The Potential of Early Intervention for Preventing and Reducing ACE-Related Trauma

2019 ◽  
Vol 18 (3) ◽  
pp. 425-434 ◽  
Author(s):  
Kirsten Asmussen ◽  
Tom McBride ◽  
Stephanie Waddell

Too many children face disadvantages that negatively impact their health, happiness and future life chances. Adverse Childhood Experiences (ACEs) represent a particularly traumatic set of circumstances that have been found through research to dramatically increase the likelihood of poor adult physical and mental health outcomes. While we do not view ACEs to represent the only or necessarily the most serious risks to children’s development, we do recognise them to pose a substantial threat. This article identifies twenty-four interventions with causal evidence of preventing or reducing ACE-related trauma and considers how they could be offered through system-wide strategies aimed at improving the lives of children who are at the greatest risk. While we are not suggesting that these interventions – on their own or in combination – represent a magic solution to ACEs, or the wider societal issues that contribute to them, we do propose that knowledge about their effectiveness can improve the quality of services that support the needs of highly vulnerable children.

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022265 ◽  
Author(s):  
Teresa N Brockie ◽  
Jessica H L Elm ◽  
Melissa L Walls

ObjectivesThe purpose of this study was to determine the frequency of select adverse childhood experiences (ACEs) among a sample of American Indian (AI) adults living with type 2 diabetes (T2D) and the associations between ACEs and self-rated physical and mental health. We also examined associations between sociocultural factors and health, including possible buffering processes.DesignSurvey data for this observational study were collected using computer-assisted survey interviewing techniques between 2013 and 2015.SettingParticipants were randomly selected from AI tribal clinic facilities on five reservations in the upper Midwestern USA.ParticipantsInclusion criteria were a diagnosis of T2D, age 18 years or older and self-identified as AI. The sample includes n=192 adults (55.7% female; mean age=46.3 years).Primary measuresWe assessed nine ACEs related to household dysfunction and child maltreatment. Independent variables included social support, diabetes support and two cultural factors: spiritual activities and connectedness. Primary outcomes were self-rated physical and mental health.ResultsAn average of 3.05 ACEs were reported by participants and 81.9% (n=149) said they had experienced at least one ACE. Controlling for gender, age and income, ACEs were negatively associated with self-rated physical and mental health (p<0.05). Connectedness and social support were positively and significantly associated with physical and mental health. Involvement in spiritual activities was positively associated with mental health and diabetes-specific support was positively associated with physical health. Social support and diabetes-specific social support moderated associations between ACEs and physical health.ConclusionsThis research demonstrates inverse associations between ACEs and well-being of adult AI patients with diabetes. The findings further demonstrate the promise of social and cultural integration as a critical component of wellness, a point of relevance for all cultures. Health professionals can use findings from this study to augment their assessment of patients and guide them to health-promoting social support services and resources for cultural involvement.


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