Adverse Childhood Experiences and Health and Well-Being Over the Lifespan

This chart shows the sequence of events that unaddressed childhood abuse and other early traumatic experiences set in motion. Without intervention, adverse childhood events (ACES) result in long-term disease, disability, chronic social problems and early death. 90% of public mental health clients have been exposed to multiple physical or sexual abuse traumas. Importantly, intergenerational transmission that perpetuates ACES will continue without implementation of interventions to interrupt the cycle.

Adverse Childhood Experiences

______________________

Abuse of Child

• Psychological abuse

• Physical abuse

• Sexual abuse

Trauma in Child’s Household Environment

• Substance abuse
• Parental separation
and/or divorce

• Mentally ill or suicidal
household member
• Violence to mother
• Imprisoned household
member

Neglect of Child
• Abandonment
• Child’s basic physical
and/or emotional
needs unmet

Impact of Trauma and Adoption of Health Risk Behaviors to Ease Pain of Trauma

______________________

Neurobiologic Effects of Trauma

• Disrupted neuro-
development

• Difficulty controlling
Anger - Rage
• Hallucinations
• Depression
• Panic reactions
• Anxiety

• Multiple (6+) somatic
problems

• Sleep problems

• Impaired memory
• Flashbacks
• Dissociation

Health Risk Behaviors
• Smoking
• Severe obesity
• Physical inactivity
• Suicide attempts
• Alcoholism
• Drug abuse
• 50+ sex partners

• Repetition of original

trauma
• Self-injury
• Eating disorders
• Perpetrate interpersonal
violence

Long-Term Consequences of Unaddressed Trauma

____________________

Disease and Disability

• Ischemic heart
disease
• Cancer
• Chronic lung
disease
• Chronic
emphysema
• Asthma
• Liver disease
• Skeletal fractures

• Poor self rated
Health

• Sexually transmitted
disease
• HIV/AIDS

Social Problems
• Homelessness
• Prostitution
• Delinquency,
violence and
criminal behavior

• Inability to sustain
employment –
welfare recipient

• Re-victimization:
rape; domestic
violence

• Inability to parent

• Inter-generational
transmission of abuse

• Long-term use of
health, behavioral
health, correctional,
and social services
systems

>>>>>>>

Data upporting the above model can be found in the Adverse Childhood Experiences Study (Center for Disease Control and Kaiser Permanente, see www.ACEstudy.org) and The Damaging Consequences of Violence and Trauma (see www.NASMHPD.org). Chart created by Ann Jennings, PhD. www.annafoundation.org

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