In the following decades, it would be one of the largest longitudinal studies ever conducted, and would eventually persuade the medical community to recognize the pervasive harm ACEs inflict on the physical health and mental wellbeing of survivors throughout their entire lives. The study categorized adverse childhood experiences as:
Abuse
Emotional abuse
Physical Abuse
Sexual Abuse
Neglect
Physical
Emotional
Household Challenges
Mother treated violently
Substance abuse in the household
Mental illness in the household
Parental Separation or divorce
Incarcerated household member
The CDC in partnership with the HMO, Kaiser Permanente conducted this study by asking more than 17,000 HMO members in Southern California to complete confidential surveys regarding the presence of ACEs while they were growing up to age eighteen. They also asked about their current health status and behaviors. The results were extraordinary. 24.7% of women and 20% men reported being sexually abused, and 27% of women and 29.9% of men reported physical abuse in childhood. As for household challenges, 26.9% disclosed that a household member abused drugs and alcohol, and nearly 20% disclosed a household member suffered from mental illness.
ACE Study Outcomes: Early Adversity has Long Lasting Negative Effects
Adults who had suffered abuse or neglect, or lived through household challenges were a major risk factor in developing a host of serious and deadly illnesses in adulthood. Heart disease, diabetes, and cancer, and alcoholism, depression, and anxiety disorders were among the illnesses survivors experienced at higher rates than those without a history of ACEs. ACEs also negatively impacted the behaviors of survivors with an increase in unintended, complicated pregnancy, unsafe sex, substance abuse, and suicide, just to name a few. Most astonishing was the statistic regarding life expectancy. Individuals who reported six adverse childhood experiences had an average life expectancy of sixty years old, while the life expectancy of respondents without ACEs was eighty years.
The ACE study laid the groundwork for understanding the neurological impacts of neglect, abuse and traumatic stress. Eventually, psychiatrists and psychologists recognized complex PTSD as a diagnosis for when trauma is pervasive and ongoing such as child abuse. But for Ivan, it wasn’t soon enough. This was the early 2000s and the DSM IV-TR (Diagnostic and Statistical Manual of Mental Disorders) didn’t mention Complex PTSD as a diagnosis. Medical residents did not routinely receive education on ACEs or the neurobiological impacts of childhood trauma. Treating the symptoms rather than diagnosing the cause was, and with some professionals still is, a standard course of action. Psychiatrists and pediatricians often diagnose children with neurodevelopmental and mood disorders such as Schizophrenia, Attention Deficit Hyperactivity Disorder, Bipolar Disorder, and Oppositional Defiant Disorder, rather than recognize their behaviors as symptoms of traumatic stress.
The Explosion of ADHD Diagnoses
With the diagnosis of ADHD, the pattern of labeling children has more than doubled. Before the 90s, less than 5% of children were diagnosed with ADHD. By 2016 that number had jumped to 11%. There are multiple factors for the increase. Public education systems with too many children in a classroom will breed chaos and disruption, which makes it difficult for teachers to maintain control and deliver curriculum. Identifying the disruptive child as a threat to the classroom sets the child up for a neurodevelopmental disorder label.
Relative age of children in the same grade level will also play a role. In a study published in the Canadian Medical Association Journal (2012) boys who were born in the last two weeks of December were 30% more likely to receive an ADHD diagnosis than boys in the same grade level who were born in January of the same year. For girls born in December, the rate of ADHD diagnosis was 70% higher than girls in their class born in January of the same year. Instead of taking into account normal developmental differences between children born eleven months apart, teachers, counselors, and pediatricians tended to medicalise these differences as a disorder.
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