Adverse Childhood Experiences (ACEs) are different types of mistreatment, household dysfunction, or neglect that occur during childhood. The investigation of ACEs and how they might affect disease, disability, and early mortality in adulthood began in the 1990s by the CDC and Kaiser Permanente. Although such childhood experiences are unfortunately common in American families, the full range of the effects of ACEs are under-studied.
A study by Nagy Youssef and colleagues looked at the relationship between ACEs and the development of depressive symptoms. They were most interested in resilience, the ability to cope with stress and thrive in the face of adversity, which they believed might mitigate the impact of depression. The researchers evaluated ACE questionnaire scores—a list of particular forms of childhood mistreatments—from over 400 study participants to evaluate their exposure to physical abuse, emotional neglect, domestic violence, and other adverse experiences prior to age 18. The more experiences of childhood adversity, the higher the ACE score.
Resilience develops over the life course. To build resilience and overcome the harmful impacts of abuse, neglect, and household dysfunction, children at risk must first be identified.
Most participants in the study had mild exposure (an occurrence of 1-2 ACEs) to childhood adversity. Household dysfunction as a result of parental marital discord was found to be the most common ACE. Of particular importance, the investigators showed that ACEs have a dose-response relationship with depression: as the exposure to childhood trauma increases, so too do symptoms of depression.
Encouragingly, young adults with high ACE scores who possessed high levels of self-confidence, self-efficacy, and optimism, among other characteristics of resilience, showed fewer depressive symptoms than those with low levels of these attributes. These results suggest that individual resilience mitigates the development of depression in young adults with a history of childhood adversity.
Resilience develops over the life course. To build resilience and overcome the harmful impacts of abuse, neglect, and household dysfunction, children at risk must first be identified. The ACE questionnaire and other measures to recognize childhood adversity need to be administered in clinical or school settings. Finding and fostering nurturing relationships within the broader community in which a child grows is key to recover from difficult suffering.