ACEs Science Research

Here are extremely useful category searches on PubMed for more than 1,000 publications relating to the link between adverse childhood experiences, trauma-informed care/practices and diseases and conditions:


We have organized the list below according to the five parts of ACEs science, which are:

  1. the epidemiology of adverse childhood experiences,
  2. the neurobiology of toxic stress caused by ACEs (effects on the developing brain),
  3. the health (biomedical) consequences of toxic stress,
  4. the epigenetic consequences of toxic stress (how the effects of ACEs are passed on from generation to generation,
  5. resilience research, which shows that the brain is plastic and the body wants to heal.

We've tried to include the seminal research or useful resources for each category. We know that this list is not complete, so if you have other publications to add, please do so in the comments section, and we'll include in the main list.

We have also included a list of external Resource Collections and Survey Validation research.


ACE Study and Related Publications

CDC-Kaiser Permanente Adverse Childhood Experiences Study
Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults, 1998
Description: This is the original ACE study conducted by Drs. Vincent Felitti and Robert Anda. [Felitti, Vincent J., et al. "Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study." American journal of preventive medicine 14.4 (1998): 245-258.]

CDC-Kaiser Permanente Adverse Childhood Experiences Study Journal Articles by Category, 1998- 2014
Description: This site provides journal articles produced by the CDC-Kaiser Permanente ACE Study cataloged by topic. The topics are: Commentary/Overview; Chronic Disease; Health Risk Behaviors; Mental Health; Methodological Issues; Reproductive Health/Sexual Behavior; Special Populations; Victimization and Perpetration; Other Health and Social Issues.

Adverse Childhood Experiences and Life Opportunities: Shifting the Narrative, 2016
Description: A recent CDC study shows early adversity can impact adult education, employment, and income. People who reported four or more ACEs were less likely to complete high school and more likely to be unemployed and live in a household with an income below the federal poverty level than those who reported no ACEs. [Metzler, Marilyn, et al. "Adverse childhood experiences and life opportunities: Shifting the narrative." Children and Youth Services Review (2016).]

The Health and Social Consequences of Adverse Childhood Experiences (ACE) Across the Lifespan: An Introduction to Prevention and Intervention in the Community, 1998
Description: This introduction to the themed issue overviews the Adverse Childhood Experiences (ACE) Study and discusses prevention and intervention with ACE and their consequences in communities. A commentary by Dr. Robert Anda, an ACE Study Co-Principal Investigator, is incorporated within this introduction. Implications of articles within the issue are addressed, and next steps are explored. [Larkin, Heather, Joseph J. Shields, and Robert F. Anda. "The health and social consequences of Adverse Childhood Experiences (ACE) across the lifespan: An introduction to prevention and intervention in the community." Journal of prevention & intervention in the community 40.4 (2012): 263-270.]

Unpacking the impact of adverse childhood experiences on adult mental health, July 2017
Description: Exposure to childhood adversity has an impact on adult mental health, increasing the risk for depression and suicide. Associations between Adverse Childhood Experiences (ACEs) and several adult mental and behavioral health outcomes are well documented in the literature, establishing the need for prevention. The current study analyzes the relationship between an expanded ACE score that includes being spanked as a child and adult mental health outcomes by examining each ACE separately to determine the contribution of each ACE. Data were drawn from Wave II of the CDC-Kaiser ACE Study, consisting of 7465 adult members of Kaiser Permanente in southern California. [Melissa T.MerrickaKatie A.PortsaDerek C.FordaTracie O.AfifibElizabeth T.GershoffcAndrewGrogan-KaylordChild Abuse & NeglectVolume 69, July 2017, Pages 10-19]

Epidemiology - International Reports

ACEs and their impact on health-harming behaviours in the Welsh adult population, 2016
Description: Results from the first Welsh Adverse Childhood Experience (ACE) study show that adults in Wales who were physically or sexually abused as children or brought up in households where there was domestic violence, alcohol or drug abuse are more likely to adopt health-harming and anti-social behaviors in adulthood. [Bellis, Mark A., et al. "Adverse Childhood Experiences (ACEs) in Wales and their Impact on Health in the Adult Population." Public Health Wales (2016)]

This is part 1 in a series of reports examining the prevalence of Adverse Childhood Experiences (ACEs) in the Welsh adult population and their impact on health and well-being across the life course.

ACEs and their association with mental wellbeing in the Welsh adult population, 2016
Description: The results from this survey contribute to a growing body of research that shows a strong link between Adverse Child Experiences and links with poor physical and mental health, chronic disease, lower educational achievement and lower economic success in adulthood. [Bellis, Mark A., et al. "ACEs and their association with mental wellbeing in the Welsh adult population." Public Health Wales (2016)]

This is part 2 in a series of reports examining the prevalence of Adverse Childhood Experiences (ACEs) in the Welsh adult population and their impact on health and well-being across the life course.

ACEs and their association with chronic disease and health service use in the Welsh adult population, 2016
Description: This report states that those in Wales who suffered four or more adverse childhood experiences (ACEs) are more than twice as likely to be diagnosed with a chronic disease in later life compared to adults that have experienced none. The report also found that over a 12-month period, those with four or more ACEs were three times more likely to have attended Accident and Emergency units, three times more likely to have stayed overnight in hospital, and twice as likely to have visited their primary care provider, compared to individuals with no ACEs. [Bellis, Mark A., et al. "ACEs and their association with chronic disease and health service use in the Welsh adult population." Public Health Wales (2016)]

This is part 3 in a series of reports examining the prevalence of Adverse Childhood Experiences (ACEs) in the Welsh adult population and their impact on health and well-being across the life course.

Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries, 2014
Description: Researchers measured the association between adverse childhood experiences and health-harming behaviors in young adults and explored how the relationships between such experiences and behaviors vary between the surveyed countries. ACE surveys were conducted by health ministries in Albania, Latvia, Lithuania, Montenegro, Romania, the Russian Federation, The former Yugoslav Republic of Macedonia, and Turkey. [Bellis, Mark A., et al. "Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries." Bulletin of the World Health Organization 92.9 (2014): 641-655.]

Adverse childhood experiences, chronic diseases, and risky health behaviors in Saudi Arabian adults: A pilot study, 2014
Description: This study examined associations between ACEs, chronic diseases, and risky behaviors in adults living in Riyadh, Saudi Arabia in 2012 using the ACE International Questionnaire (ACE-IQ). [Almuneef, Maha, et al. "Adverse childhood experiences, chronic diseases, and risky health behaviors in Saudi Arabian adults: A pilot study." Child abuse & neglect 38.11 (2014): 1787-1793.]

Adverse childhood experiences: retrospective study to determine their impact on adult health behaviours and health outcomes in a UK population, 2014
Description: This research investigates the links between ACEs and poor adult health and social outcomes in a non-US population. [Bellis, Mark A., et al. "Adverse childhood experiences: retrospective study to determine their impact on adult health behaviours and health outcomes in a UK population." Journal of public health 36.1 (2014): 81-91.]

Adverse childhood experiences survey among university students in Turkey, 2014
Description: The results of this study show a high prevalence of physical, emotional, and sexual abuse beside emotional and physical neglect in university students in Turkey. Overall, 49.7% of respondent reported exposure to at least one type of ACE. ACE score was positively associated with health risk behaviors of respondents. Respondents with a history of ACEs were more likely to have family, school, or financial problems.

Measuring mortality and the burden of adult disease associated with adverse childhood experiences in England: a national survey, 2015
Description: The researches employed the short ACE survey to examine associations between the number of ACE categories and cancer, diabetes, stroke, respiratory, liver/digestive, and cardiovascular disease. They also added a measure of premature mortality to associations between childhood stressors and the development of morbidity across the life course. [Bellis, Mark A., et al. "Measuring mortality and the burden of adult disease associated with adverse childhood experiences in England: a national survey." Journal of public health (2014): fdu065.]

Modelling the Relationship between Child Abuse and Long-Term Health Care Costs and Wellbeing: Results from an Australian Community-Based Survey, 2013
Description: Researchers model the relationship between childhood abuse and long-term health, health care costs, and well being using data from the 2007 Australian National Survey of Mental Health and Wellbeing. The full article is available for purchase. [Reeve, Rebecca, and Kees Gool. "Modelling the Relationship between Child Abuse and Long‐Term Health Care Costs and Wellbeing: Results from an Australian Community‐Based Survey." Economic Record 89.286 (2013): 300-318.]

National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England, 2014
Description: A national household survey of adults resident in England was undertaken to measure levels of ACEs across England, calculate the prevalence of exposure to multiple ACE counts, and examine the relationships between ACE exposure and health-harming behaviors. [Bellis, Mark A., et al. "National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England." BMC medicine 12.1 (2014): 1.]

Relationships between adverse childhood experiences and adult mental well-being: results from an English national household survey, 2016
Description: Using a randomly selected national household sample of English adults, the study found a strong cumulative relationship between childhood adversities and two widely used measures of mental well-being: SWEMWBS scores and life satisfaction. These relationships remained after controlling for demographics [Hughes, Karen, et al. "Relationships between adverse childhood experiences and adult mental well-being: results from an English national household survey." BMC public health 16.1 (2016): 1.]

Survey of Adverse Childhood Experiences among Romanian university students, 2013
Description: A survey on adverse childhood experiences was conducted on a representative sample of 2088 young adults from 17 public universities in Romania. The aim of the study was to assess the prevalence of ACE in Romania, and to identify relationships between exposure to ACE and health risk behaviors, and health outcomes. [Baban, A., et al. "Survey of adverse childhood experiences among romanian university students. Copenhagen, WHO Regional Office for Europe." (2013).]

Survey of adverse childhood experiences among young people in the former Yugoslav Republic of Macedonia, 2013
Description: This survey of adverse childhood experiences was undertaken in 1277 students aged over 18 years from a representative sample of high schools and universities in the former Yugoslav Republic of Macedonia. [Raleva, Marija, et al. "Survey of adverse childhood experiences among young people in the former Yugoslav Republic of Macedonia." (2013).]

Survey of adverse childhood experiences among young people in the former Yugoslav Republic of Macedonia, 2014
Description: The survey on the prevalence of ACEs in Russia was conducted in a sample of young adult students in higher education institutions and colleges. ACEs were common and 84.6% reported at least one. The findings show that the odds of developing health risk behaviors such as smoking, alcohol, illicit drugs, multiple sexual partners, and suicide attempts increased with the ACE score.

Epidemiology - National & State Reports

U.S. State ACE survey reports, 2014
Description: Link to state reports on Behavioral Risk Factor Surveillance System (BRFSS) ACEs module data. 

Adverse Childhood Experiences Data Links Trauma and Outcomes, 1998
Description: This 3-page brief describes the use of the ACE data by Washington State to develop community-based collaborative groups to focus services on areas most in need.

Adverse Childhood Experiences in Shelby County Tennessee, 2015
Description: The ACE Center Task Force of Shelby County released data showing a direct link between chronic exposure to traumatic events throughout childhood and negative behaviors and health conditions as adults. According to the report, adults of all races and ethnicities report having experienced ACEs, which for the purpose of the survey include abuse, neglect, and household dysfunction. The group also unveiled “Universal Parenting Places,” a parenting resource intended to prevent those traumatic childhood experiences.

Adverse Childhood Events and Current Depressive Symptoms Among Women in Hawaii: 2010 BRFSS, Hawaii, 2013
Description: This abstract summarizes the research on the association between adverse childhood events (ACEs) and depression among women in Hawaii. The full article is available for purchase. [Remigio-Baker, Rosemay A., Donald K. Hayes, and Florentina Reyes-Salvail. "Adverse childhood events and current depressive symptoms among women in Hawaii: 2010 BRFSS, Hawaii." Maternal and child health journal 18.10 (2014): 2300-2308.]

Adverse Childhood Experiences: National and State-Level Prevalence, 2014
Description: In this brief, the prevalence of one or more ACEs among children ages birth through 17, as reported by their parents, using nationally representative data from the 2011/12 National Survey of Children’s Health (NSCH) is described. Authors estimate the prevalence of eight specific ACEs for the U.S., contrasting the prevalence of specific ACEs among the states and between children of different age groups.

Explore the data through the website's interactive data query here.

Adverse Experiences: Indicators on Children & Youth, 2014
Description: This indicator uses a list of nine adverse experiences, developed for the 2011/12 National Survey of Children’s Health. Differences in age, race, poverty level, and parental education trends are illustrated. [City Trends Data Bank, 2013]

BRIEF: Beyond ACEs, 2016
Description: The National Crittenton Foundation highlights findings of the 2014-2015 administration of the ACE survey at 18 Crittenton agencies in 16 states. This second administration of the ACE survey included additional demographic information, which includes outcomes data and the pilot use of well-being questions.

A webinar covering the use of the well-being questions piloted by seven of the participating Crittenton agencies can be accessed here.

Disparities in adversity among children with autism spectrum disorder: a population-based study, 2016
Description: The prevalence of ACEs in children with and without autism spectrum disorder. The data for this population-based sample comes from the 2011 to 2012 National Survey of Children Health.

Exploring the Prevalence of Adverse Childhood Experiences in Soldiers Seeking Behavioral Health Care During a Combat Deployment, 2016
Description: This exploratory study examines the prevalence of ACEs in soldiers who sought behavioral health support during a combat deployment. Of those who sought support, 83% reported at least 1 ACE. 40% had 4 or more ACEs. [Applewhite, Larry, Derrick Arincorayan, and Barry Adams. "Exploring the prevalence of adverse childhood experiences in soldiers seeking behavioral health care during a combat deployment." Military medicine 181.10 (2016): 1275-1280.]

Full text available for purchase.

Human Trafficking of Minors and Childhood Adversity in Florida, 2017
Description: The results of this study are as follows: ACE composite scores were higher and 6 ACEs indicative of child maltreatment were more prevalent among youths who had human trafficking abuse reports. Sexual abuse was the strongest predictor of human trafficking: the odds of human trafficking was 2.52 times greater for girls who experienced sexual abuse, and there was a 8.21 times greater risk for boys who had histories of sexual abuse. [Reid, Joan A., et al. "Human trafficking of minors and childhood adversity in Florida." American Journal of Public Health (ajph) (2017).]

National Survey of Child and Adolescent Well-Being (NSCAW), No. 20: Adverse Child Experiences in NSCAW, 2013
Description: NSCAW II is a national longitudinal study of 5,873 children, ranging in age from 2 months to 17.5 years old, who had contact with the child welfare system between 2008 and 2009.

Self-Rated Health and Association with ACEs, 2012
Description: Data from a retrospective cross-sectional survey of low-income minority primary care patients (18 years and older) at a federally qualified community-based NMHCC located in the northeastern region of the US is examined.  [Waite, Roberta, Maureen Davey, and Laura Lynch. "Self-rated health and association with ACES." Journal of Behavioral Health 2.3 (2013): 197-205.]

Epidemiology - Local Reports

ACEs in Head Start Children and Impact on Development, 2014
Description: This report provides initial findings of the level of risk in a Head Start population and the predictive power of children’s ACEs and school readiness measures. This is an ongoing ACEs screening in Spokane, WA of young children and their parents. [Blodgett, Christopher. "ACEs in Head Start Children and Impact on Development." Washington State University. CLEAR Trauma Center. (2014).]

Adverse Childhood Experiences in the New Mexico Juvenile Justice Population, 2016
Description: A study out of the University of New Mexico School of Law, in collaboration with the New Mexico Sentencing Commission, shows the relationship betweenACEs and juvenile delinquency. The study found that youth in the New Mexico juvenile justice facilities suffered high numbers of adverse childhood experiences and other trauma prior to incarceration.

Adverse Childhood Experiences of Low-Income Urban Youth (Philadelphia, PA, USA), 2014
Description: Current ACE assessments may not adequately encompass the breadth of adversity to which low-income urban children are exposed. This study used focus groups of young adults who grew up in low-income Philadelphia neighborhoods to identify and characterize the range of ACEs faced. Additional experiences not included in the original ACE survey, but endorsed by the study participants include: single-parent homes, bullying, and discrimination. [Wade, Roy, et al. "Adverse childhood experiences of low-income urban youth." Pediatrics 134.1 (2014): e13-e20.]

The Impact of Adverse Childhood Experiences on an Urban Pediatric Population, 2011
Description: Data from a retrospective chart review of 701 subjects from the Bayview Child Health Center in San Francisco are presented. [Burke, Nadine J., et al. "The impact of adverse childhood experiences on an urban pediatric population." Child abuse & neglect 35.6 (2011): 408-413.]

Epigenetics

Epigenetics Backgrounders

Association of Socioeconomic Status in Childhood With Left Ventricular Structure and Diastolic Function in Adulthood, 2017
Description: Researchers investigate the association between childhood family socioeconomic status and cardiovascular disease in adulthood. [Laitinen TT, Puolakka E, Ruohonen S, Magnussen CG, Smith KJ, Viikari JSA, Heinonen OJ, Kartiosuo N, Hutri-Kähönen N, Kähönen M, Jokinen E, Laitinen TP, Tossavainen P, Pulkki-Råback L, Elovainio M, Raitakari OT, Pahkala K, Juonala M. Association of Socioeconomic Status in Childhood With Left Ventricular Structure and Diastolic Function in AdulthoodThe Cardiovascular Risk in Young Finns Study. JAMA Pediatr. Published online June 26, 2017]

Brain on stress: How the social environment gets under the skin, 2012
Description: An overview emphasizing the interplay between cumulative wear and tear (allostatic load/overload) facilitated by the same mediators that are essential for adaptation and survival. [McEwen, Bruce S. "Brain on stress: how the social environment gets under the skin." Proceedings of the National Academy of Sciences 109.Supplement 2 (2012): 17180-17185.]

Biological memory of childhood maltreatment: current knowledge and recommendations for future research, 2012
Description: Child maltreatment (CM) leads to detrimental and lifelong psychological and physiological alterations - building a biological memory of CM, which might even be transmitted to the next generation. [Schury, Katharina, and Iris‐Tatjana Kolassa. "Biological memory of childhood maltreatment: current knowledge and recommendations for future research." Annals of the New York Academy of Sciences 1262.1 (2012): 93-100.]

Early Experiences Can Alter Gene Expression and Affect Long-Term Development: Working Paper No. 10, 2010
Description: This working paper explains why it is important consider carefully the early environmental influences of young children. [National Scientific Council on the Developing Child (2010). Early Experiences Can Alter Gene Expression and Affect Long-Term Development: Working Paper No. 10. Retrieved from www.developingchild.harvard.edu.]

Epigenetic Risk Factors in PTSD and Depression, 2013
Description: Identification of early-life stress-associated epigenetic risk markers informing on previous stress history can help to advance early diagnosis, personalized prevention, and timely therapeutic interventions, thus reducing long-term social and health costs. [Raabe, Florian Joachim, and Dietmar Spengler. "Epigenetic risk factors in PTSD and depression." Epigenetic pathways in PTSD: how traumatic experiences leave their signature on the genome (2015): 33.]

Epigenetics and child abuse: Modern-day darwinism — The miraculous ability of the human genome to adapt, and then adapt again, 2015
Description: This is a review of a growing body of literature implicating ACEs in a broad range of negative health consequences.[Gershon, Naomi B., and Pamela C. High. "Epigenetics and child abuse: Modern‐day darwinism—The miraculous ability of the human genome to adapt, and then adapt again." American Journal of Medical Genetics Part C: Seminars in Medical Genetics. Vol. 169. No. 4. 2015.]

Full text available for purchase.

Germ line–inherited H3K27me3 restricts enhancer function during maternal-to-zygotic transition, 2017
Description: Researchers from the Max Planck Institute of Immunobiology and Epigenetics provide evidence that inherited epigenetic instructions contribute to the regulation of gene expression in offspring. [Zenk, Fides, et al. "Germ line–inherited H3K27me3 restricts enhancer function during maternal-to-zygotic transition." Science 357.6347 (2017): 212-216.]

Holocaust Exposure Induced Intergenerational Effects on FKBP5 Methylation, 2015
Description: The children of traumatized people have long been known to be at increased risk for posttraumatic stress disorder, and mood and anxiety disorders. However, according to researchers, there are very few opportunities to examine biologic alterations and epigenetic effects of trauma in exposed people and their adult children born after the event. This is the first demonstration of an association of preconception parental trauma with epigenetic alterations that is evident in both exposed parent and offspring, providing potential insight into how severe psychophysiological trauma can have intergenerational effects. [Yehuda, Rachel, et al. "Holocaust exposure induced intergenerational effects on FKBP5 methylation." Biological psychiatry (2015).]

Prereproductive Stress to Female Rats Alters Corticotropin Releasing Factor Type 1 Expression in Ova and Behavior and Brain Corticotropin Releasing Factor Type 1 Expression in Offspring, 2015
Description: Researchers investigated changes in CRF1 expression in brain and ova of stressed female rats and in the brain of their neonate and adult offspring. Behavioral changes in adulthood were also assessed. Full text is available for purchase. [Zaidan, Hiba, Micah Leshem, and Inna Gaisler-Salomon. "Prereproductive stress to female rats alters corticotropin releasing factor type 1 expression in ova and behavior and brain corticotropin releasing factor type 1 expression in offspring." Biological psychiatry 74.9 (2013): 680-687.]

Social and physical environments early in development predict DNA methylation of inflammatory genes in young adulthood, 2017
Description: This study investigates environmental conditions early in development that can cause inflammation in adulthood. [McDade, Thomas W., et al. "Social and physical environments early in development predict DNA methylation of inflammatory genes in young adulthood." Proceedings of the National Academy of Sciences 114.29 (2017): 7611-7616.]

You may also find a link to an article (in English and Spanish) published on Smithsonian.com about this research.

Additional resources on Adverse Childhood Experiences and epigenetics

Neurobiology & Biomedical Effects

Neurobiology Backgrounders
  • Alberta Family Wellness Initiative's Brain Development & Addiction, 2018 online learning modules. This is a very thorough set of modules that include text documents, presentations and videos. The modules include brain architecture & development; early experiences & gene expression; building cognitive, emotional and social capacities; positive, tolerable & toxic stress; brain plasticity & behavioural change; interventions & treatments in children's mental health; the development of addiction; different kinds of addiction; prevention, intervention & treatment of addiction; policy implications. Each of these modules has several parts. The Alberta Family Wellness Initiative focuses on the Canadian community; the modules draw from contributions of experts in Canada and the U.S., and its content is applicable in any country.
  • Harvard University's Center on the Developing Child -- Three Core Concepts in Early Development, 2018. This three-part video series from the Center and the National Scientific Council on the Developing Child depicts how advances in neuroscience, molecular biology, and genomics describe how early experiences are built into our bodies and brains.

Accelerated telomere shortening in response to life stress, 2004
Description: This study provides evidence that psychological stress— both perceived stress and chronicity of stress—is significantly associated with higher oxidative stress, lower telomerase activity, and shorter telomere length, which are known determinants of cell senescence and longevity, in peripheral blood mononuclear cells from healthy premenopausal women. [Epel, Elissa S., et al. "Accelerated telomere shortening in response to life stress." Proceedings of the National Academy of Sciences of the United States of America 101.49 (2004): 17312-17315.]

Adverse childhood experiences, allostasis, allostatic load, and age-related disease, 2012
Description: Research reviewed here suggests that adverse childhood experiences are associated with changes in biological systems responsible for maintaining physiological stability through environmental changes, or allostasis. [Danese, Andrea, and Bruce S. McEwen. "Adverse childhood experiences, allostasis, allostatic load, and age-related disease." Physiology & behavior 106.1 (2012): 29-39.]

Adverse Childhood Experiences and Adult Risk Factors for Age-Related Disease: Depression, Inflammation, and Clustering of Metabolic Risk Markers, 2009
Description:- The authors concluded that children exposed to adverse psychosocial experiences have enduring emotional, immune, and metabolic abnormalities that contribute to explaining their elevated risk for age-related disease. [Danese, Andrea, et al. "Adverse childhood experiences and adult risk factors for age-related disease: depression, inflammation, and clustering of metabolic risk markers." Archives of pediatrics & adolescent medicine 163.12 (2009): 1135-1143.]

Adverse Childhood Experiences and Adult Well-Being in a Low-income, Urban Cohort, 2016
Description: This long term study of 1202 low-income Chicago individuals reveals that those with 4 or more ACEs were only 2/3 as likely to graduate from high school, had 3.9 times increased risk of depression, 4.5 times health compromising behaviors, 3 .1 times juvenile or 2.8 times felony adult arrest, and were half as likely to hold a skilled job.  The investigators state that "[e]ffective and widely available preventive interventions are needed to counteract the long-term consequences of ACEs.” [Giovanelli, Alison, et al. "Adverse childhood experiences and adult well-being in a low-income, urban cohort." Pediatrics (2016): peds-2015.]

Adversity in Preschool-Aged Children: Effects on Salivary Interleukin-1β, 2015
Description: This study investigated pro-inflammatory cytokine levels in relation to stress exposure in 40 children aged 3 to 5 years who were enrolled in a larger study of early life adversity. The results of the study suggest the involvement of IL-1β in the neuropathology of psychiatric conditions. [Tyrka, Audrey R., et al. "Adversity in preschool-aged children: effects on salivary interleukin-1β." Development and psychopathology 27.2 (2015): 567-576.]

Association of Reports of Childhood Abuse and All-Cause Mortality Rates in Women, 2016
Description: This cohort study investigated the experience of retrospectively reported severe physical abuse, moderate physical abuse, or emotional abuse in childhood and found all were associated with a higher risk of all-cause mortality during a 20-year follow-up period in women but not in men. [Chen E, Turiano NA, Mroczek DK, Miller GE. Association of Reports of Childhood Abuse and All-Cause Mortality Rates in Women. JAMA Psychiatry. 2016;73(9):920–927. doi:10.1001/jamapsychiatry.2016.1786]

Associations Between Adverse Childhood Experiences and ADHD Diagnosis and Severity, 2016
Description: Investigators at the Children's Hospital at Montefiore (CHAM) have published research indicating that children who experience family and environmental stressors and traumatic experiences are more likely to be diagnosed with ADHD. [Germán, Miguelina, Peter F. Belamarich, and Suzette O. Oyeku. "Associations Between Adverse Childhood Experiences and ADHD Diagnosis and Severity." Academic Pediatrics 1 (2016): 7.]

Child Maltreatment and Adult Living Standards at 50 Years, 2017
Description: In this study, 8076 British adults are followed over time, and despite adjusting for early-life factors such as social class and parental education, long-term associations of childhood abuse and neglect with unfavorable outcomes in mid-adulthood across a range of important socioeconomic indicators such as long term sickness, employment, education, assets, and social mobility were evident.  Negative outcomes increased with multiple types of maltreatment. [Pereira, Snehal M. Pinto, Leah Li, and Chris Power. "Child maltreatment and adult living standards at 50 years." Pediatrics (2016): e20161595.]

Exposure to violence during childhood is associated with telomere erosion from 5 to 10 years of age: a longitudinal study, 2012
Description: Researchers examined telomere erosion in relation to children’s exposure to violence, which has known long-term consequences for well-being. [Shalev, I., et al. "Exposure to violence during childhood is associated with telomere erosion from 5 to 10 years of age: a longitudinal study." Molecular psychiatry 18.5 (2013): 576-581.]

Father Loss and Child Telomere Length, 2017
Description: This research examined the association of father loss due to separation, divorce, death, and/or incarceration with cellular function, as estimated by telomere length. [Mitchell, Colter, et al. "Father Loss and Child Telomere Length." Pediatrics (2017): e20163245.]

The impact of adverse childhood experiences on health service use across the life course using a retrospective cohort study, 2017
Description: Researchers determined that use of primary, emergency and in-patient care rose with increasing ACE score. [Bellis, Mark, et al. "The impact of adverse childhood experiences on health service use across the life course using a retrospective cohort study." Journal of Health Services Research & Policy 22.3 (2017): 168-177.]

Leveraging the biology of adversity to address the roots of disparities in health and development, 2012
Description: Drawing on emerging hypotheses about causal mechanisms that link early adversity with lifelong impairments in learning, behavior, and health, this paper proposes an enhanced theory of change to promote better outcomes for vulnerable, young children by strengthening caregiver and community capacities to reduce or mitigate the impacts of toxic stress, rather than simply providing developmental enrichment for the children and parenting education for their mothers. [Shonkoff, Jack P. "Leveraging the biology of adversity to address the roots of disparities in health and development." Proceedings of the National Academy of Sciences 109.Supplement 2 (2012): 17302-17307.]

Lifespan adversity and later adulthood telomere length in the nationally representative US Health and Retirement Study, 2016
Description: The gradual aging of the immune system is partly marked by shortened telomeres, the DNA–protein caps at the ends of chromosomes that protect genes from degradation. Accumulated adverse experiences in childhood significantly predicted an increased likelihood of having short telomeres later in life, suggesting a potential pathway through which childhood experiences have been previously shown to predict adulthood morbidity and mortality. [Puterman, Eli, et al. "Lifespan adversity and later adulthood telomere length in the nationally representative US Health and Retirement Study." Proceedings of the National Academy of Sciences 113.42 (2016): E6335-E6342.]

Neuroscience, Molecular Biology, and the Childhood Roots of Health Disparities - Building a New Framework for Health Promotion and Disease Prevention, 2009
Description: A scientific consensus is emerging that the origins of adult disease are often found among developmental and biological disruptions occurring during the early years of life. These early experiences can affect adult health in 2 ways—either by cumulative damage over time or by the biological embedding of adversities during sensitive developmental periods. Confronting the origins of disparities in physical and mental health early in life may produce greater effects than attempting to modify health-related behaviors or improve access to health care in adulthood. [Shonkoff, Jack P., W. Thomas Boyce, and Bruce S. McEwen. "Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention." Jama 301.21 (2009): 2252-2259.]

The Painful Legacy of Childhood Violence: Migraine Headaches Among Adult Survivors of Adverse Childhood Experiences, 2015
Description: This was a large Canadian survey looking at 3 childhood adverse experiences (witnessing parental domestic violence, childhood physical abuse or childhood sexual abuse) and controlling for multiple variables. The risk for adult migraines increased with increasing number of ACEs in both men and women. [Brennenstuhl, Sarah, and Esme Fuller‐Thomson. "The painful legacy of childhood violence: migraine headaches among adult survivors of adverse childhood experiences." Headache: The Journal of Head and Face Pain 55.7 (2015): 973-983.]

Full text available for purchase.

Social Adversity in Adolescence Increases the Physiological Vulnerability to Job Strain in Adulthood: A Prospective Population-Based Study, 2012
Description: Researchers investigate if early life exposure to adversity increases the individual's physiological vulnerability job strain in adulthood. [Westerlund, Hugo, et al. "Social adversity in adolescence increases the physiological vulnerability to job strain in adulthood: a prospective population-based study." PLoS One 7.4 (2012): e35967.]

Spanking and Adult Mental Health Impairment: The Case for the Designation of Spanking as an Adverse Childhood Experience, 2017
Description: Spanking currently is not considered an ACE, but the physical and emotional abuse shown in previous research to correlate highly with poor health outcomes may be similar in nature to spanking. This study proposes that spanking is empirically similar to physical and emotional abuse and including spanking with abuse adds to our understanding of mental health problems.

Description: This research explores current evidence of the physiological embedding of stress to discuss whether adverse childhood experiences (ACE) causing chronic or acute stress responses may alter fundamental biological functions. Full text available for purchase. [Kelly-Irving, Michelle, et al. "The embodiment of adverse childhood experiences and cancer development: potential biological mechanisms and pathways across the life course." International Journal of Public Health 58.1 (2013): 3-11.]

Description: The authors found that a graded relationship of the ACE score to 18 different outcomes in multiple domains theoretically parallels the cumulative exposure of the developing brain to the stress response with resulting impairment in multiple brain structures and functions. [Anda, Robert F., et al. "The enduring effects of abuse and related adverse experiences in childhood." European archives of psychiatry and clinical neuroscience 256.3 (2006): 174-186.]

Additional resources on Adverse Childhood Experiences and neurobiology

Resilience

Child and Family Resilience: A Call for Integrated Science, Practice, and Professional Training, 2015
Description: Ann Masten and Amy Monn describe components of an integrated approach to child and family resilience, highlighting examples from recent research, and discuss implications for research, practice, and professional training. Full text available for purchase. [Masten, Ann S., and Amy R. Monn. "Child and family resilience: A call for integrated science, practice, and professional training." Family Relations 64.1 (2015): 5-21.]

Does continuous trusted adult support in childhood impart life-course resilience against adverse childhood experiences - a retrospective study on adult health-harming behaviours and mental well-being, 2017
Description: This national British survey reveals ACEs adversely impacted mental and physical health throughout life, but the support or not of an adult “someone you trust in childhood” had a very significant effect on outcome. [Bellis, Mark A., et al. "Does continuous trusted adult support in childhood impart life-course resilience against adverse childhood experiences-a retrospective study on adult health-harming behaviours and mental well-being." BMC psychiatry 17.1 (2017): 110.]

Research Brief – Promoting Resilience, 2014
Description: This brief provides an introduction to resilience, one of many protective factors that child abuse and neglect prevention professionals are examining. It covers resilience promotion in the individual, family, and community.

What Is the Molecular Signature of Mind-Body Interventions? A Systematic Review of Gene Expression Changes Induced by Meditation and Related Practices, 2017
Description: This paper is a review of research on molecular changes induced by mind-body interventions such as mindfulness, yoga, Tai-Chi, Qigong, and breath regulation.  Research appears to downregulate the pathway normally associated with inflammation-related diseases. [Buric, Ivana, et al. "what is the Molecular Signature of Mind–Body interventions? A Systematic Review of Gene expression Changes induced by Meditation and Related Practices." Frontiers in Immunology 8 (2017).]

Resource Collections

Center on the Developing Child at Harvard University Resource Library, ongoing
DescriptionA collection of trauma-related resources, searchable by media type and topic. Topics include brain architecture, lifelong health, mental health, neglect, resilience, and toxic stress. Sign up for their mailing service to be notified of newly released resources.

The National Crittenton Foundation Resources and Tools, 2017
Description: This site lists resources and tools that support the provision of quality services and the rights of girls and young women.  

National Library of Medicine/PubMed, 2018

Description: List of scientific literature on adverse childhood experiences.  

National Library of Medicine/PubMed, 2018

DescriptionList of scientific literature on ACEs and neurobiology.

Survey Validation

Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic, 2004
Description: This study examined the test-retest reliability of retrospective reports of adverse childhood experiences. This study used data from 658 participants who completed the ACE Study questionnaire on two separate occasions. This does not allow one to address the issue of whether or not there was a change in reporting from childhood to adulthood, but the results provide an overall indication that there is good to excellent reliability in the reports of adverse childhood experiences during adulthood. [Dube, Shanta R., et al. "Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic." Child abuse & neglect 28.7 (2004): 729-737.]

Description: The goal of this study was to develop and validate a short form of the Childhood Trauma Questionnaire (the CTQ-SF) as a screening measure for maltreatment histories in both clinical and nonreferred groups. Findings support the viability of the CTQ-SF across diverse clinical and nonreferred populations. [Bernstein, David P., et al. "Development and validation of a brief screening version of the Childhood Trauma Questionnaire." Child abuse & neglect 27.2 (2003): 169-190.]

Description: This study found that students and future health care practitioners who voluntarily assess their ACE Score are significantly more likely to understand scientific and clinical findings of the ACE Study as well as trauma-informed care. (Research on Humanities and Social Sciences, Kazeem)

Consideration of Personal Adverse Childhood Experiences during Implementation of Trauma-Informed Care Curriculum in Graduate Health Programs, 2016
Description: This study examined concurrent validity of ACE-IQ and Childhood Trauma Questionnaire (CTQ) using responses of 253 prison inmates on both instruments. The instruments were administered concurrently to selected inmates in Agodi Prison, Ibadan. The results indicated that the ACE-IQ and CTQ have concurrent validity and ACE IQ is a reliable and valid index of the adverse childhood experience in the study population. [Strait, J., and T. Bolman. "Consideration of Personal Adverse Childhood Experiences during Implementation of Trauma-Informed Care Curriculum in Graduate Health Programs." The Permanente journal 21 (2016).]

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Eric Weaver posted:

Does continuous support from always available adult (AAA) increase resiliency against ACEs:

  1. through other than a parent, like a school teacher?
  2. does AAA mean hourly, daily, or weekly?
  3. will the AAA of a spouse later in life subside ACE impacts?

I am attending the Duke University's 2018 Spirituality and Health Research Workshop 8/13-17 and seek collaborators in developing this research. . . 

Thanks

eric, http://eweaver.myweb.usf.edu/ 

Excellent that you've posted to Ask the Community - General Discussion and have received several replies! If you wanted to reach out to more specific communities, I would suggest you also post to Ask the Communities in communities you think are relevant to your question, perhaps ACEs in Education Ask the Community, for example.

Does continuous support from always available adult (AAA) increase resiliency against ACEs:

  1. through other than a parent, like a school teacher?
  2. does AAA mean hourly, daily, or weekly?
  3. will the AAA of a spouse later in life subside ACE impacts?

I am attending the Duke University's 2018 Spirituality and Health Research Workshop 8/13-17 and seek collaborators in developing this research. . . 

Thanks

eric, http://eweaver.myweb.usf.edu/ 

Does continuous trusted adult support in childhood impart life-course resilience against adverse childhood experiences - a retrospective study on adult health-harming behaviours and mental well-being

  • Mark A. Bellis1, 2Email author,
  • Katie Hardcastle2,
  • Kat Ford2,
  • Karen Hughes1, 2,
  • Kathryn Ashton2,
  • Zara Quigg3 and
  • Nadia Butler3
BMC PsychiatryBMC series – open, inclusive and trusted2017
available at
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