The ACE Study
The Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted on the links between childhood maltreatment and later-life health and well-being. As a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente’s Health Appraisal Clinic in San Diego, Health Maintenance Organization (HMO) members undergoing a comprehensive physical examination provided detailed information about their childhood experience of abuse, neglect, and family dysfunction. Over 17,000 members chose to participate. To date, over 50 scientific articles have been published and over 100 conference and workshop presentations have been made.The ACE Study findings suggest that these experiences are major risk factors for the leading causes of illness and death as well as poor quality of life in the United States.
Adverse events:
recurrent and severe physical abuse (11%)
recurrent and severe emotional abuse (11%)
contact sexual abuse (22%)
growing up in a household with:
— an alcoholic or drug-user (25%)
— a member being imprisoned (3%)
— a mentally ill, depressed, or institutionalized member (19%)
— the mother being treated violently (12%)
— both biological parents not being present (22%)
Findings:
Adverse childhood experiences are surprisingly common, although typically concealed and unrecognized.
ACEs still have a profound effect 50 years later, although now transformed from psychosocial experience into organic disease, social malfunction, and mental illness.
Adverse childhood experiences are the main determinant of the health and social well-being of the nation.
Re-thinking addiction
In our detailed study of over 17,000 middle-class American adults of diverse
ethnicity, we found that the compulsive use of nicotine, alcohol, and injected street drugs
increases proportionally in a strong, graded, dose-response manner that closely parallels
the intensity of adverse life experiences during childhood. This of course supports old
psychoanalytic views and is at odds with current concepts, including those of biological
psychiatry, drug-treatment programs, and drug-eradication programs. Our findings are
disturbing to some because they imply that the basic causes of addiction lie within us and
the way we treat each other, not in drug dealers or dangerous chemicals. They suggest
that billions of dollars have been spent everywhere except where the answer is to be
found.
Vincent Felitti, M.D.
principal co-investigator
