Nobody arguing otherwise. As with many simplified concepts, ACEs present limitations. View all Google Scholar citations The ACE framework is relatively narrow, it only covers certain events, Of course. ACEs is an explanatory factor at cohort level. Adverse childhood experiences (ACEs) have emerged as a major research theme. Change ), You are commenting using your Facebook account. ACEs are common and the effects can add up over time. Disagree here. Will never be smoking gun linking risk to outcome over long latency periods, Apply Bradford Hill criteria – strength of association, temporal nature, biological plausibility etc. The criticism comes from several perspectives, often well founded. 2020. See here (plus tables with supporting evidence) for an excellent summary from Prof Bellis and others. Nobody is saying that cuddles are the answer to toxic stress or the long term consequences arising from poverty or other factors upstream of individual adversities. There IS a need for a different response – what happened to you vs what matter with you etc. Those with 4+ ACEs were more likely to live in deprived areas, be unemployed/on long-term sickness and have no qualifications. ACEs have a … Tell me a model that isn’t problematic. experienced four or more ACEs were 4.4 times more likely to be high-risk drinkers as adults and 4.7 times more likely to have low mental well-being compared to individuals reporting no ACEs. However the framework and thinking that ACEs can give us can certainly open up new responses to (and reasons for) improving our primary prevention and improving resilience and our response across multiple settings and across a whole life course. Research in this space can be obscuring cause and effect, confounding, random variation. ACEs and health inequalities Preventing ACEs should be seen within the wider context of tackling societal inequalities. 2020. 3. and Nobody is arguing with the fact that poverty, poor housing etc isn’t important, and more important. What is already known on this topic This is tricky. Many with significant ACEs also have no issues and problems, and vice versa – many with significant problems have no ACEs. As a probabilistic and population-level tool, it is not adapted to diagnose individual-level vulnerabilities, an approach which could ultimately exacerbate inequalities. We tend to think about ACEs (whether narrowly or broadly defined) as the positive presence of some bad things. Spratt, Trevor Briggs, Robert ‘The Problem with ACEs’. ACEs have a dose-response relationship with many health problems. Kenny, Rose Anne Lacey, Rebecca E. O'Halloran, Aisling M People being critical of the ACE framework seems increasingly common. A narrow concept of ACEs is just wrong. 22 Among the hypothesized pathways, adverse childhood experiences lead to depression and posttraumatic stress disorder, which in turn can … They make reference to an array of potentially harmful exposures occurring from birth to eighteen years of age and may be involved in the construction of health inequalities over the lifecourse. and Change ), You are commenting using your Google account. The focus of this review was to identify evidence around ACEs and trauma-informed approaches to education and how ACEs can impact educational outcomes. Darra, Susanne We do misconstrue epidemiological and direct clinical evidence, that is different. As the ACEs concept becomes popular in the context of policy interventions, concerns have emerged. Minnis, Helen They include diverse types of exposures, are often considered cumulatively, can be identified using prospective and retrospective approaches, and their multidimensional nature may lead to greater measurement error. Email your librarian or administrator to recommend adding this journal to your organisation's collection. To offer some reflections about how the ideas informing the ACE study could support policy, practice and research in Northern Ireland The environment and disease: association or causation? Many people do not realize that exposure to ACEs is associated with increased risk for health problems across the lifespan. Science overwhelming! 61% of adults had at least one ACE and 16% had 4 or more types of ACEs. Lacey, Rebecca E and Would love to see this more dialogically constructed. Andy Turner offered a rapid canter through the criticisms in this thread. Iob, Eleonora Change ), on the problem with ACEs. Change ), You are commenting using your Twitter account. Armour, Gillian Thanks to Dr Zoe Brownlie for helpful comments on an earlier draft. Evidence of effectiveness of interventions affected by bias of who is framing it and summarising it. Abstract views reflect the number of visits to the article landing page. Of course there is Potential for a narrow conceptualisation of social problems. The criticism comes from several perspectives, often well founded. Wahrendorf, Morten 2020. The Adverse Childhood Experiences (ACE) Study, Screening for adverse childhood experiences (ACEs): cautions and suggestions, Nongenomic transmission across generations of maternal behavior and stress responses in the rat, Validity of adult retrospective reports of adverse childhood experiences: review of the evidence, Journal of Child Psychology and Psychiatry and Allied Disciplines. The rest of whole lives matter. Davies, Mike In this case the clue isn’t in the title. D Howe, Laura nobody saying there are magic bullets inherent in a response to ACEs and nobody is over simplifying this.
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