In the 1990s, Vincent Felitti and Robert Anda conducted a study on adverse childhood experiences. They asked 17,000 mostly white, mostly upscale patients enrolled in a Kaiser H.M.O. to describe whether they had experienced any of 10 categories of childhood trauma. They asked them if they had been abused, if their parents had divorced, if family members had been incarcerated or declared mentally ill. Then they gave them what came to be known as ACE scores, depending on how many of the 10 experiences they had endured.
The link between childhood trauma and adult outcomes was striking. People with an ACE score of 4 were seven times more likely to be alcoholics as adults than people with an ACE score of 0. They were six times more likely to have had sex before age 15, twice as likely to be diagnosed with cancer, four times as likely to suffer emphysema. People with an ACE score above 6 were 30 times more likely to have attempted suicide.
Later research suggested that only 3 percent of students with an ACE score of 0 had learning or behavioral problems in school. Among students with an ACE score of 4 or higher, 51 percent had those problems.
Brooks notes the public policy implications:
When we look over the domestic policy landscape, you see all these different people in different policy silos with different budgets: in health care, education, crime, poverty, social mobility and labor force issues. But, in their disjointed ways, they are all dealing with the same problem — that across vast stretches of America, economic, social and family breakdowns are producing enormous amounts of stress and unregulated behavior, which dulls motivation, undermines self-control and distorts lives.
Here are the ACE-study questions, and here are some of my thoughts on childhood trauma and chronic stress that aren't covered by the questionnaire.
Some of the questions could be associated with underlying heritable difficulties, but it's also clear that trauma and chronic stress during childhood can have catastrophic effects on adult functioning.
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