Adverse Childhood Experiences (ACE) Trauma

by Robert L. Smith, PhD

The Adverse Childhood Experiences (ACE) study has been landmark research in the fields of Psychiatry, Psychology, and all areas of mental health. This research is an especially important finding for people who suffer from trauma and anxiety. The results of the study suggest individuals with higher ACEs had higher correlations with difficulties with relationships, management of emotions and other difficult issues that might still linger in their lives.

Adverse childhood experiences (ACEs) are events that occurred before the age of 18. ACEs from the effects of poverty, neglect and caregivers who were mentally ill can be factors in determining ACE scores. Families with members who have a history of drug and alcohol issues are included as well as families who had a member go to prison.

Individuals presenting in psychotherapy and counseling with 4 or more ACEs are at a higher risk for behavioral and organic disorders. Sixty-four percent of adults have more than one ACE in the survey. ACEs do not usually occur alone. If you have one, there is an 85% chance that you will have two or more. The more ACEs, the higher the risk for a lowered capacity for resilience.

Many psychotherapists and other clinicians have reported seeing patients and clients with high ACE scores that deal with chronic health problems, mental health disorders, addiction issues and mood and anxiety disorders (including anxiety and PTSD). ACEs are responsible for a significant share of workplace absenteeism and increased healthcare costs. Higher ACE scores with individuals may also give a clinician and client valuable information about shame-based traumas that may indicate evidence of Complex Post Traumatic Stress Disorder.

There are a number of other studies that suggest other issues with individuals who have a higher number of ACEs. ACEs can negatively affect infants in Utero. High ACEs can disrupt the needed attachment to a caregiver that a child needs to develop a sense of self and security. Eighty percent of the brain’s development occurs before the age of three. Lower or no ACE survey scores can help a child learn self-soothing and regulation of emotions through consistent parenting and supportive environments.

Research also suggests that there is good news. The brain continues to change throughout our lives. Neuroplasticity is the development of new neuropathways that can provide healing. These positive brain changes can occur in many ways. Supportive relationships, supportive environments and psychotherapy can foster healing. Therapies such as Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing therapy (EMDR) have been found to be effective in treating the damage from childhood adverse experiences.

This material has been adapted from the following references:

Anda, R. et al. The Enduring Effects of Abuse and Related Adverse Experiences in Childhood. European Archives of Psychiatry and Clinical Neuroscience 256 (3), 174-186, 2006.

Lain, K.L. and Terrell, S.J. Nurturing Resilience. North Atlantic Books, Berkeley California, 2018

Siegel, D.J. The Pocket Guide to Interpersonal Neurobiology. Norton, 2012

Teicher, M.H., Child Maltreatment, Brain Development and Psychopathology. 2018

Copyright 2026, Robert L. Smith, Ph.D.