)
frequent headaches and fatigue
anxiety, substance abuse and depression

ACE score of 4 or higher has healthcare costs roughly 25 % higher than those with scores between 0 – 3.

The findings are from the research, “Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study.”  Felitti et al (1998).

For the full article click here. 

From a 2016 Canadian study, experiencing any type of child abuse was associated with increased odds of:

• arthritis, back problems
• high blood pressure
• migraine headaches
• chronic bronchitis/emphysema /COPD
• cancer
• stroke
• bowel disease
• chronic fatigue syndrome

More specifically …

~   physical abuse was associated with high blood pressure and stroke; back problems, migraine headaches, and stroke
~   sexual abuse was associated with chronic bronchitis/emphysema/COPD and diabetes
~   exposure to intimate partner violence was associated with chronic bronchitis/emphysema/COPD and migraines.

[“Child abuse and physical health in adulthood”; Tracie O. Afifi et al,  March 16, 2016]

Adverse Childhood Experience (ACE) Questionnaire

Answer ‘Yes’ or  ‘No’ to the following questions.

While you were growing up, during your first 18 years of life:

1. Did a parent or other adult in the household often …
   Swear at you, insult you, put you down, or humiliate you?
   or
   Act in a way that made you afraid that you might be physically hurt?2. Did a parent or other adult in the household often …
   Push, grab, slap, or throw something at you?
   or
   Ever hit you so hard that you had marks or were injured?

   3. Did an adult or person at least 5 years older than you ever…
   Touch or fondle you or have you touch their body in a sexual way?
   or
   Try to or actually have oral, anal, or vaginal sex with you?

   4. Did you often feel that …
   No one in your family loved you or thought you were important or special?
   or
   Your family didn’t look out for each other, feel close to each other, or support each other?

   5. Did you often feel that …
   You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?
   or
   Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

   6. Were your parents ever separated or divorced?

   7. Was your mother or stepmother:
   Often pushed, grabbed, slapped, or had something thrown at her?
   or
   Sometimes or often kicked, bitten, hit with a fist, or hit with something hard?
   or
   Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?

   8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?

   9. Was a household member depressed or mentally ill or did a household member attempt suicide?

   10. Did a household member go to prison?

   Now add up your “Yes” answers: _______ This is your ACE Score.

What does your ACE score mean?

Studies show that 51% of the general North American population have experienced trauma in childhood and that 98% of users of services in the public mental health system have trauma histories (e.g., car accidents, deaths, abuse, etc.).

Unresolved or untreated trauma leads to symptoms such as depression, anxiety, panic attacks, alcohol and drug dependency, reliance upon social support, missed work and unemployment, relationship dysfunction, and the increased risk for serious and chronic circulatory, digestive, musculoskeletal, respiratory and infectious diseases.

Social services (e.g., housing, medical, employment, criminal justice, etc.) workers see symptoms (e.g., missed work, mood issues, addiction, etc.) in their clients, yet need to understand them as possible adaptive responses to past trau­ma. For example, children who experience child abuse/neglect are 59% more likely to be arrested as a juvenile, 28% more likely to be arrested as an adult, and 30% more likely to commit a violent crime.

Presuming that many clients seeking services do have a history of traumatic childhood experiences shifts systems to one that is trauma-informed. However, for what purpose?

One reason is to direct clients to trauma resources and treatment. Many people go through the system without being asked about the possibility of any past trauma/abuse. Unnamed and untreated, the person is caught in the unbeknown and bewildering cycle of traumatic adaptation.

Professor Richard Bentall suggested that “it is even more vital that services routinely question patients about their life experience.” This recommendation can be addressed by screening and assessing for past or current trauma(s) during intakes in a timely and respectful manner. For example, “How do you and your partner solve disagreements” or “Were you ever treated harshly as a child?”

Another reason is that there is a real possibility that workers unintentionally cause harm by using practices, policies and activities that are insensitive to the needs, the vulnerabilities and the triggers of traumatized clients which leads to further re-traumatization and the likelihood that people will not seek support in the future.

If trauma is the ultimate lack of relationship and void of protection, then the basis of trauma-informed practices must be the importance of relationship, and emotional and physical safety. Thus, interactions need to be based upon support, patience, reassurance, honesty and acceptance. Environments should be welcoming, calm and safe.

If trauma takes away a person’s sense of power, then rebuilding personal control and empowerment is also a key factor. People receiving services would be encouraged and given opportunities to use their voice, make choices and to self-advocate.

Understanding trauma also means recognizing that our personal traumatic experiences or the stress associated with working in human services may impact our well-being as well as our work success and satisfaction, which further impacts the people we service.

On a societal level, we can be curious about the circumstance a person is in rather than judging the circumstance. What hurts is thinking “What is wrong with this person?” versus wondering “What harmful events may have contributed to the current problems and to the way the person is coping?” And, what can we do about the prevention of such events?

On May 23, 2013, former NHLer Theo Fleury, who was sexually abused by his hockey coach in the 1980’s, completed a 10-day “Victor Walk” aimed at raising awareness about childhood sex abuse and the need for healing. Yet, what exactly needs to be healed?

A ‘Little Warriors’ ad cited that “60% of women with panic disorder are victims of sexual abuse.” The charitable organization’s website (www.littlewarriors.ca) provides additional statistics around the consequences of childhood sexual abuse such as “70% of sexual abuse survivors report excessive use of drugs and alcohol.”

The link between childhood abuse and both mental health and addiction is significant. Author and physician ofVancouver’s Onsite detox centre, Dr. Gabor Maté stated he had “never met a single female patient down here [at the centre] who was not sexually abused as a child.”

Although girls are almost twice as likely to experience childhood sexual abuse, Maté observed that if his male patients had not been as a child sexually abused, “they were physically abused, abandoned, neglected, serially abandoned, or serially neglected.”

Regardless of the abuse, these actions cause immediate and long-lasting emotional and psychological suffering. Jung noted that the enduring emotional impact of childhood trauma “remains hidden all along from the [person], so that not reaching consciousness, the emotion never wears itself out, it is never used up.”

The intense feelings of anger, helplessness and shame along with horrific memories of the abuse are overwhelming for the child. Unable to process the emotions and events, trauma gets stored in the body. Physically, the person may later experience headaches, fibromyalgia, chronic fatigue, and gastro-intestinal and pelvic complaints.

On a neurological level, studies by Allan Schore and Bessel van der Kolk show specific changes in the brains of traumatized individuals. These changes correspond to noticeable inabilities to process feelings and to self-reflect, inhibited creative capacities and the altering of one’s sense of identity.

It is this shattered sense of self that brings real psychic suffering. As analyst Petra Affeld-Niemeyer observed, for many traumatized people, “It is as if the soul stopped breathing.”

How does one cope with such psychic suffering? As statistics show, one way is through addictive behaviours. Maté concluded that “the fundamental dynamic” which drives his patients’ addiction is the “immense pain that they have never been able to resolve or haven’t had the help to resolve.” The individual who has experienced trauma longs for (as we all do) the reconnection with his or her true self.

Researcher Robert Anda noted that the cumulative, long-term and invasive effects of traumatic childhood events are “likely to be invisible to health care providers, educators, social service organizations, and policy makers because the linkage between cause and effect is concealed by time.”

Many people, even those with traumatic backgrounds, do not fully see the connection between past abuse and current behaviours, body symptoms and psycho-emotional suffering. In most cases, time does not heal the pain; yet, awareness of these can lead to hope.