December 16, 2019
In California, where many social experiments seem to start, there currently is a movement to make it mandatory for all adults to be assessed for adverse childhood experiences (ACES), Psychology Today reports.
So, regardless of an adult patient’s presenting issue(s)—be they medical, psychological, or both— clinicians in public and private medical and psychotherapeutic settings would screen for childhood trauma.
The ACES test that is used in California to for ten forms of childhood trauma—five personal, five familial; as follows:
Personal traumas include physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect.
Familial traumas include addiction, domestic violence, incarceration, mental illness; and divorce or abandonment.
The ACES test is scored on a scale of one through ten, Psychology Today notes, with each type of trauma experienced counting as one point. So an individual with an alcoholic father— and an early-life history of verbal abuse and emotional neglect—would score three on the ACES screening.
Research consistently links ACES to adult-life physical, emotional, and relational issues. The higher a person’s ACES score is, the more likely that person is to experience physical ailments like heart disease, diabetes, and cancer. Similarly, the higher a person’s ACES score is, the more likely he or she is to experience psychological and behavioral issues like anxiety, depression, and addiction.
Indeed, according to the news outlet, research very consistently reaches these results. For example, one wide-ranging study found that individuals with an ACES score of four or higher are:
- 1.8 times as likely to smoke cigarettes;
- 1.9 times as likely to become obese;
- 2.4 times as likely to experience ongoing anxiety;
- 2.5 times as likely to experience panic reactions;
- 3.6 times as likely to be depressed;
- 3.6 times as likely to qualify as promiscuous;
- 6.6 times as likely to engage in early-life sexual intercourse;
- 7.2 times as likely to become alcoholic; and
- 11.1 times as likely to become intravenous drug users.
The amount of research producing similar results is almost overwhelming. So there’s an undeniable link between early-life trauma and numerous adult-life physical and psychological disorders.
In a nutshell, research reveals that childhood trauma is very common among all races and social strata. Very often it is unidentified, unacknowledged, and unaddressed. And it contributes to all sorts of adult-life physical, emotional, and relational problems.
The basic ACES Screening test is a mere ten questions, and it’s limited to five personal and five familial categories. The instrument does not examine bullying, racism, financial struggles, severe illness or accident, and a thousand other possible forms of trauma
Additionally, there is a lack of explanation about what may qualify in a particular category. For instance, an overly enmeshed, covertly sexualized relationship with a parent is, from a psychological standpoint, a form of both sexual abuse and emotional abuse/neglect (adversely affecting the child’s emotional and relational development). But most people, especially those new to the process of healing, will not readily identify it as such.
Usually, however, forms of trauma not covered by the ACES screening and not-so-easily spotted forms of trauma that are covered will trigger at least one or two peripheral yes responses. At the very least, a client will say, “Hmmm, I’m not sure about this one.” Any yes response or any uncertain response should automatically cause the clinician to explore the matter further, recognizing that a full course of treatment, whatever the presenting issue happens to be, may eventually require the exploration, acceptance, and resolution of underlying ACES.
When early-life trauma is uncovered via assessment or during the course of another treatment, and when that trauma appears to be linked to the patient’s adult-life issues (physical, emotional, relational), it will need to be acknowledged and addressed, preferably with the assistance of a clinician who specializes in trauma work as part of his or her practice.
The ACES screening assessment can be found at this link.
Research contact: @PsychToday