Childhood Trauma – the ACE-study.


Understanding Trauma in Childhood – Exposure and risk; the ACE study.


The ACE-study itself.

Initially the ‘Adverse Childhood Experiences Study’ or ACE-study was conducted by Vincent Felitti. He wondered why so many people did drop out of his losing weight program despite successfully losing the weight[1]. He discovered that a majority of 286 people he interviewed had experienced childhood sexual abuse. The interview findings suggested to Felitti that weight gain might be a coping mechanism for depression, anxiety, and fear.[2]

Later Felitti and Robert Anda went on to survey childhood trauma experiences of over 17,000 Kaiser Permanente patient volunteers. The 17,337 participants were volunteers from approximately 26,000 consecutive Kaiser Permanente members. About half were female; 74.8% were white; the average age was 57; 75.2% had attended college; all had jobs and good health care, because they were members of the Kaiser health maintenance organization. Participants were asked about different types of childhood trauma that had been identified in earlier research literature.



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What traumatic events were taken into account in the ACE-study?

Research found that our risk for mental and physical health problems from a past trauma goes up with the number of traumatic events you’ve experienced. For example, your risk for problems is much higher if you’ve had three or more negative experiences, called Adverse Childhood Experiences (ACEs). If you click the link, you can get a feeling what experiences are brought into account and you can calculate your score.

Adverse Childhood Experiences include physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, witnessing domestic violence, substance misuse within the household, mental illness within the household, parental separation or divorce and incarceration of a household member.


What were the findings of the ACE-study?

Adverse childhood experiences are common. 28% of study participants reported physical abuse and 21% reported sexual abuse. Many also reported experiencing a divorce or parental separation, or having a parent with a mental and/or substance use disorder.

Adverse childhood experiences often occur together. Almost 40% of the original sample reported two or more ACEs and 12.5% experienced four or more. They often occur in clusters.

As researchers followed participants over time, they discovered that a person’s cumulative ACEs score has a strong, graded relationship to numerous health, social, and behavioral problems throughout their lifespan, including substance use disorders. Furthermore, many problems related to ACEs tend to be comorbid, or co-occurring.


Why is this so important?

Early exposure to adversities affects the body and brains of children. It affects the pleasure and reward system of the brain, the nucleus accumbens. It inhibits the prefrontal cortex (impulse control and executive functions, learning ability) On MRI-scans we see differences in the amygdala, the region in the brain responsible for fear response.

Based on these findings we can conclude that people who experienced a high score on the ACE questionnaire are more likely to involve in high-risk behavior later in life. Even when you don’t engage in high risk behavior you are still more likely to develop heart disease or cancer. This has to do with the HPA-axis in your brain or what sets your fight or flight response in action. If you want to know more about the HPA-axis, you can read ‘What stress can do to your body’.

In short, when your HPA-axis works overtime because of high doses of stress, you stay in a more stressed state. There are consequences on your immune and hormonal system.

Now you have an understanding what trauma can be next week I’ll look into the health risks engaged with the occurrence of traumatic events in childhood.



References and resources.


TED talk from Nadine Burke Harris on YouTube.

Online article Harvard Health Publishing (2019). Past trauma may haunt your future health. 

Website trauma dissociation where you can find the Adverse Childhood Experiences Questionnaire and other useful information related to trauma.

[1] Wikipedia article about the ACE-study. More info on the study itself you can find there.

[2] Stevens, Jane Ellen (8 October 2012). “The Adverse Childhood Experiences Study — the Largest Public Health Study You Never Heard Of”. The Huffington Post.

Illustration credits click here.

28 thoughts on “Childhood Trauma – the ACE-study.

  1. Do you ever think about just how many child molesters are out there? It’s got to be in the millions based on those reporting abuse…and that doesn’t account for those who don’t. There’s got to be some common themes, symptoms and indicators that science could find that might identify these people before they do it. I had no idea how many people had to deal with this until I started talking about mine. It’s tragic.

    Liked by 1 person

    1. Yes it’s very very common yet a big taboo! I guess maybe because people ‘hope’ it isn’t going to be ‘their’ child.
      I feel like both party’s are being victimized in the ‘wrong’ way.
      People just want to sweep it under the rug. I’ve noticed some (maybe more) dirty looks when I tell my story (which is not that weird or upsetting, it’s not sexual). Like there is something ‘wrong’ with me.
      Like you said, help should be offered and some scenarios could be prevented. Or ‘normalized’ in a way that there would be more openness to identify all the important factors that play a role in it. And that victims could open up more about their experiences.

      Liked by 2 people

    2. I have a question: My understanding is that in the USA you need (sometimes?) register as a sex offender when you are convicted for such things. And those records are public I believe. Do you think that can be a good thing for parents, children and society? To know that information? Is it helpful or does it hinder some closure or a better outcome for the ‘offender’ in terms of getting help, getting better.
      I ask this because in Belgium that doesn’t happen. We don’t know who lives near a school or a park. We don’t know but the last years a lot awareness is brought on how to protect children but more in general terms.


      1. I think the registry is designed to make politicians look good and citizens feel safer, but there is no scientific proof it has any more positive effect than not having one. You can actually commit manslaughter — killing someone — be released from prison prior to a sex offender with a fairly mild charge, and not be put on a list. You can sell drugs to a child, be convicted, but when you return to society, you’re not put on a list. You can beat the shit out of a child…no list.

        There is also no delineation of levels on the list, at least in America. In New Zealand, I think it is, there are three tiers so people know how heinous the crime was and your risk of reoffending, but here, you can do what I did, accidentally talk to a teenager online who takes off her clothes, and you’re on the same list with people who brutally rape their own children.

        Being on this list means in most cities, there are certain places you can’t live. It means that you have to check in with the police every few months. It means that when you travel, if you spend more than 5 days in one spot, you have to alert the authorities. It means difficulty — if not impossibility — of getting an apartment, loan or a decent job.

        The way that the US does it is a farce. It may make people who don’t need proof it doesn’t work sleep at night, but there is no proof it’s helping. It’s mostly only helping people who made a horrible mistake and are just trying to get their life back together.

        Liked by 1 person

      2. I’m starting to wonder if there is any system that works for somebody.
        There should be differences in ‘risk’ to relapse. I can imagine someone suffering very hard from this system for maybe a crime that ‘looked’ wrong and someone who has a thicker skin and really doesn’t care about the law or other people. They don’t care and they can do it again.
        I think people should watch out for people. When you see something or have a feeling something is really wrong, speak up! Don’t accuse anybody out of the blue but use your speech with reason. I think I would feel the most safe, when I knew that several people are looking out for each other.
        Sounds like 100 years back in time!


  2. I do not discuss weight with her, but my daughter must weigh easily over 100kg. At 20 years old and maybe 160cm.

    From our observations, she has no “full” indicator and overeats anyway. Which is not helped by making poor nutritional choices to start with.
    But then you have seen from my posts about what happened – it must have been traumatic for her too. I think one place they put her, she found a syringe in her mattress. So none of that helped her weight.

    Liked by 1 person

    1. A lot of those issues with weight, plastic surgery, the need for (excessive) attention, obsessing about … have to do with an underlying theme that hasn’t been resolved. Some things also need time to learn and to heal. Live is a journey and we grow as we travel with the luggage we have. I find it ‘refreshing’ for me to know that there a causes for my behavior and that I’m not ‘just’ stupid for doing this or that. That the behavior is a choice to some point but also a ‘directed’ one, possibly. What we do with it now it up to us. There is some responsibility to be taken otherwise nothing will ever change.

      Liked by 1 person

      1. I used to say to daughter that for all her ills (she was diagnosed ADHD at about Age 10) that yes, it just meant that she had to make that much extra effort to get along in life. It is still true for her, it is true for me now as well.

        Liked by 1 person

  3. Do you ever think that all this information only leads to to more information? With all due respect Kacha, maybe the reasons don’t matter as much as we would like to believe. We have to play the hand we’re dealt and move on from trying to fix ourselves.

    Liked by 1 person

    1. Information is just that, information. It is what it is. I agree 100%
      For me it’s fun to find out what we know already and I like to understand things and look at them in different ways.
      But knowing or not, understanding or not, the work is there. And we need to live our lives as they present themselves.
      Information gathers dust when it’s not useful to the practice.
      But to be honest, brr, information and understanding things is a security blanket for me. I’m doing things in my life, I change but on my blog I like to gather information, for old times sake. I hope this makes any sense to you. Thank you for such a good comment!

      Liked by 1 person

      1. Its been said that How we do things is more important than Why. I know my cousin who has schizophrenia was told to stop reading about her condition because she was always finding new reasons which only made her look for more reasons.
        take care Kacha

        Liked by 1 person

      2. I see what you mean. Too much digging or too much information doesn’t serve its purpose that is very true. And maybe even a little true in my personal case.
        I’ve studied psychology so I’m used to read about studies and things. I’m naturally curious about all that. Some things have a connection with me and my history but not all. Sometimes I write things up because I find them interesting. I understand that it can be maybe boring and a lot of ‘the same’. But it is what gets me up in the morning.
        Take care of you too

        Liked by 1 person

    2. Mike Ross I played the hand I was held for many many years I was successful. I went to uni two degrees and then my world collapsed. I had a break down, I have battled all my life to belong in my own family. If I had not asked for help I would not be here anymore, I would have killed myself. I am very very happy to be waking up each day. I am a very different person to the person I was before my breakdown. If I had not had it and had some incredible help I would still be trying to be accepted into my family. I have no communications with most of them. I communicate in my way on my terms. I was scapegoat and physically verbal emotionally abused by my parents, I was neglected. Yet when I asked my siblings they both would not answer if they had been belted and treated the way I had been. Yet all I wanted was to be accepted by them. In some ways my siblings continued some of the emotional and verbal abuse.

      I kept ending up in the same place regularly lost. Confused and bewildered. I do not see it as fixing myself, I believe I have always known what was best for me, yet it contradicted my family values and life. I beat to a very different drum. So am I fixing myself, no I am just taking who I really am and learning to be that person. Free from restraints that the tapes in my head have played over and over for manny years.

      Liked by 1 person

      1. Tazzie I’m so sorry you had to through this. Thank you so much for your honest and elaborate answer.
        Probebly not the same but your story did ring some bells here.
        It’s a (long) journey to free yourself from the tapes in your head but one step at the time (in your new winterboots) will do the trick. You’re incredibly courageous! (I know your comment wasn’t ment for me but still)

        Liked by 1 person

  4. I had been getting the sense that Adverse Childhood Experiences were fairly common or at least more common than we generally like to think. I can’t say I’m happy to be right, but I’m also not surprised. When I was in my teens, I often read the Readers Write section of a magazine called The Sun. People would share their experiences on a topic, often with brutal honesty. Many of the stories mentioned one or more of the experiences in this questionnaire.

    Reading those stories was not always a pleasant experience, but what struck me most was that while the writers definitely lived with scars, they also still fought to be happy and decent human beings. I think my mother sometimes worried about me reading those stories, but for me they were eye-opening and ultimately inspiring.

    Liked by 2 people

    1. Seeing reality for what it is and still find the courage to fight and to strive to overcome your own struggles is something to admire.
      I sometimes can’t believe stories of people who survived horrible things and still manage to hold on a happy outlook on life and to build a life and a family.
      Honest stories are so inspiring.

      Liked by 2 people

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