People who have ACEs -- it's not just them; it's us, too

"We should know this about everybody we encounter in health and human services," said Dr. Robert Anda, a physician and research epidemiologist. He was giving a presentation at the Casey Family Programs Early Learning Symposium last November 4 in Seattle, WA.

He was referring to the child trauma histories of the 17,241 people who participated in the Centers for Disease Control and Prevention's ACE Study. Now, mind you, this group of people belong to the upper socioeconomic tier of this country (not the super-rich....they're in the socioeconomic stratosphere, but not without their ACE issues, as the news of celebrities' problems with alcohol or drug addiction shows). As Anda points out in his presentation (the video is here), they live in San Diego, not an inexpensive place to live. Only 6 percent have NOT graduated from high school. Most attended college. They all had good jobs, or were married to someone with a good job, and belonged to one of the best health-care organizations in the country. With their average age at 57, they had a prosperous life. But, take a look at this.

Nearly one out of three of these middle- and upper-middle class overwhelmingly white people grew up in a household where a parent was addicted...mostly to alcohol, but other drugs also. Nearly one out of three experienced physical abuse. Almost one out of four lost a parent to divorce or separation. One out of five were sexually abused. One out of six suffered emotional neglect and had a family member diagnosed with a mental illlness.

Prior to the ACE Study, we believed that these issues were found only in people who were poor and lived in the inner city, or were poor and lived in rural areas. As Anda has pointed out, "It's not just them; it's us, too." Which explains a lot, such as why our obesity, heart disease, and cancer rates are so high and climbing.

The kicker is that if a person has one adverse childhood experience, they're likely to have more. Only one out of three people had no childhood trauma. One our of four had an ACE score of one. Forty percent had at least two. One out of four had three or more, which is the level where significant links between ACE scores and adult onset of chronic illness begin to show up. One out of 10 had five or more, and these people are often those that physicians see the most, or who show up in emergency rooms the most often.

Anda told me that, when the ACE Study first started, he got up in the middle of the night to check the computer run for the first batch of questionnaires. As he looked at the results, he began crying. He couldn't believe what he was seeing. As he says in the video, "How come I didn't know this? Nobody taught me this!"

How do the CDC researchers who are involved in the ACE Study know it's for real? Well, it's a little difficult for 17,000 people to coordinate their responses; and if you keep seeing the same trends, it's unlikely that people are making this stuff up. And, the researchers been cross-checking with other studies -- most of which focus on just one of the experiences -- and those results are pretty much the same. And other states that are conducting their own ACE studies, are finding similar results. In his presentation, he compares Washington State's results with San Diego's.

So, why is this so important? When a child grows up in a toxic environment, one where there's a LOT of stress and danger, that child's brain is physically affected. More about that in tomorrow's post.

To cope, many kids start "escaping" into alcohol or other drugs, risky sexual behavior, risky financial behavior (shopaholicis), overeating, smoking, etc. Choose your poison. The poison that masks itself as a solution to give you a break from a misery that surrounds you as soon as you go home.

The kids that choose alcohol risk further damage to their brain development. Brains, those complex globs of jelly, don't mature until we're in our mid-20s. In this study reviewed by Karin Zeitvogel at Agence France Presse, Stanford University and University of California researchers found that binge-drinking can have a long-lasting effect on teens, especially on girls. Binge-drinking is at least five drinks for males and four for females. The brain scans of the research participants, none of whom had a drinking problem, showed less activity in several regions than teens who had not been drinking in the previous three months.

"These differences in brain activity were linked to worse performance on other measures of attention and working memory ability," Stanford University psychiatry professor Susan Tapert, a co-author of the study, said.

This is the second in a series of posts that accompany questions from the simple version of the ACE Study questionnaire. There are 10 questions on the general ACE Study questionnaire, and for the next two weeks, we'll be putting one question out each day in a poll. Today is the second question. Each day I'll take a look at some of the research — ACE, brain development, and epigenetic — to provide more information and context. I encourage you to take the simple ACE test for yourself. There's also a link to the full 200-question survey.

Day One post is here. And its accompanying poll question is here. Here's a snapshot of the poll, as of 7:30 a.m. this morning.

Tagged: child trauma, ACE Study, CDC, alcoholism

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