Adverse Childhood Experiences and Traumatic Stress Disorders

Adverse childhood experiences (ACEs) refer to a broad range of events that can reflect physical or psychological threats to safety, as well as deprivation of basic needs, essential resources, or caregiving necessary for children to thrive and attain healthy development. ACEs can constitute potentially traumatic experiences or nontraumatic adversities with the potential to exacerbate trauma-related impairment or compromise trauma recovery and resilience. This chapter explores ACEs in the context of trauma and trauma-related impairment across the life span. It covers research employing variable- and person-centered analytic strategies for quantifying cumulative and unique constellations of ACEs that probabilistically co-occur, contemporaneously or across development, to influence risk and resilience. Studies examining intergenerational patterns and biological correlates are introduced and progress toward delineating causal risk mechanisms discussed. In addition, several existing tools and methods for assessing ACEs in young and school-age children, adolescents, and adults are summarized. Clinical and public health implications of ACE screening in healthcare, schools, and other settings are considered, as is the clinical application of research on ACEs in trauma-specific prevention and treatment. The chapter concludes with a focus on future research priorities.