Raising Awareness of the Prevalence and Impact of Trauma

​What is Trauma?

"Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life."  - Judith Herman, Trauma and Recovery

The word trauma is used to describe experiences or situations that are emotionally painful and distressing and that overwhelm people’s ability to cope, leaving them powerless. Trauma has sometimes been designed in reference to circumstances that are outside the realm of normal human experience. Unfortunately, this definition does not always hold true. For some groups of people, trauma can occur frequently and become part of the human experience.

In addition to terrifying events such as violence and assault, we suggest that relatively subtle and insidious forms of trauma—such as discrimination, racism, oppression and poverty—are pervasive and, when experienced chronically, have a cumulative impact that can be fundamentally life-altering. Particular forms of trauma, such as intentional violence and/or witnessing violence, sustained discrimination, poverty, and ensuing chaotic life conditions are directly related to chronic illness and society, with serious long-term effects on health and other life outcomes.

Adverse Childhood Experience Study

Trauma results in adverse childhood experiences and can be detrimental to a child’s physical, social, and psychological health. In a landmark study conducted by researchers, The CDC, and Kaiser Permanente published by the American Journal of Preventive Medicine in 1998, we discovered the deleterious affects of ACE on adulthood. The study, entitled Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults was made up of 17,000 participants between 1995 and 1997 who had a physical exam and were given a confidential survey which included questions regarding childhood maltreatment. The survey revealed that more than half of the participants had experienced at least one ACE, while 1 in 5 participants experienced three or more ACEs. The study determined that as the number of ACEs increase, the risk for health problems increases as well. Some of those health problems are listed below:
  • Alcoholism and alcohol abuse
  • Chronic obstructive pulmonary disease (COPD)
  • Depression
  • Fetal death
  • Health-related quality of life
  • Illicit drug use
  • Ischemic heart disease (IHD)
  • Liver disease
  • Risk for intimate partner violence
  • Multiple sexual partners
  • Sexually transmitted diseases (STDs)
  • Smoking
  • Suicide attempts
  • Unintended pregnancies
  • Early initiation of smoking
  • Early initiation of sexual activity
  • Adolescent pregnancy                                                            
        (CDC, 2014)
Since this study was published, an enormous amount of research has been produced on ACE with telling evidence of the maleficence of ACE on adults. The US Department of Health and Human Services: The Health Resources and Services Administration and Maternal and Child Health Bureau published The Health and Well-Being of Children: A Portrait of States and the Nation, 2011-2012 (2014). Within this publication, researchers asked parents about 9 specific adverse childhood experiences:
  • how often it was very hard to get by on the family’s income,
  • whether the child experienced the divorce/ separation of parents,
  • whether the child experienced the death of a parent,
  • whether a parent served time in jail,
  • whether the child witnessed domestic violence,
  • whether the child was a victim of neighborhood violence,
  • whether the child lived with someone who was mentally ill or suicidal,
  • whether the child lived with someone with alcohol/drug problem, and
  • whether the child was treated or judged unfairly due to their race or ethnicity

This survey found that 56.5% of adolescents 12-17, 50.2% of children aged 6-11, and 36.6% of children aged 0-5 had experienced one or more ACE in their lifetime. Children in homes with household incomes at or below federal poverty levels were more likely to experience one or more ACE – and this study was not the only one to make this correlation. Additionally, this study reviewed data on each state. The state of Florida is slightly below the national average for resilience in children aged 6-17, whereas the Florida is above average on ACE.

Not surprisingly, researchers have realized an association exists between telomere length “an established biological indicator of cellular aging and, more recently, toxic stress” (Drury et al, 2014, p. e129_), and exposure to family violence.
​References:
Drury, S. S., Mabile, E., Brett, Z. H., Esteves, K., Jones, E., Shirtcliff, E. A., & Theall, K. P. (2014). The association of telomere length with family violence and disruption. Pediatrics, 134(1), e128-e137.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., … & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American journal of preventive medicine, 14(4), 245-258.
U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, The Health and Well-Being of Children: A Portrait of States and the Nation, 2011-2012. Rockville, Maryland: U.S. Department of Health and Human Services, 2014.

Resilience

Resilience is our ability to remain calm and cope when faced with adversity. Research shows that resilience can negate the effects of adverse childhood experiences. One study conducted on children ages 6 – 17 found a positive correlation between higher resilience scores and higher school engagement. Conversely, the study found a positive correlation between lower resilience scores and lower rates of school engagement. Additionally, the children with lower resilience scores were more likely to suffer from chronic conditions such as asthma, attention deficit hyperactivity disorder (ADHD), and obesity. The study also found that children who experienced two or more ACE were 2.67 times more likely to repeat a grade in school, however resilience assuaged the influence of adverse experiences on grade repetition (Bethell, Newacheck, Hawes & Halfon, 2014).
Building resilience is the key to combating ACEs. Resiliencetrumpsaces.org has developed informative materials to assist individuals, parents, professionals, and communities with ways to build resilience.