Post-traumatic Stress Syndrome & Adverse Childhood Experiences

Evidence of Post-traumatic Stress Syndrome/Adverse Childhood Experiences (PTSD/ACEs) in children is specific to the population being researched. The evidence provides information that helps health care and public health professionals identify signs of ACEs/PTSD in children, including methods for screening to rule out traumatic experiences, being witnesses to abuse, and traumatic hospitalization experiences. 

Epidemiological data provides substantial evidence of the impact of ACEs/PTSD in childhood. One of the earlier and largest ACE studies sponsored by the CDC and Kaiser Permanente from 1995-1998 studied seven categories of ACEs, including psychological, physical abuse, sexual abuse, violence against a mother, living with substance abusers, suicidal, or previously imprisoned persons. Out of 9,508 survey respondents, 52% experienced >/= 1 category of ACE, 6.2% report exposures. The most prevalent exposure reported (25.6%), was substance abuse. (Felitti, 1998) Literature over the years has continued to substantiate the impact of ACEs on mental health and health outcomes and also reveal evidence of population disparities. A South Dakota Health Survey produced data comparing the American Indian (AI) population with the non-AI population. Significantly higher prevalence of PTSD, and positive screening for anxiety, and depression were found. Additionally, significantly higher prevalence of exposure was found among AI respondents in comparison with non-AI respondents. (Warne, 2017)

The evidence underscores the need to provide interventions for children at risk of exposure to adverse childhood events and PTSD. One action is to identify risks and exposure early on so that interventions may be employed to support childhood development and mitigate long-term and intergenerational health effects. This includes educating clinicians and providing new tools and methods for screening and intervention options. (R) Evidence shows that ACEs/PTSDs in children must be considered a significant health problem to ensure this public health issue gets the attention needed and support the health of our future generations. (T) The estimated time needed to thoroughly evaluate recommendations and propose viable solutions, including compiling a list of recommendations and areas needing further exploration will vary. An evaluation of resources and interprofessional collaboration will help facilitate this process in a timely manner to enable clinicians and public health professionals to support children and their families susceptible to and who have been diagnosed with PTSD/ACEs. 

References

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245-258.  https://doi.org/10.1016/S0749-3797(98)00017-8

Warne, D., MD, MPH, Dulacki, K., Spurlock, M., Meath, T., Davis, M. M., Wright, B., & McConnell, K. J. (2017). Adverse childhood experiences (ACE) among american indians in south dakota and associations with mental health conditions, alcohol use, and smoking. Journal of Health for the Poor and Underserved, 28(4), 1559. https://doi.org/10.1353/hpu.2017.0133