ACEs - PTSD and Trauma Therapy Fort Lauderdale

Most People Have Adverse Childhood Experiences (ACEs): Here’s Why We Should Care

Estimated reading time: 7 minutes

It’s common knowledge that the experiences we have growing up have an impact on our well-being as teens and adults. What’s not so commonly known, is just how impactful these early experiences could be to our physical and emotional health and what we can do about it.

Studies have found that most of us will experience at least one really difficult circumstance as kids. These Adverse Childhood Experiences, called ACEs for short, have been associated with infectious diseases, health risk behaviors, limited educational and economic opportunity, and early death.

This post will explain more about ACEs and how we can increase resilience to be less impacted by them.

What is an adverse childhood experience (ACE)?

Adverse childhood experiences are potentially traumatic events that occur before turning 18 years old (from birth to 17 y/o). Potentially traumatic events may include events such as witnessing and/or experiencing verbal/emotional, physical, or sexual abuse. 

According to the DSM 5, — a diagnostic and statistical manual clinicians use to understand and diagnose psychological conditions — traumatic events entail “exposure to actual or threatened death, serious injury, or sexual abuse.”

These exposures could occur by:

  • Directly experiencing or witnessing the event(s)
  • Having someone close to you go through a threatening event that was violent or accidental in nature (e.g., losing a family member to homicide) 
  • Being repeatedly exposed to aversive details of the event

In general, it is important to note that stressful events are not inherently traumatic, it depends on different factors. Such as:

  • The nature of the events
  • Frequency and
  • The person’s interpretation of the event(s)/subjective experience

Furthermore, Adverse Childhood Experiences (ACEs) can vary in intensity and duration and can negatively impact a person’s development, as well as their physical and mental health. 

Different Types of ACEs: 

Here are the different types of ACEs

  • Abuse
    • Emotional
    • Physical
    • Sexual
  • Neglect (physical and emotional)
  • Household Dysfunction; exposure to:
    • Incarceration of a household member
    • Mental illness
    • Substance abuse
    • Domestic violence
    • Parental separation or divorce
  • Poverty
  • Exposure to community violence/unsafe neighborhood
  • Bullying
  • Racial discrimination
  • Foster care
  • Separation from immigrant parents

The last 6 experiences that are mentioned on the list above were more recently included (Chronholm et al., 2015; Finkelhor et al., 2015), expanding upon the original research from Felitti and colleagues (1998).

Additional categories of ACEs have also been proposed by Taylor and Weems (2009), such as: natural disasters, automobile/other accidents, war/explosions, and entertainment violence. 

Adverse Childhood Experiences Statistics

Research has consistently shown that ACEs are common and prevalent.

In a study conducted across 25 states, 60.9% of adults reported having experienced at least one ACE, and 15.6% (nearly 1 in 6 individuals) identified having experienced 4 or more ACEs.

According to the CDC, some children are at greater risk of experiencing ACEs than others. Furthermore, they highlight that women and other racial/ethnic minorities have demonstrated being at greater risk for experiencing 4 or more types of ACEs.

Subsequent research also highlights even higher prevalence rates of ACEs among socially marginalized populations, and populations with low education and/or low-income levels. 

Studies have also shown that exposure to ACEs are “associated with increased risk for health problems across the lifespan;” and ACEs are associated with at least 5 of the top 10 leading causes of death.

Additionally, ACEs have been associated with infectious diseases, health risk behaviors, limited educational and economic opportunity, and early death.

Revised TRaumatic and Adverse Childhood Experiences (TRACEs +) Pyramid with Resilience Pinnacle

Weems and his colleagues (2021) proposed an integrative model of traumatic and adverse childhood experiences (TRACEs +) that highlights that different outcomes may result from these experiences; in other words, there is no one “set” outcome that follows an ACE or traumatic experience.  

This pyramid is more comprehensive than the original ACE pyramid and includes two peaks, one that outlines the impact resilience and intervention, and the other that highlights risk factors. In order to better understand the revised pyramid below, it is helpful to define concepts such as equifinality and multifinality

  • Equifinality- when different/multiple risks (e.g., poverty, traumatic stress, etc.) can lead to the same outcome 
  • Multifinality- when a specific risk can lead to different outcomes
ACES Pyramid Updated - PTSD and Trauma Therapy Fort Lauderdale

Weems, C. F., Russell, J. D., Herringa, R. J., & Carrion, V. G. (2021). Translating the neuroscience of adverse childhood experiences to inform policy and foster population-level resilience. American Psychologist, 76(2), 188–202. https://doi.org/10.1037/amp0000780

Weems and his colleagues (2021) proposed an integrative model of traumatic and adverse childhood experiences (TRACEs +) that highlights that different outcomes may result from these experiences; in other words, there is no one “set” outcome that follows an ACE or traumatic experience.  

Preventing ACEs and Building resilience

Resilience is the capacity to “bounce back,” successfully adapt, or recover from adverse/stressful events. 

According to the CDC, there are different strategies to prevent ACEs.

Strategies to Prevent ACEs

  • Increasing economic supports for families
  • Encouraging social norms that protect against violence and adversity
  • Providing a supportive environment for children to reach their full potential
    • Safe and stable housing
    • Adequate child care
    • Monitoring, supervising and consistently enforcing rules
  • Providing education to parents and children/youth regarding how to handle stress, manage emotions, and face day to day challenges
  • Connecting children/youth with activities and caring adults
  • Intervening with the purpose of decreasing immediate and long-term harm/injury
    • Enhancing primary care and providing victim-centered services
    • Prevention services

There are also different Protective And Compensatory Experiences (PACEs) that can be implemented to mitigate the impact of ACEs. PACEs include two types of protective factors: relationships and resources.

PACE Relationship factors:

  1. Unconditional love from parent/caregiver
  2. Having a best friend
  3. Being part of a social group
  4. Volunteering or helping others in the community
  5. Having support from an adult outside of the family (e.g., coach, teacher, etc.)

PACE Resource factors:

  1. Living in a clean, safe home with enough food
  2. Attending school or having educational opportunities
  3. Having a hobby
  4. Being active/playing sports
  5. Having routines and fair rules at home

In short, ACEs can significantly impact a person’s physical (neurobiological and developmental) and emotional well-being. The good news is there are different protective and reducing factors that can lessen their impact; which means that there is not a “standard” outcome for these experiences. 

If you or a loved one has gone through adverse or potentially traumatic experiences that are negatively impacting your life, therapy is can help. Therapy can provide support and interventions to increase skillful behavior, self-awareness, and self-compassion. Please don’t hesitate to reach out if we can be of service.


Fort Lauderdale Psychologist Dr. Gabriela Sadurni Rodriguez
License: PY10619

Dr. Gabriela Sadurní Rodríguez is a licensed psychologist and is an expert in trauma-related issuesdepressionanxiety, life transitions/adjustments, and difficulties in interpersonal relationships. Call 954-488-2933 or email today to discuss how our services can help you.

Servicios disponibles en español.

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