I’m learning about child abuse and neglect in my Child and Family Assessment class. Today I read about the ACE study, by the US Center for Disease Control. It is a huge study, with over 17,000 participants, where they gathered information about childhood abuse, neglect, and household dysfunction, and then proceeded to see what health outcomes and behaviors they could predict with that information. It turns out they can predict a lot. They’ve published 50 articles on the study and the research is ongoing–they are continuing to collect health information as the participants in the study age. I’ll present a few of their findings below. For more, see the ACE Study.
Here are some of their findings. I’ll paste in the definitions of the categories of adverse childhood experiences below. Strong correlations were found with the following:
- alcoholism and alcohol abuse (4 or more categories of ACE meant 4-12 times increase)
- chronic obstructive pulmonary disease (that is, lung disease)
- depression (4 or more categories of ACE meant 4-12 times increase)
- fetal death
- health-related quality of life (way more inactivity, severe obesity, bone fractures)
- illicit drug use
- ischemic heart disease (IHD)
- liver disease
- risk for intimate partner violence
- multiple sexual partners (4 or more categories of ACE correlated with 50 or more sexual partners)
- sexually transmitted diseases (STDs) (4 or more categories of ACE meant 4-12 times increase)
- smoking
- suicide attempts (4 or more categories of ACE meant 4-12 times increase)
- unintended pregnancies
Here are the kinds of abuse, neglect, and dysfunction they asked about, quoted from the site:
Abuse
Emotional Abuse:
Often or very often a parent or other adult in the household swore at you, insulted you, or put you down and/or sometimes, often or very often acted in a way that made you think that you might be physically hurt.
Physical Abuse:
Sometimes, often, or very often pushed, grabbed, slapped, or had something thrown at you and/or ever hit so hard that you had marks or were injured.
Sexual Abuse:
An adult or person at least 5 years older ever touched or fondled you in a sexual way, and/or had you touch their body in a sexual way, and/or attempted oral, anal, or vaginal intercourse with you and/or actually had oral, anal, or vaginal intercourse with you.
Neglect
Emotional Neglect1
Respondents were asked whether their family made them feel special, loved, and if their family was a source of strength, support, and protection. Emotional neglect was defined using scale scores that represent moderate to extreme exposure on the Emotional Neglect subscale of the Childhood Trauma Questionnaire (CTQ) short form.
Physical Neglect1
Respondents were asked whether there was enough to eat, if their parents drinking interfered with their care, if they ever wore dirty clothes, and if there was someone to take them to the doctor. Physical neglect was defined using scale scores that represent moderate to extreme exposure on the Physical Neglect subscale of the Childhood Trauma Questionnaire (CTQ) short form constituted physical neglect.
Household Dysfunction
Mother Treated Violently:
Your mother or stepmother was sometimes, often, or very often pushed, grabbed, slapped, or had something thrown at her and/or sometimes often, or very often kicked, bitten, hit with a fist, or hit with something hard, and/or ever repeatedly hit over at least a few minutes and/or ever threatened or hurt by a knife or gun.
Household Substance Abuse:
Lived with anyone who was a problem drinker or alcoholic and/or lived with anyone who used street drugs.
Household Mental Illness:
A household member was depressed or mentally ill and/or a household member attempted suicide.
Parental Separation or Divorce:
Parents were ever separated or divorced.
Incarcerated Household Member:
A household member went to prison.
May 9, 2010 at 11:46 am
Wow. One hell of a study. That’s awesome that it was done, and totally mirrors my experience. Kinda validating.
I wonder what good interventions look like, and what kind of partnerships are most effective at intervening
May 9, 2010 at 12:12 pm
No kidding! It’s so much data–very exciting. They are making all of the info available for free, too, which is cool.
Interventions are more difficult to study than correlations, but my program is doing something called “Healthy Nests,” a free “relationship consultation” for couples with babies or pregnant. It’s based on John Gottman’s work: http://education.uoregon.edu/field.htm?id=153
Also, attachment theory is one of most successful ideas in personality psychology and there’s a lot of research and interventions based around it, both psychoeducational and behavioral, for parents.
May 9, 2010 at 2:56 pm
It seems to me that those conditions could potentially be attributed to financial problems.
I just attended a lecture on child abuse that asserted that child abuse was often related to financial problems. Perhaps the two are interrelated?
May 9, 2010 at 3:02 pm
Yes, in fact, poverty is one of the primary correlates with child abuse, along with substance abuse. There is _some_ controversy about this, with a few maintaining that poor people are merely caught more often, as a result of being under the eye of the state, depending on state assistance etc. Most people believe that the stresses involved in being poor are causes of child abuse. Another factor is that social class is highly heritable, so all of these factors can escalate through the generations: If your parents were poor, abused drugs and you, then you are likely to do the same. Maybe even more of the same.