Trauma and ACEs

What is trauma?

When many people think of and conceptualize trauma, they may immediately think of trauma as an event that occurs; for example, one may explain a near-death experience as trauma. However, such situations are traumatic events. Adverse childhood experiences (ACEs) are potentially traumatic events that occur in childhood (0-17 years) and may include experiencing violence, abuse or neglect, violence in the home or community, or having a family member attempt or die by suicide; aspects of a child’s environment that can undermine perceived safety are also included on this list, specifically environments riddled with substance abuse problems, mental health problems, and instability due to parental separation or household members being incarcerated (CDC, 2021). The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) describes a traumatic event as requiring actual or threatened death, serious injury, or sexual violence (APA, 2013). Trauma is a response to a deeply distressing or disturbing traumatic event; it often manifests through changes in psychological and physiological responses. 

Impact.

Traumatic events can create a lasting impact on one’s life. Around 61% of adults surveyed across 25 states reported that they had experienced at least one type of ACE; further, nearly 1 in 6 reported having endured four or more types of ACEs (CDC, 2021). ACEs are associated with mental illness, chronic health problems, and substance use in adulthood; this being said, ACEs have the potential to negatively impact one’s education, vocational opportunities, and earning potential (CDC, 2021). Many but not all individuals who encounter traumatic experiences will develop trauma-related mental health disorders such as acute stress disorder or post-traumatic stress disorder (PTSD). Increased risk of developing PTSD may entail direct exposure to the traumatic event, repetition of traumatic events, past trauma, pre-existing mental health problems, and the seriousness of the threat to life (CDC, 2021). Psychologically, people may experience adverse changes in mood, dissociation, flashbacks, and increased arousal (Psychology Today, 2021). Physiologically, trauma hypersensitizes our hypothalamic-pituitary-adrenal (HPA) axis (our body’s stress response system) which in turn increases the cortisol levels in our bloodstream; persistently high levels of cortisol can increase the risk of developing conditions like depression and heart disease (Psychology Today, 2021). 

How to help.

After a traumatic event, self-care, leaning on a strong support system, and seeking professional help are all strongly recommended. It is advised that anyone who experiences a traumatic event seek mental health help to better cope with the potential psychological aftermath of such events. If adverse psychological and physiological symptoms persist for months, this indicates that professional mental health help may be necessary to aid healthy psychological functioning. Trauma-informed clinicians will approach care in a sensitive and educated manner such that a patient is not re-traumatized during the treatment process. Clinicians such as therapists and psychiatrists may utilize eye movement desensitization and reprocessing therapy (EMDR) or trauma-informed cognitive behavioral therapy (T-CBT) as part of the treatment process for those experiencing enduring trauma.

Resources.

  • The Body Keeps Score – a self-help book written by trauma expert Bessel van der Kolk M.D. which provides education on how trauma impacts our minds and bodies as well as ways to address these reactions in healthy ways.
  • Coping with a Traumatic Event – a factsheet developed by the CDC outlining the basics of trauma.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013)

Centers for Disease Control and Prevention. (2021). Preventing adverse childhood experiences |violence prevention|injury Center|CDC. Centers for Disease Control and Prevention. Retrieved January 27, 2022, from https://www.cdc.gov/violenceprevention/aces/fastfact.html 

Psychology Today. (2021). How trauma affects the body | psychology today. Retrieved January 27, 2022, from https://www.psychologytoday.com/us/blog/the-addiction-connection/202103/how-trauma-affects-the-body