Post-Traumatic Stress Disorder and Screening Tool for Adverse Childhood Experiences
June was Post-Traumatic Stress Disorder (PTSD) Awareness Month. In May, the Mental Health and Wellness blog discussed ACEs (adverse childhood experiences) that sometimes result in PTSD, a mental disorder. Our July blog will tie together information about trauma, PTSD, ACEs in childhood, and their impact on child and adult health.
Research reports help us estimate that childhood adversity plays a major role in 45% of children’s mental health disorders and 30% of mental health disorders among adults. These studies show an increased risk for major depression, anxiety, schizophrenia, and other psychotic disorders following childhood trauma or adverse childhood experiences.
The original Adverse Childhood Experience study was published in 1998 and is based on a simple ten-item survey of adversities that may have taken place during the first 18 years of life. This first ACE study found a correlation between the ACE score and nine major causes of death in adult life, meaning the more adversity you had in childhood, the greater your risk for health problems. Subsequent studies have demonstrated similar correlations between an adult ACE score and risk for suicide, mental health problems, substance use and dependence, and a host of other problems.
ACE studies are important, but the ACE score doesn’t have much real predictive power on an individual basis or as a clinical tool. Mostly, it provides a superficial glance of “what happened to you.” Simply having a high ACE score does not mean you will get heart disease or have mental health problems; it merely means your risk for mental health problems or heart disease goes up. Having an ACE score of 5 merely means you will likely struggle more than someone with a score of 1. The ACE score does not tell your “story.” The timing, pattern, and intensity of stress and distress experiences, or the presence of buffering or healing factors, affect health predictions and outcomes.
Decades of studies have shown a major finding that your history of relational health–your connectedness to family, community, and culture–is more predictive of your mental health than your history of adversity. Connectedness has the power to counterbalance adversity. Also, the timing of adversity is everything; it makes a huge difference in determining overall risk. For example, if you experience trauma at age two, it will have more impact on your health than the same trauma taking place at age seventeen. Consideration of connectedness and timing is essential as we build developmentally informed trauma-aware systems in families, schools, churches, and communities. It helps us focus on “What happened to you?” rather than “What’s wrong with you?”
Source: What Happened to You? Conversations on Trauma, Resilience, and Healing, 2021. Bruce D. Perry, MD, Ph.D., and Oprah Winfrey (This book is available in the WMPC Caldwell Library)
Take time to read and score the survey below. It helps to provide an understanding of some of the kinds of adverse experiences that may occur at any age and have an impact on health. This is not a predictive tool.
Adverse Childhood Experience Survey
For each question you answer YES, one point will be assigned to the question. A NO response earns no points. When all questions are answered, count the number of YES answers; that number is your ACE score.
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.
- 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?
- Did an adult or person at least 5 years older than you ever…Touch or fondle you or have you sexually touch their body? Or attempt or have oral, anal, or vaginal intercourse with you?
- Did you often or very often feel that…No one in your family loved you or thought were important or special? Or your family didn’t look out for each other, feel close to each other, or support each other?
- 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?
- Were your parents ever separated or divorced?
- 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?
- Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
- Was a household member depressed or mentally ill, or did a household member attempt suicide?
- Did a household member go to prison?
Now add up your YES answers. _________Score