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Adverse Childhood Experiences and Trauma
~ 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

~ 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
~ 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

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