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O'Halloran, Aisling M Andy Turner offered a rapid canter through the criticisms in this thread. As the ACEs concept becomes popular in the context of policy interventions, concerns have emerged. 1. Often also this is compounded by a need to focus evidence towards recommendations for practitioners rather than at policy makers across many different national actors. Of course there is Potential for a narrow conceptualisation of social problems. 2020. ACEs are an upstream issue in some contexts (to treatment and punishment), but downstream in others (eg poverty and marginalisation) lies further upstream, Of course we need to take great care to not victimise people, it would be easy to do so, Narrow construct. The focus of this review was to identify evidence around ACEs and trauma-informed approaches to education and how ACEs can impact educational outcomes. The ACEs evidence base for interventions has limitations that have not been fully addressed. As with many simplified concepts, ACEs present limitations. Bruce also challenges the narrow concept of how ACEs research is being used in a very clear way based on the neuro-science. ACEs tend to cluster—where there is one category, there are likely others. The negative consequence of using this as a diagnostic framework often not acknowledged. Walsh, David Keith, Scott W. Demakakos, Panayotes Compared with people with zero ACEs, those with four categories of ACEs had a 240% greater risk of hepatitis, were 390% more likely to have chronic obstructive pulmonary disease (emphysema or chronic bronchitis), and a 240% higher risk of a sexually- experienced four or more ACEs were 4.4 times more likely to be high-risk drinkers as adults and 4.7 times more likely to have low mental well-being compared to individuals reporting no ACEs. Proceedings of the Royal Society of Medicine, The association between adverse childhood experiences and risk of cancer in adulthood: a systematic review of the literature, Adverse childhood experiences in the children of the Avon Longitudinal Study of Parents and Children (ALSPAC) [version 1; referees: 1 approved], The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis, Adverse childhood experiences and premature all-cause mortality, Childhood adversity as a risk for cancer: findings from the 1958 British birth cohort study. See here (plus tables with supporting evidence) for an excellent summary from Prof Bellis and others. Devaney, John This data will be updated every 24 hours. These relationships suggest adverse childhoods may inhibit social movement and trap successive family generations in poverty. Nothing new here, nothing special to ACEs on this one. This shouldn’t exclude judicious enquiry, followed by appropriate response. We over extrapolate from animal studies on cortisol, toxic stress etc. Thanks to Dr Zoe Brownlie for helpful comments on an earlier draft. They include diverse types of exposures, are often considered cumulatively, can be identified using prospective and retrospective approaches, and their multidimensional nature may lead to greater measurement error. 2. 2020. Nobody arguing otherwise. Pinto Pereira, Snehal M. Implementation without critical analysis is a mistake. There IS a need for a different response – what happened to you vs what matter with you etc. Research in this space can be obscuring cause and effect, confounding, random variation. Of the ACE study participants who experienced one ACE category, 87 percent experienced others and over 50 percent experienced four or more. Jones, Sara ACEs have long-lasting effects. The ACEs approach, as with other attempts to diagnose and label sections of the population as deficient, has the potential for damaging consequences for the children and adults who are said to possess such deficiencies. and The bottom line is that we ignore trauma at our peril – the important message from ACEs research is that is has a huge impact on people’s outcomes and then we need to be very mindful as to how we apply this knowledge. While ACEs are found across the population, there is more risk of experiencing ACEs in areas of higher deprivation. and ‘The Problem with ACEs’. Ward, Mike R. M. 3. Change ), on the problem with ACEs. The rest of young lives also matter. Lacey, Rebecca E. ( Log Out /  As with many simplified concepts, ACEs present limitations. Here put up a critique of the critique and a counter narrative. The ACE framework is relatively narrow, it only covers certain events, Of course. 2019. ( Log Out /  The Adverse Childhood Experiences (ACE) Study, Screening for adverse childhood experiences (ACEs): cautions and suggestions, Nongenomic transmission across generations of maternal behavior and stress responses in the rat, Validity of adult retrospective reports of adverse childhood experiences: review of the evidence, Journal of Child Psychology and Psychiatry and Allied Disciplines. ACEs are common and the effects can add up over time. Nobody is arguing with the fact that poverty, poor housing etc isn’t important, and more important. Can lead to medicalisation of social construct & There is often enthusiasm as an answer to all social ills. Ward, Mark In this case the clue isn’t in the title. and Adverse childhood experiences (ACEs) have emerged as a major research theme. Jones, Sara W. People being critical of the ACE framework seems increasingly common. Epidemiology and the web of causation: has anyone seen the spider? LaNoue, Marianna D. * Views captured on Cambridge Core between . Of course early years matter, primary, secondary and tertiary prevention. Ward, Michael R.M. 5. Danese, Andrea Responses to Edwards et al.’s submission to the House of Commons Science and Technology Select Committee Inquiry into the evidence-base for early years intervention (EY10039). Abstract views reflect the number of visits to the article landing page. Kenny, Rose Anne The WHO and CDC are collaborating to work with multiple countries to implement the ACE Study and determine the global impact of … Adverse childhood experiences (ACEs) have emerged as a major research theme. The rest of whole lives matter. Sunderland‐Evans, Wendy A 45-year prospective epidemiologic study, Adverse childhood experiences and adult risk factors for age-related disease depression, inflammation, and clustering of metabolic risk markers, Archives of Pediatrics and Adolescent Medicine, Insights into causal pathways for ischemic heart disease: adverse childhood experiences study, Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study, The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900, The condition of the working class in England, Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. This video from Bruce Perry on ACEs, brain development, trauma and importance of relationship, early years and trauma debriefing is worth a watch. Social pathways between childhood and adult health, A Life Course Approach to Chronic Disease Epidemiology, Maternal care, hippocampal glucocorticoid receptors, and hypothalamic-pituitary-adrenal responses to stress, Effects of stress throughout the lifespan on the brain, behaviour and cognition, Income inequality and mortality: importance to health of individual income, psychosocial environment, or material conditions, Psychosocial and material pathways in the relation between income and health: a response to Lynch et al, Adverse childhood experiences and life opportunities: shifting the narrative, GABAA receptor promoter hypermethylation in suicide brain: implications for the involvement of epigenetic processes, Welsh Adverse Childhood Experiences Study, Adverse childhood experiences run deep: toxic early life stress, telomeres, and mitochondrial dna copy number, the biological markers of cumulative stress, The long-term effects of early experience, Developmental Medicine and Child Neurology, From Neurons to Neighborhoods: The Science of Early Childhood Development, Adverse childhood experiences and physiological wear- and-tear in midlife: findings from the 1958 British birth cohort, Proceedings of the National Academy of Sciences of the United States of America, Choosing a future for epidemiology: I. Eras and paradigms, https://doi.org/10.1017/S1474746419000101, Therelationship of adverse childhood experiences to adult medical disease, psychiatric disorders and sexual behavior: implications for healthcare, Early life experiences and social cognition in major psychiatric disorders: A systematic review, Early life adversity increases the salience of later life stress: an investigation of interactive effects in the PSID, Journal of Developmental Origins of Health and Disease, Sensitizing effect of early adversity on depressive reactions to later proximal stress: Moderation by polymorphisms in serotonin transporter and corticotropin releasing hormone receptor genes in a 20-year longitudinal study, The impact of childhood trauma and psychophysiological reactivity on at-risk women's adjustment to parenthood, Associations of adverse childhood experiences and social support with self-injurious behaviour and suicidality in adolescents, Social buffering of the maternal and infant HPA axes: Mediation and moderation in the intergenerational transmission of adverse childhood experiences, Attachment security moderates the link between adverse childhood experiences and cellular aging. 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