APA Task Force Calls Attention to Adverse Childhood Experiences
> 11/16/2006 1:34:31 PM

Earlier this year, Dr. Steven Sharfstein announced the formation of a new American Psychiatric Association task force that would examine the effects of exposure to interpersonal violence in childhood, and its relationship to mental illness. Writing in the APA's Psychiatric News, Sharfstein said: "What cigarette smoking is to the rest of medicine, early childhood violence is to psychiatry."

This month's edition of Clinical Psychiatry News reports that the task force has made a stern recommendation to the APA. "Traumatic stress in youth is the single most important contributor to later psychiatric morbidity and mortality, and the American Psychiatric Association should make violence and its sequelae a major organizational priority, according to a new report."

A good deal of the data that the Task Force on the Biopsychosocial Consequences of Childhood Violence used came from the Adverse Childhood Experiences (ACE) Study, a collaboration between Kaiser Permanente’s Department of Preventive Medicine in San Diego, California, and the Centers for Disease Control and Prevention. As Clinical Psychiatry News explains:

The ACE study has identified several specific categories of adverse childhood experiences that are associated with numerous health risk factors later in life, and has found these experiences to be far more common than was previously appreciated...

More than half reported having experienced at least one of these early life adverse events (ACE score one) and one-quarter reported having two or more, according to Dr. Felitti. Serious physical and emotional abuse was reported by one in nine people, and sexual abuse was reported by 28% of women and 16% of men. “This is hard to believe unless you routinely ask people—in which case it becomes blatantly obvious,” he said.

The ACE study was able to find statistical support for the hypothesis that higher ACE scores, i.e. more adverse childhood experiences, indicated a much greater risk of a variety of negative outcomes including intravenous drug use, smoking and suicidality. Working against this increased risk however, were preventative factors or what Dr. Carl C. Bell, chief executive officer of Community Mental Health Council Inc. in Chicago, called "protective factors," which include "intellectual ability, a feeling of connectedness and having an internal locus of control and blame."

The task force recommended that the APA push for greater awareness of the problems created by ACE's and that the group push to raise the consciousness of psychiatrists about the issues and the protective factors that they can play such a strong part in cultivating and managing. Indeed, society as a whole can benefit from a greater understanding of how exposure to violence and other negative extremes can effect a child for the rest of his or her life. Doctors, therapists and social workers might be dealing with these issues on the ground level, but we can all do our part to address them in our own lives and the lives of those that we care about.


Though evidence of the link between childhood trauma and mental health existed though studies, this seems to almost confirm it. I wonder though, if there exists mechanisms to reverse these effects?Though logic dictates the stopping childhood violence is the answer, this becomes problematic when exposure to childhood violence cannot be isolated. For example, a mechanism that will help combat the effects could be beneficial in war and in the case of refugee situations.
URL: http://astrorat.blogspot.com
Posted by: Astrorat 11/17/2006 8:34:30 AM

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