Adverse childhood experiences and trauma informed care: the future of health care

Oral, Resmiye; Ramirez, Marizen; Coohey, Carol; Nakada, S; Walz, Amy E.; Kuntz, Angela; Benoit, Jenna A.; Peek‐Asa, Corinne

doi:10.1038/pr.2015.197

Cited by 366 publications

(300 citation statements)

References 62 publications

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“…The Behavioral Risk Factor Surveillance System (BRFSS) began collecting ACE data after the CDC-Kaiser ACE Study was completed on childhood neglect and abuse, among other (Cranston & Davis, 2011;Najavits & Hien, 2013;Oral et al, 2015).…”

Section: Resultsmentioning

confidence: 99%

“…Interventions for trauma geared towards women were examined, however, both males and females are equally affected (CDC, 2010). Additional research and funding is needed for this high-risk population, given the existing research specific to women with co-occurring trauma and SUD have demonstrated poor outcomes when trauma is not identified during initial evaluation (Cranston & Davis, 2011;Najavits & Hien, 2013;Oral et al, 2015).…”

Section: Resultsmentioning

confidence: 99%

“…The literature over the last decade has provided a significant amount of research demonstrating the lasting impact of ACE on risk factors over the lifespan in terms of psychological, emotional, and physical illness (Banducci et al, 2014;Felitti et al, 1998;SAMHSA, 2014 (Cranston & Davis, 2011;Najavits & Hien, 2013;Oral et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, screening and referral for treatment opportunities are missed. Critical gaps exist in recognition of and responding to those individuals with a history of ACE (Oral et al, 2015). Knowledge concerning the prolonged effects of ACE on the physical, emotional, and psychological long-term functioning is lacking.…”

Section: Screening and Brief Intervention For Adverse Childhood Expermentioning

confidence: 99%

“…Trauma-informed care provides a framework for incorporating a safe, empathetic Several studies examined TIC within the SUD treatment programs and the impact on recovery from SUD and trauma (Jason, Olson, Mueller, Walt, & Aase, 2011;Oral et al, 2015;Reevs, 2015). The major theme of a Level III meta-synthesis of the literature on TIC found that in spite of the extensive research on the effects of trauma on physical and mental health, there is limited research and implementation of TIC within diverse settings (Reevs, 2015).…”

Section: Theoretical Framework/evidence Based Practice Modelmentioning

confidence: 99%

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Screening Adults With Substance Use Disorder for Adverse Childhood Experiences

Chandler

Kalmakis²,

Murtha³

2018

UJAN

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Objective: The purpose of this study was to assess the incidence of adverse childhood experiences (ACEs) and the efficacy and feasibility of a trauma-informed screening for ACEs among individuals in a substance use disorder recovery program. Method: Individual interviews, questionnaires, and postinterview survey and reflections were used in this cross-sectional clinical translation project. Descriptive statistics were used to analyze demographics, ACE scores, protective childhood experiences, self-reported diagnoses, and postintervention survey data. Postinterview reflections were reviewed and grouped into common ideas as shared by participants, as well as interesting impressions, insights, and responses to the interviews. Results: Thirty clients participated in the interview process. Among the 29 participants who completed the questionnaires, all reported at least one ACE, and 82.8% reported six or more ACEs. In addition, 96.6% reported experiencing more than four protective factors. Twelve (40%) clients were referred for further mental health counseling after the interviews. Notable findings from the interviews were the general lack of awareness of the relationship between ACEs and current substance use disorder among participants. Gaining knowledge about the impact of ACEs on their recovery seemed to provide a sense of relief and a feeling that they were “normal.” Conclusions: The trauma-informed care approach is intended to promote mindfulness regarding the effect of ACEs on substance abuse in this population. Screening for ACEs is necessary if effective interventions are to be provided, with the goal of improving client outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Screening and Brief Intervention For Adverse Childhood Expermentioning

confidence: 99%

Section: Theoretical Framework/evidence Based Practice Modelmentioning

confidence: 99%

See 3 more Smart Citations

Screening Adults With Substance Use Disorder for Adverse Childhood Experiences

Chandler

Kalmakis²,

Murtha³

2018

UJAN

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Screening for Adverse Childhood Experiences (ACEs) in Primary Care

Campbell

2020

JAMA

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Adverse childhood experiences (ACEs), such as experiencing or witnessing violence or abuse or living with a parent with mental illness or substance use disorder, have been shown to have a powerful influence on subsequent mental and physical health and life expectancy. Exposure to ACEs has been linked to more than 40 negative health conditions, including poor mental health, substance use disorder, adverse health behaviors, chronic physical disease, and shortened life span. 1 A meta-analysis of 37 studies that examined 23 health outcomes found that individuals who reported more than 4 ACEs had higher odds of cancer, heart disease, respiratory disease, and poor self-rated health (odds ratios ranging from 2 to 3); mental illness, alcohol use disorder, and risky sexual behavior (odds ratios ranging from 3 to 6); and drug use disorder and interpersonal or self-directed violence (odds ratios greater than 7). 2 Early childhood adversity and high levels of "toxic stress" have been found to have widespread and longstanding effects on multiple systems, and have been associated with reduced immunity, high levels of inflammation, shortened telomeres, subsequent poor health outcomes, and premature mortality. 3 As a result of this extensive body of research, many have recommended that clinicians, especially those in primary care, screen for ACEs and intervene to prevent some of these adverse health effects. The state of

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Association of Adverse Childhood Experiences With Cardiovascular Disease Later in Life

et al. 2021

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xposure to adversity early in life has been linked to negative long-term health outcomes. The consequences in late life of these adverse childhood experiences (ACEs), which include different forms of abuse, household dysfunction, and neglect, are now recognized. 1,2 ACEs have been traditionally related to an increased risk of psychological disturbances and substance use disorders. 3 The landmark Adverse Childhood Experiences study, authored by Felitti and colleagues 2 20 years ago, was the first study to propose that ACEs are also associated with the development of chronic physical conditions in adulthood, including cardiovascular disease (CVD). Since then, multiple studies have shown that traumatic events in childhood are associated with an increased likelihood of developing risk factors for CVD (eg, obesity, smoking, hypertension, diabetes) as well as CVD during the lifetime. 4 Interventions that mitigate the negative consequences of ACEs or prevent their initial onset may reduce the incidence of CVD. This narrative review summarizes the current literature regarding the association of ACEs with CVD and discusses possible pathophysiological mechanisms along with management approaches. ACE DefinitionACEs encapsulate a broad spectrum of traumatic and distressing events that threaten a child's physical, familial, or social safety and security before the age of 18 years. 4 These events may include direct mistreatment and neglect, exposure to household dysfunction, physical or sexual abuse, or violence. There are several methods of assessing ACEs. The initial Adverse Childhood Experiences study 2 introduced a 10-category ACE questionnaire to identify abuse, household dysfunction, or neglect up to age 18 years that is still used in its original and expanded versions. 5 Recently, additional factors, such as bullying, economic hardship, and loss of or severe disease in close persons, have also been recognized as ACEs (Table ). 6 ACEs tend to occur in clusters, such that individuals who experience at least 1 ACE are more likely to experience others, putting them at an even higher risk of poor future health. 7 Multiple ACEs may suggest a chaotic family environment that places not only individuals at risk but also family members, eliciting a potentially vicious cycle of intergenerational risk. 8 IMPORTANCE Adverse childhood experiences (ACEs) are potentially harmful events that occur during childhood, spanning neglect, physical or sexual abuse, parental separation, or death, among others. At least 50% of the US adult population has experienced 1 or more ACEs before the age of 18 years, but in clinical practice, ACEs remain underrecognized. Adults who have experienced ACEs are at increased risk of developing health risk behaviors and, ultimately, cardiovascular disease (CVD). This review summarizes the evidence regarding the association of ACEs with CVD and the accompanying diagnostic and therapeutic approaches in the adult population.OBSERVATIONS ACEs are commonly classified into 3 domains: abuse (psychological, phys...

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Adverse childhood experiences and trauma informed care: the future of health care

Cited by 366 publications

References 62 publications

Screening Adults With Substance Use Disorder for Adverse Childhood Experiences

Screening Adults With Substance Use Disorder for Adverse Childhood Experiences

Screening for Adverse Childhood Experiences (ACEs) in Primary Care

Association of Adverse Childhood Experiences With Cardiovascular Disease Later in Life

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