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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Adverse childhood experiences | 5/6 | https://en.wikipedia.org/wiki/Adverse_childhood_experiences | reference | science, encyclopedia | 2026-05-05T15:31:17.921938+00:00 | kb-cron |
== Adverse Childhood Experiences Study == The Adverse Childhood Experiences Study was a collaborative effort between the US private healthcare organization Kaiser Permanente and the government-run Centers for Disease Control and Prevention to examine the long-term relationship between adverse childhood experiences and a variety of health behaviors and health outcomes in adulthood. An underlying thesis of the ACE Study is that stressful or traumatic childhood experiences have negative neurodevelopmental impacts that persist over the lifespan and increase the risk of a variety of health and social problems. The ACE Study was based at Kaiser Permanente's San Diego Health Appraisal Clinic, a primary care clinic where each year more than 50,000 adult members of the Kaiser Permanente Health Maintenance Organization receive an annual, standardized, biopsychosocial medical examination. Each member who visits the Health Appraisal Clinic completes a standardized medical questionnaire. The medical history is completed by a health care provider who also performs a general physical examination and reviews laboratory test results with the patient. Appointments for most members are obtained by self-referral with 20% referred by their health care provider. In the 1980s, the dropout rate of participants at Kaiser Permanente's obesity clinic in San Diego, California, was about 50%; despite all of the dropouts successfully losing weight under the program. Vincent Felitti, head of Kaiser Permanente's Department of Preventive Medicine in San Diego, conducted interviews with people who had left the program, and 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. Felitti and Robert Anda from the Centers for Disease Control and Prevention (CDC) 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. Participants were asked about different types of adverse childhood experiences that had been identified in earlier research literature: physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, exposure to domestic violence, household substance abuse, household mental illness, parental separation or divorce, and incarcerated household member. This article incorporates text from this source, which is by David W Brown, Robert F Anda, Vincent J Felitti, Valerie J Edwards, Ann Marie Malarcher, Janet B Croft, and Wayne H Giles available under the CC BY 2.0 license.
=== Findings ===
According to the United States' Substance Abuse and Mental Health Services Administration, the ACE study found that:
Adverse childhood experiences are common. For example, 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. Because ACEs occur in clusters, many subsequent studies have examined the cumulative effects of ACEs rather than the individual effects of each. Adverse childhood experiences have an exponential dose–response relationship with many health problems. 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. About two-thirds of individuals reported at least one adverse childhood experience; 87% of individuals who reported one ACE reported at least one additional ACE. The number of ACEs was strongly associated with adulthood high-risk health behaviors such as smoking, alcohol and drug abuse, promiscuity, and severe obesity, which were correlated with ill health, including depression, heart disease, cancer, chronic lung disease and shortened lifespan. Compared to an ACE score of zero, having four adverse childhood experiences was associated with:
a seven-fold (700%) increase in alcoholism an elevenfold (1100%) increase in using drugs a twofold (200%) increase in smoking a threefold (300%) increase in smoking before the age of 14 a doubling risk of being diagnosed with cancer a four-fold increase in emphysema a 3.9-fold (390%) increase in risk of being diagnosed with COPD An ACE score above six was associated with a 30-fold (3000%) increase in attempted suicide. The study also found that two-thirds of suicide attempts are directly linked to ACEs. The effects of ACEs on lifestyle problems also depend on the types of ACEs experienced with studies reporting that individuals who experienced household substance abuse during childhood were 3.3 times as likely to abuse substances as adults compared to people with the same ACE score but who did not experience household substance abuse during childhood.
==== Other studies ==== One study conducted in the United Kingdom found that having four or more ACEs was associated with a twofold increase in alcoholism.
=== Subsequent surveys === The ACE Study has produced more than 50 articles that look at the prevalence and consequences of ACEs. The original study questions have been used to develop a 10-item screening questionnaire.