Understanding ACEs with Dr. Nadine Burke Harris

Summary

The video script discusses Adverse Childhood Experiences (ACES), highlighting their prevalence and significant impact on health and behavior in adulthood. It reveals the correlation between ACES and serious health conditions, emphasizing the toxic stress response in children due to prolonged stress activation. The script suggests that nurturing relationships and stress-regulating activities can mitigate ACES effects, advocating for health providers' training in ACES awareness to improve outcomes. It concludes with a hopeful message that ACES and toxic stress can be reduced within a generation.

Takeaways

• 📊 Adverse Childhood Experiences (ACES) are common and can significantly impact health and behavior later in life.
• 🔍 The original ACE study by the CDC and Kaiser identified 10 categories of childhood trauma and their correlation with adult health issues.
• 👥 Two-thirds of individuals have experienced at least one ACE, and one in eight have experienced four or more.
• 🏥 ACES are linked to a higher risk of serious health conditions like heart disease, stroke, cancer, liver disease, and diabetes.
• 🧠 The toxic stress response is the result of prolonged activation of the body's stress response, affecting brain and body development, especially in children.
• 👶 High doses of adversity in childhood can alter brain development, hormonal systems, immune system, and even DNA transcription.
• 🔄 ACES tend to be cyclical, affecting families and communities across generations.
• 🧘‍♂️ Strategies like mindfulness, meditation, mental health interventions, exercise, and healthy relationships can help regulate the stress response and improve outcomes.
• 🤝 Nurturing relationships can change biology, improving neurologic, hormonal, and immune functioning, which is crucial for healing.
• 🏥 ACES Aware is a program to train healthcare providers in screening for ACES and responding in a trauma-informed way.
• 💪 Recognizing and addressing ACES is key to breaking the cycle and improving health outcomes, with the potential to halve the impact in one generation.

Q & A

What does the term 'ACES' stand for?

ACES stands for Adverse Childhood Experiences, which are stressful or traumatic experiences during childhood that can lead to significant health, mental health, and behavioral issues later in life.

What was the purpose of the research study conducted by the CDC and Kaiser more than 20 years ago?

The research study aimed to investigate the prevalence of adverse childhood experiences among adults and their correlation with serious health conditions in later life.

What are the 10 categories of adverse childhood experiences that were inquired about in the CDC and Kaiser study?

The categories include physical, emotional, or sexual abuse; physical or emotional neglect; growing up in a household with mental illness, substance dependence, incarceration, parental separation or divorce, or intimate partner violence.

What was the significant finding of the ACE study regarding the prevalence of ACES?

The study found that ACES are extremely common, with two-thirds of individuals having experienced at least one ACE and one in eight having experienced four or more.

How does the ACE study relate the experiences of childhood trauma to health conditions in adulthood?

The study established a dose-response relationship between the number of adverse childhood experiences and the risk of serious health conditions such as heart disease, stroke, cancer, liver disease, diabetes, and autoimmune disease.

How do ACES impact different communities and demographic groups?

ACES affect every community and demographic group, but they disproportionately impact vulnerable communities.

What is the term used to describe the prolonged activation of the body's stress response due to childhood adversity?

The term used is 'toxic stress response'.

How does the toxic stress response affect a child's development?

The toxic stress response can change the way a child's brain, hormonal systems, immune system, and even DNA are read and transcribed, leading to long-term changes.

Why is it challenging for individuals to break the cycle of ACES in families?

ACES tend to repeat in families due to a lack of understanding of how they impact individuals and the absence of strategies to regulate the stress response effectively.

What are some strategies that have been scientifically demonstrated to help regulate the biological stress response in individuals who have experienced ACES?

Strategies include mindfulness, meditation, spending time in nature, mental health interventions, regular exercise, nutritional strategies, and maintaining healthy relationships.

What is the 'ACES Aware' initiative and its goal?

ACES Aware is a nationwide effort to train healthcare providers to screen for adverse childhood experiences and respond in an evidence-based, trauma-informed way to improve outcomes for children and adults.

What is the potential impact of recognizing and addressing ACES on an individual and community level?

Recognizing and addressing ACES can lead to a reduction in the negative outcomes associated with them, improved neurologic, hormonal, and immune functioning, and the potential to cut ACES and toxic stress by half in one generation.

Outlines

00:00

🚨 Adverse Childhood Experiences (ACES) Overview

The script discusses Adverse Childhood Experiences (ACES), which are stressful or traumatic events during childhood linked to increased health, mental health, and behavioral issues in adulthood. Originating from a CDC and Kaiser study over 20 years ago, ACES encompass 10 categories including various forms of abuse and neglect. The study revealed a dose-response relationship between ACES and severe health conditions, with two-thirds of individuals reporting at least one ACE and one in eight experiencing four or more. The impact of ACES is widespread across communities but disproportionately affects vulnerable groups. The script also introduces the concept of the toxic stress response, explaining how prolonged stress activation during childhood can alter brain and body development, leading to long-term health issues.

05:02

🌱 Healing and Preventing ACES

This paragraph delves into the challenges of ACES, which often recur across generations, and the importance of recognizing and understanding one's own experiences to break the cycle. It highlights the role of the toxic stress response in the body and the importance of stress regulation strategies such as mindfulness, meditation, nature exposure, mental health interventions, exercise, nutrition, and healthy relationships. These strategies are scientifically proven to help regulate the biological stress response and improve outcomes for individuals who have experienced ACES. The paragraph also discusses the 'ACES Aware' initiative, which trains healthcare providers to screen for ACES and respond in a trauma-informed manner. The script concludes with an optimistic view that recognizing and addressing ACES can lead to a significant reduction in their prevalence within a single generation.

Keywords

💡Adverse Childhood Experiences (ACES)

Adverse Childhood Experiences, often abbreviated as ACES, refer to a spectrum of traumatic or stressful events that occur during childhood. These experiences can significantly increase the risk of health, mental health, and behavioral issues later in life. In the video, ACES are highlighted as a major public health issue, with a direct correlation between the number of ACES and the prevalence of serious health conditions among adults.

💡Stressful or Traumatic Experiences

Stressful or traumatic experiences are events that cause significant emotional or psychological strain. Within the context of the video, these experiences are specifically those that happen during childhood and can have long-term detrimental effects on an individual's well-being. Examples given in the script include physical, emotional, or sexual abuse, and neglect.

💡Dose-Response Relationship

The dose-response relationship in the video refers to the direct correlation between the number of adverse childhood experiences and the severity of health issues later in life. The more ACES an individual has experienced, the higher their risk for certain health conditions, illustrating a proportional increase in risk.

💡Toxic Stress Response

Toxic stress response is a term used to describe the prolonged activation of the body's stress response system due to adverse experiences, particularly in childhood. The video explains that this response involves the release of stress hormones and can have lasting effects on a child's developing brain, hormonal systems, immune system, and even DNA transcription.

💡Health Consequences

Health consequences in the video pertain to the serious health conditions that are linked to ACES. These include heart disease, stroke, cancer, liver disease, diabetes, and autoimmune diseases. The video emphasizes that these conditions are not traditionally associated with childhood trauma, but the research shows a clear connection.

💡Vulnerable Communities

Vulnerable communities, as mentioned in the video, are groups that are disproportionately affected by ACES. While ACES impact every demographic group, these communities bear a heavier burden, highlighting the need for targeted interventions and support.

💡Mindfulness

Mindfulness, in the context of the video, is presented as a method to help regulate the biological stress response. It is one of several strategies, including meditation and spending time in nature, that can be used to mitigate the effects of ACES and promote overall well-being.

💡Mental Health Interventions

Mental health interventions are professional treatments or therapies aimed at addressing and treating mental health issues. The video suggests that such interventions are crucial for individuals who have experienced ACES, as they can help regulate the stress response and improve outcomes.

💡Nutritional Strategies

Nutritional strategies refer to the dietary approaches and habits that can contribute to better health and well-being. In the video, they are mentioned as a means to help regulate the stress response and are part of a broader set of recommendations for individuals affected by ACES.

💡Nurturing Relationships

Nurturing relationships are those that provide emotional support, care, and stability. The video emphasizes their importance in the healing process for individuals who have experienced ACES. These relationships can positively influence neurologic functioning, hormonal regulation, and immune functioning.

💡ACES Aware

ACES Aware is an initiative mentioned in the video that focuses on training healthcare providers to screen for adverse childhood experiences and respond in a trauma-informed manner. This effort aims to improve health outcomes for both children and adults who have experienced ACES.

💡Trauma-Informed Care

Trauma-informed care is an approach to healthcare that recognizes the presence of trauma and its impact on an individual's physical and mental health. The video discusses how healthcare providers can be trained to screen for ACES and respond in a way that is sensitive to the trauma experienced by the patient.

Highlights

Adverse Childhood Experiences (ACES) are linked to increased risk of health, mental health, and behavioral issues later in life.

ACES originate from a landmark study by the CDC and Kaiser, identifying 10 categories of childhood trauma.

The study revealed a dose-response relationship between ACES and serious health conditions among Americans.

Two-thirds of individuals had experienced at least one ACE, and one in eight had experienced four or more.

ACES impact every community and demographic group, with a disproportionate effect on vulnerable communities.

Individuals with four or more ACES have double the risk of heart disease, stroke, cancer, liver disease, and diabetes.

The toxic stress response refers to the prolonged activation of the body's stress response system.

Children are particularly vulnerable to the toxic stress response due to their developing brains and bodies.

High doses of adversity in childhood can change brain, hormonal, immune system development, and DNA transcription.

ACES tend to repeat in families from generation to generation.

Recognizing and understanding ACES is key to breaking the cycle and doing things differently.

Mindfulness, meditation, nature, mental health interventions, exercise, nutrition, and healthy relationships help regulate the stress response.

Nurturing relationships can change biology, improving neurologic, hormonal, and immune functioning.

Understanding one's role in providing buffering care to a young person in need can be transformative.

ACES Aware is a program to train healthcare providers in screening for ACES and responding in a trauma-informed way.

Recognizing ACES is a crucial step in asking for needed support and potentially halving the impact in one generation.

ACES are not a predetermined destiny, and significant outcomes can be mitigated with awareness and intervention.

Transcripts

the term aces stands for adverse

childhood experiences

and these are stressful or traumatic

experiences that happen in childhood

that can increase the risk for

significant health mental health and

behavioral consequences later in life

they really come from

a

big landmark research study that was

done by the cdc and kaiser now more than

20 years ago in which they asked adults

about their history of 10 categories of

adverse childhood experiences and these

include physical emotional or sexual

abuse physical or emotional neglect or

growing up in a household where parents

experience mental illness substance

dependence

incarceration where there is parental

separation or divorce or intimate

partner violence what they found was

number one aces are super common

and number two

that there's this really significant

effect so there's a direct what we call

a dose response relationship between

adverse childhood experiences and some

of the most significant and serious

health conditions that are facing

americans today

two-thirds of individuals had

experienced at least one

and one in eight folks had experienced

four or more when we talk about

how many of us have experienced aces

what we see is that aces impact every

community any every demographic group

but it impacts our vulnerable

communities in a disproportionate level

the big surprise about the ace study was

that for someone with four more aces

their risk of heart disease

was double right for stroke and cancer

and liver disease and diabetes even

autoimmune disease and a lot of these

things are things that we didn't

kind of traditionally or intuitively

associate with childhood trauma

but now we can use this science to

understand

actually what happens in our brains and

bodies when we're exposed to trauma or

adversity and especially in childhood

[Music]

the term the toxic stress response

actually refers to the prolonged

activation of our body's stress response

the release of all those stress hormones

like adrenaline and cortisol and all

those things that go along with our

stress response

and then also the ways in which that

affects our bodies children

are especially

vulnerable to this repeated activation

of the stress response

because their brains and bodies are just

developing

so high doses of adversity in children

actually changes

the way their brains develop it changes

the way their hormonal systems develop

their immune system develops and even

the way their dna is read and

transcribed and those long-term changes

are what we refer to as the toxic stress

response

[Music]

one of the things that's really

challenging

about aces is that

they tend to

repeat

in families generation after generation

and i will say this as someone who

has experienced my fair share of aces

understanding how

that might be impacting me and being

able to recognize that

for me is really the key

for being able to do things differently

we understand what happens in our bodies

with the toxic stress response and we

understand that it's that prolonged

activation of our stress response then

step one

is really understanding what are the

things that help to regulate our stress

response and immediately at that point

we begin

decreasing the harm

that happened as a result of our past

experiences so things like mindfulness

right meditation spending time in nature

mental health interventions regular

exercise nutritional strategies

and

my favorite healthy relationships

all of these things are really

scientifically demonstrated to help to

regulate the biological stress response

and they

improve our outcomes

for those of us who have experienced

stasis

these nurturing relationships

they

they feel good which is good of course

but they

literally change our biology

when we have

safe stable and nurturing relationships

in our lives

it improves

our neurologic functioning it improves

our hormonal regulation it improves our

immune functioning and these social

supports are critical

part of healing if we all understand our

role

in

being a source of buffering care to a

young person in need

that is truly

transformative

aces aware is a first in the nation

effort

to train our health care providers

how to screen for adverse childhood

experiences

and how to respond

in an evidence-based

trauma-informed way

that helps to improve outcomes for

children

and adults

aces are not destiny

even if someone has experienced

significant aces

it doesn't mean that they are absolutely

going to have

these negative outcomes recognizing our

aces

requires us to recognize our

vulnerability

and that can be really scary

but it also is the place where

we

we get a chance to ask for what we need

i

deeply believe

that we can

cut aces and toxic stress by half

in one generation

[Music]

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