Part 1 – Understanding the ACE Study

If you know nothing else, as an abuse survivor, you need to know about this one clinical study. It is a groundbreaking and pivotal part of understanding what you have been through and how it affects your mind and body. Bear with me, as Claude and I, explain the research and why you should care about it. I promise that it is important. And if you suffered through abuse as an adult and had a great childhood, this information still applies to you. The ACE study explains the mechanism that affects us all. You won’t be disappointed once you understand what we are talking about. For the sake of clarity, we have split this information into four posts. We will explain each part and what it means. If you wish to know more, please see the references listed at the end of this post.

In the mid-1990s, Dr. Vincent Felitti wasn’t looking for childhood trauma. He was running an obesity clinic at Kaiser Permanente in San Diego, puzzled by why so many patients dropped out after successfully losing weight. When he started asking careful questions, a pattern emerged: many had histories of childhood sexual abuse, and for some, the weight had become a form of protection. The obesity wasn’t the problem. It was a solution to a problem no one had asked about. That observation became one of the largest investigations into childhood adversity ever conducted.

Between 1995 and 1997, Felitti partnered with Dr. Robert Anda at the CDC to survey more than 17,000 adults — mostly middle-class, insured, college-educated people receiving routine checkups (Felitti et al., 1998). These were not a “high-risk” population in the way we usually imagine it. That’s part of what made the findings so striking.

The study asked about ten types of adverse childhood experiences, or ACEs, grouped into three buckets.

Each “yes” counts as one point, producing an ACE score from 0 to 10. The score doesn’t measure how severe any single event was — it measures how many kinds of adversity a child lived through.

I have a total ACE Score of 7. That means that I am considered a ‘high risk’ for toxic stress. That means that I have a statistically higher risk of developing, heart disease, chronic depression, obesity, and substance abuse. If you are curious about your own Ace score, you can take the quiz at https://www.acesaware.org/wp-content/uploads/2022/07/ACE-Questionnaire-for-Adults-Identified-English-rev.7.26.22.pdf

In my mid forties, I can testify to having two of the four conditions listed above. Now, no one can say with 100% certainty that the abuse I suffered is responsible for those conditions. But the study did find a statistically significant correlation between high ACE scores and negative health outcomes. That is what I want you to take away from this discussion.

The deeper point of Part 1 is simple but radical: the things that happen to us as children don’t stay in childhood. They travel with us into our bodies and our adult lives. The ACE Study was the first time mainstream medicine had hard numbers to prove it.

The remarkable thing about this study is that it greatly changed how medical and mental health professionals looked at abuse and its risk factors. And the craziest part? The discovery was accidental! The doctors were just trying to help their patients! But because they cared, we now have a better understanding of how trauma affects us today. The results of this study have been replicated and verified many times over. Once I learned about this body of research, I understood myself and the world so much more. I hope that it helps you in your journey of self understanding. If you have any questions or comments, please leave them below. I always love hearing from my fellow survivors.

References

Bethell, C. D., Jones, J., Gombojav, N., Linkenbach, J., & Sege, R. (2019). Positive childhood experiences and adult mental and relational health in a statewide sample: Associations across adverse childhood experiences levels. JAMA Pediatrics, 173(11), e193007. https://doi.org/10.1001/jamapediatrics.2019.3007

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). 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), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8

Shonkoff, J. P., Garner, A. S., & Committee on Psychosocial Aspects of Child and Family Health. (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), e232–e246. https://doi.org/10.1542/peds.2011-2663

Swedo, E. A., Aslam, M. V., Dahlberg, L. L., Niolon, P. H., Guinn, A. S., Simon, T. R., & Mercy, J. A. (2023). Prevalence of adverse childhood experiences among U.S. adults — Behavioral Risk Factor Surveillance System, 2011–2020. MMWR. Morbidity and Mortality Weekly Report, 72(26), 707–715. https://doi.org/10.15585/mmwr.mm7226a2