An adverse childhood event (ACE) is a traumatic event that occurs during childhood that affects a child’s physical and mental health throughout their life (Harris, 2020). In the United States, child maltreatment has been identified as a significant and growing problem that needs attention (Bartlett et al., 2015). Approximately three million referrals are made to child protective services annually for child abuse and neglect (Bartlett et al., 2015). Many types of abuse can affect a child’s physical and mental health, such as recurrent emotional, physical, and sexual abuse(Harris, 2020). Also, physical neglect, emotional neglect, witnessing violent behaviors towards the mother, parents separating or going through a divorce, living in the household with those who suffer from substance abuse or mental illnesses, and seeing household members going to prison for criminal justice behaviors(Harris, 2020). A child witnessing such traumatic events often leads to long-term life issues and concerns due to changes in brain development and how they respond to stress (“Adverse childhood experiences (aces),” n.d.).
In the reading, Dr. Harris spoke about her struggles growing up as an immigrant and living with a mother with untreated paranoid schizophrenia, which shows that she is also subject to stress responses from childhood exposures (Harris, 2020). While working in Bayview, she spoke about several encounters with patients with childhood exposure events and trauma, causing a negative impact on their lives. Bayview was a predominantly black California community with limited healthcare and food access and increased street violence. Dr. Harris shared the story of Caroline, a successful technology entrepreneur whose child and herself experienced severe verbal and emotional abuse from her husband. She did not understand the negative effect ACEs and trauma may have on their lives from exposure. Caroline and her son were treated with therapy, education, and an understanding of the importance of self-care to assist with healing(Harris, 2020). Another patient was Nia, diagnosed with failure to thrive secondary to her mother’s emotional disconnection and inability to provide care, leading to the child’s poor health. The goal was to strengthen the parent-child relationship by addressing the multigenerational and complexities of ACEs (Harris, 2020). Stress and trauma experiences can negatively affect one’s well-being and parenting capacities, increasing the risk of poor outcomes for the child (Kiser et al.,2020). Lastly, Diego was a seven-year-old with a developmental growth delay. The growth development was around the same time the child was sexually abused. He managed his stress response through the provided support and resources but occasionally had setbacks (Harris, 2020). Sexual abuse is linked to emotional and behavioral problems during childhood but can also cause persistent emotional distress throughout life (Barnum & Perrone-McGovern, 2017). However, with adequate support, Diego could move forward and succeed. Dr. Harris aimed to identify ACEs early and provide the services needed to treat and improve the patient’s overall well-being.
Dysregulated stress response occurs when the body cannot turn off the stress response, especially in children who have experienced trauma and many ACEs at an early age. Because of their exposure, their body produces high levels of stress hormones even when it is not necessary. The body is known to have elevated cortisol in the morning to help start the day, but it gradually decreases as the body begins to slow down for bed. ACEs can lead to dysregulated stress responses with continuous exposure to traumatic events, causing the body’s inability to cut off the hormones that regulate the stress response, which has long-term effects on the brain and other systems of the body. Dr. Harris compares this response to living in a forest or a house with a bear or bears because of the body’s inability to control the stress response.
Bartlett, J. D., Barto, B., Griffin, J. L., Fraser, J. G., Hodgdon, H., & Bodian, R. (2015). Trauma-informed care in the
Massachusetts Child Trauma Project. Child Maltreatment, 21(2), 101â€“112. https://doi.org/10.1177/1077559515615700
Barnum, E. L., & Perrone-McGovern, K. M. (2017). Attachment, self-esteem and subjective well-being among survivors of childhood sexual trauma. Journal of Mental Health Counseling, 39(1), 39â€“55. https://doi.org/10.17744/mehc.39.1.04
Centers for Disease Control and Prevention. (n.d.). Adverse childhood experiences (aces).Centers for Disease Control and Prevention. Retrieved October 5, 2022, fromhttps://www.cdc.gov/vitalsigns/aces/index.html
Harris, N. B. (2020). The deepest well. Pan Macmillan.
Kiser, L. J., Miller, A. B., Mooney, M. A., Vivrette, R., & Davis, S. R. (2020). Integratingparents with trauma histories into child trauma treatment: Establishing core components. Practice Innovations, 5(1), 65-80. https://doi.org/10.1037/pri0000109.supp(Supplemental)
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Re: Week 6 Discussion 1: The Deepest Well
by Gwendolyn Molina-Carranza – Wednesday, 5 October 2022, 10:05 PM
Adverse Childhood Event (ACE)
An adverse childhood event is a potentially traumatic event that occurs in childhood. Some of these events include physical abuse, sexual abuse, emotional abuse, or neglect. Adverse events can also include the child witnessing any of these forms of abuse. According to Harris (2018), she encountered growth discrepancies in children that experienced trauma and older adults, such as Evan, where stress from early childhood trauma was correlated with his stroke. Harris also found a correlation among a patient, Patty, in which she could lose weight, but the weight would return (Harris, 2018). Harris suspected it was due to early adverse childhood events in which food became a protective mechanism for Patty.
DNA and traumatic experiences
According to Bhattacharya, Fontaine, MacCallum, Drover, & Blundell (2019), the trauma and stress of a generation can be passed down to the next generation. For example, Bhattacharya et al. (2019) found that â€œveterans of the 1982 Lebanon War who were offspring of Holocaust survivors were more likely to develop PTSD than other Israeli soldiers following their military experiences who did not have parents interned in Nazi concentration camps.â€ The authors also found the exact correlation among the Israeli Yom Kippur War prisoners and their offspring (Bhattacharya et al., 2019). With that in mind, stress hormones play a role and assist with the vulnerability to stress. Bhattacharya et al. (2019) provide that our body is balanced. But, when stress occurs, the hypothalamic-pituitary-adrenal axis is altered, thus producing more corticotropin-releasing hormone, which stimulates ACTH into the general circulation. Dysregulation can happen when too much stress occurs, or an extended amount goes by with the form of stress or the different stress levels (Bhattacharya et al., 2019).
In addition, Fachim et al. (2021) further add that stressful life events experienced in early childhood can change the epigenome. The authors provide that it is plausible that significant adverse childhood events can lead to an increase in â€œBDNF methylation, providing a mechanism underlying the association between early-life stress and psychosis (Fachim et al., 2021).
Bhattacharya, S., Fontaine, A., MacCallum, P., Drover, J., & Blundell, J. (2019). Stress Across
Generations: DNA Methylation as a Potential Mechanism Underlying Intergenerational Effects
Of Stress in Both Post-traumatic stress disorder and Pre-clinical Predator Stress Rodent Models.
Frontiers in Behavioral Neuroscience, 13: 113. Doi: 10.3389/fnbeh.2019.00113.
Fachim, H., Corsi-Zuelli, F., Loureiro, C., Iamjan, S., Shuhama, R., Joca, S., Menezes, P., Heald, A.
Louzada-Junior, P., Dalton, C., Del-Ben, C., & Reynolds, G. (2021). Early-life stress effects on
BDNF DNA methylation in first-episode psychosis and in rats reared in isolation. Progress in
Neuro-Psychopharmacology and Biological Psychiatry, 108: Doi: 10.1016/j.pnpbp.2020.110188
Harris, N. (2018). The Deepest Well. Boston, MA: HarperCollins Publishers.