New study released for effects of ACE (adverse childhood experience)
September 17, 2018 11:49 AM   Subscribe

Some groups affected more than others (surprise). When researchers first discovered a link in the late 1990s between childhood adversity and chronic health problems later in life, the real revelation was how common those experiences were across all socioeconomic groups. But the first major study to focus on adverse childhood experiences (ACEs) was limited to a single healthcare system in San Diego. Now a new study — the largest nationally representative study to date on ACEs — confirms that these experiences are universal, yet highlights some disparities among socioeconomic groups.
posted by aleph (16 comments total) 29 users marked this as a favorite
 
The study points out that divorce is a source of trauma for children. Which I get. But in many cases, on the green people cousel that it's never a good idea to stay married "for the children's sake", and I've heard plenty of people express relief that their parents finally, finally got divorced. So is it really a situation of having parents that can't get along (even non-abusively), the source of the trauma and that the divorce is just the trackable indicator of that situation?

The article also states "The participants answered 11 questions about whether they'd experienced what have now become well recognized as ACEs: parental separation or divorce, child abuse (physical, emotional and sexual), domestic violence and living with someone who has been incarcerated or has a mental illness or a substance use disorder."

I wish they had clarified that if that was untreated mental illness, or if it didn't matter. Anyone know if it makes a difference?

I was also surprised to find that bisexuals had the worst outcomes. That just seems, as a woman who is attracted to both men and women, so bizzare. Is it both genders or do male bisexual people feel more isolated?

Lastly, it makes me wonder what's going to happen down the line. Genetic tests at in utero but instead of just testing for biological sex and any desises it'll eventually tell you if you're kid will be a leader or a follower, a delicate flower or a strong-willed warrior, extroverted or introverted? People already end up putting so many unfair expectations on kids just because of their birth gender. I want this knowledge to be used to help, but I can only see the ways people are going to misuse it.
posted by sharp pointy objects at 12:26 PM on September 17, 2018 [5 favorites]


I was also surprised to find that bisexuals had the worst outcomes. That just seems, as a woman who is attracted to both men and women, so bizzare. Is it both genders or do male bisexual people feel more isolated?

Bi folks are have often been found to have higher rates of mental illness, suicide, addiction, etc. and to experience higher rates of sexual assault.

In what I've read, this is often attributed to not feeling welcome either in straight or in queer spaces, although I'm sure people's experiences vary a lot on this count.

Personally, I was disappointed that this research included LGB people but not trans folks, since I'm pretty confident a lot of us would score high on this scale as well.
posted by ITheCosmos at 12:47 PM on September 17, 2018 [30 favorites]


Personally, I was disappointed that this research included LGB people but not trans folks, since I'm pretty confident a lot of us would score high on this scale as well.

The research probably did include trans people, but if the absolute numbers were low, the findings may not be statistically significant. You can't report on what you don't have sufficient data for.
posted by jb at 12:53 PM on September 17, 2018 [16 favorites]


Thanks jb, that's helpful to know as a non-researcher!
posted by ITheCosmos at 12:58 PM on September 17, 2018 [5 favorites]


"The study points out that divorce is a source of trauma for children. Which I get. But in many cases, on the green people cousel that it's never a good idea to stay married "for the children's sake", and I've heard plenty of people express relief that their parents finally, finally got divorced. So is it really a situation of having parents that can't get along (even non-abusively), the source of the trauma and that the divorce is just the trackable indicator of that situation?"

I would have to ask the same thing. It makes sense that especially bad relationships might result in especially bad divorces sometimes, fighting over custody or the general nastiness that can arise between two people in such circumstances. But again, that has nothing to do with the act of divorce and everything to do with behaviour of individuals involved.
posted by GoblinHoney at 1:30 PM on September 17, 2018 [2 favorites]


Like with everything else, taking the statement “divorce is a source of trauma” out of context isn’t helpful. Please don’t think this has any bearing on AskMe advice. It would be really unfortunate if a discussion of the disparate impact of trauma got derailed by a ... shallow interpretation of the article in like the first 5 comments.

Anyway.

Trauma is a fact of life; whether a child stays traumatized, or has a chance to recover, matters. There’s a sometimes companion scale of resilience factors that I don’t feel like hunting down, but it’s out there. (Stuff like did you have an adult to confide in, did someone comfort you/hold you as a baby, safe places, etc.)

Anecdotally, the really bad outcomes seem to be more likely when there’s a bigger discrepancy. CPTSD seems to become much more frequent at ACE scores of 4 or 5, especially if resilience scores are low. OTOH, people who were left alone as infants or otherwise didnt have anyone to teach their little nervous systems to be soothed seem to have a really hard time of it no matter what.

One thing: IIRC, the 11 point ACE questionnaire they’re referencing doesn’t have any items that ask about group-specific trauma. There’s nothing about racism or misogyny, and, especially glaringly considering it’s easier to ask about, there’s nothing about coming out or being in the closet. There’s unique trauma to all of those things.
posted by schadenfrau at 1:58 PM on September 17, 2018 [18 favorites]


My uneducated guess about the divorce issue is that it's not necessarily the divorce itself, but some of the other aspects that can come along with divorce - lower parent income and resources, decrease in parental involvement (either one parent becomes less involved overall in a child's life, or possibly both parents just have less energy to invest with their kids, no matter how much they might want to, because they are managing a household alone), conflict within step families (again, many step family relationships are great, but statistically, step-family relationships involve more conflict). Of course, it could also be the divorce itself in some cases, but I bet that's not it most of the time.
posted by odayoday at 2:25 PM on September 17, 2018 [13 favorites]


For those who are interested, here is a link to the full article, with more details on the sample, methods and results.

IANAEBIWWT (I am not an epidemiologist but I work with them) and I have done survey work (administering, setting up, etc.). Getting items in surveys is always a fight - there are always 10 times as many questions you'd like to ask as you have time/room for, and people don't like long surveys. It sucks, but cuts always have to be made. This is true for both specific items (like the length of the ACE) and demographic questions (such as whether someone is cis or trans). There are real limits on what you can ask, and it would be more productive to do a specific survey of trans people and then compare the prevalence of adverse childhood events among trans people with the population as a whole.

As for the group effects (racism, misogyny, etc.): yes, those are significant, but they aren't within the scope of the ACE. They are measured by other measures - for one, they aren't childhood specific. So are issues about coming-out. The fact that visible minorities and LGB people have a higher prevalence on the ACE is interesting - it suggests that racism and homo/biphobia may contribute to ACE, as does poverty.
posted by jb at 2:34 PM on September 17, 2018 [5 favorites]


Yeah, my parents getting divorced was certainly better than the alternative, but that didn't mean it came without any trauma at all. The crushing poverty sucked, for one, as well as losing all my aunts, uncles, and cousins on my father's side.
posted by The Underpants Monster at 2:34 PM on September 17, 2018 [5 favorites]


It would be interesting to show how specific ACEs correlate to some of these categories. For example, I can see how an LGBT child might be more likely to be emotionally abused as a result, but I'd be surprised if there was a correlation between, say, being LGBT and having an incarcerated family member.

The finding that multi-racial children are more likely to have higher ACE scores, even compared to other POC / minority groups, is surprising. Is the difference significant? Do the study authors have any hypothesis for the mechanism there?
posted by phoenixy at 3:00 PM on September 17, 2018


How much more "perfect stock photo" could picture of the kid in the teddy bear costume be? None more.
posted by poe at 3:23 PM on September 17, 2018 [1 favorite]


demographic questions (such as whether someone is cis or trans)

I don't think I'm cynical in saying that it very likely did not occur to them to ask.
posted by hoyland at 4:40 PM on September 17, 2018 [2 favorites]


Hoyland, perhaps you will be reassured to hear that a question on trans status was included in the same module which asked about sexual orientation. The national behavioral risk survey this study was based on has included an optional set of questions on sexual orientation and gender identities since 2014. I would wager the study authors excluded trans status as a variable due to small sample size, not lack of interest in the population.
posted by reren at 6:41 PM on September 17, 2018 [5 favorites]


The finding that multi-racial children are more likely to have higher ACE scores, even compared to other POC / minority groups, is surprising.

I'd imagine for some multi-racial kids it's a similar experience to bi-sexual people: experiencing rejection from both groups that they nominally belong to. And since a lot of people are still not supportive of mixed-race relationships, especially when there are children, that's an additional stress on their parents' relationship.
posted by Secret Sparrow at 9:26 PM on September 17, 2018 [6 favorites]


So I was curious how an 11 question test ended up with a score between 1.0 and 8.0 and then I found this model of the scoring breakdown and found it very interesting, but I'm also a visual person.

I got a 6!
posted by elsietheeel at 7:47 AM on September 18, 2018


I got a 6!

Me too! High... five?

posted by ITheCosmos at 8:43 AM on September 18, 2018 [1 favorite]


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