A troubled childhood increases risk of a troubled life
Some childhoods are filled with wonderfully amazing and happy times. Other childhood experiences are downright nightmares. As suspected by psychologists and other social scientists for years, a study by the Centers for Disease Control has confirmed that whether a childhood is magnificent or terrible, the traumatic adverse events during these formative years can have profound, lifelong effects on a person’s social, mental and physical health.
When I was in college, I tried to learn a language. Much to my surprise, I found learning a second language extraordinarily difficult. I wondered why it is so easy, as a child, to learn a language and so difficult as an adult.
Psychologists, doctors and researchers have come to understand that there are certain windows of opportunity to acquire and perfect different elements of learning, self-esteem, and knowledge for the human mind. When it comes to acquiring a language, the time for optimal learning is childhood. Sure, anyone can learn a different language at any time, but as an infant and small child, learning a language is almost effortless.
When it comes to developing a sense of self-worth, self-esteem, and limitless social skills, a safe and nurturing childhood is essential. Social development is optimal in this “frame” of time, too. The rougher your childhood, the likelier one is to have significant behavioral, health, social and psychological problems later in life.
In fact, many researchers say that when a child, adolescent or young adult is acting out or having significant problems, or if a person is having problems in school, work or with relationships or finds themselves in trouble with the law or substance abuse, the old question was “Why are you behaving this way?” The new way of approaching a problem person is to ask, “What has happened to you in your life that causes you to behave this way?”
This is a very subtle yet powerfully important change in the way troubled people should be understood and evaluated. Psychologists, other social scientists and doctors have come to understand that traumatic or adverse events that happen to a child can have profoundly devastating effects on a person that can last a lifetime. “A rough childhood dramatically increases the risk for a rough life.”
The list of adverse or traumatic events includes three areas: abuse, neglect, and household dysfunction.
Psychologists have developed a test to score these traumatic events called the ACE (Adverse Childhood Events) examination, though a landmark study by the Centers for Disease Control and Kaiser Permanente, called the Adverse Childhood Events Study. The ACE test specifically screens these factors:
- Physical abuse
- Sexual abuse
- Emotional abuse
- Physical neglect
- Emotional neglect
- Homelessness or housing insecurity
- Mother treated violently
- Household substance abuse
- Household mental illness
- Parental separation or divorce
- Incarcerated household member
Screening test questions
Here are the 10 questions of the ACE (Adverse Childhood Events) screening test:
- Before your 18th birthday, did a parent or other adult in the household often or very often swear at you, insult you, put you down, or humiliate you? Or act in a way that made you afraid that you might be physically hurt?
- Before your 18th birthday, did a parent or other adult in the household often or very often push, grab, slap, or throw something at you? Or ever hit you so hard that you had marks or were injured?
- Before your 18th birthday, did an adult or person at least five years older than you ever touch or fondle you or have you touch their body in a sexual way? Or attempt or actually have oral, anal or vaginal intercourse with you?
- Before your 18th birthday, did you often or very often feel that no one in your family loved you or thought you were important or special? Or your family didn’t look out for each other, feel close to each other, or support each other?
- Before your 18th birthday, did you often or very often feel that you didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? Or your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
- Before your 18th birthday, was a biological parent ever lost to you through divorce, abandonment, or other reason?
- Before your 18th birthday, was your mother or stepmother often or very often pushed, grabbed, slapped, or had something thrown at her? Or sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? Or ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
- Before your 18th birthday, did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
- Before your 18th birthday, was a household member depressed or mentally ill, or did a household member attempt suicide?
- Before your 18th birthday, did a household member go to prison?
Although not specifically in the original list of questions, psychologists also believe that housing insecurity or homelessness is also a major traumatic event that plays a huge role in the development of a child.
An elevated ACE score is certainly not a crystal ball on one’s future. However, elevated ACE scores are associated with social, emotional, behavioral and cognitive impairment that can have long-term and profound effects.
High-scoring people are more prone to engage in high-risk behaviors such as:
- Alcohol abuse
- Drug abuse
- Sexual promiscuity
High-scoring people also have an increased incidence of:
- School drop-out
- Anti-social and criminal behavior
- Physical confrontations or abuse
- Inability to maintain healthy relationships
- Failure to keep steady jobs
- Cancer development
- Lung disease
- Heart disease
- Early death
The ACE study’s results suggest that neglect, insecurity, maltreatment and household dysfunction in childhood can contribute to health, social, and behavioral problems that can be devastating and, without help, last a lifetime.
For many people, this new understanding can open doorways to addressing and overcoming obstacles that can be life-changing. In a recent CBS news segment related to the issue of adverse traumatic childhood events and the way they affect subsequent human behavior, the correspondent, Oprah Winfrey, commented that this new way of looking at and understanding human behavior was “absolutely life-changing and will influence all of her future relationships.”
If you or a loved one have an elevated ACE score, talk to your doctor about your results and develop a well-designed and thoughtful plan for a better life. The good news is that it can be done at any age.
This article was originally published on March 21, 2018.
Charles E. Crutchfield III, MD is a board-certified dermatologist and clinical professor of dermatology at the University of Minnesota Medical School and a Benedict Distinguished Visiting Professor of biology at Carleton College. He also has a private practice, Crutchfield Dermatology in Eagan, MN.
He received his MD and Master’s Degree in molecular biology and
genomics from the Mayo Clinic. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine. Minnesota Medicine recognized Dr. Crutchfield as one of the 100 Most Influential Healthcare Leaders in Minnesota. Dr. Crutchfield specializes in
skin-of-color and has been selected by physicians and nurses as one of the leading dermatologists in Minnesota for the past 18 years.
He is the team dermatologist for the Minnesota Twins, Vikings, Timberwolves, Wild and Lynx. Dr. Crutchfield is an active member of both the American and National Medical Associations and president of the Minnesota Association of Black Physicians. He can be reached at CrutchfieldDermatology.com or by calling 651-209-3600.