Exploring the Shadow: How Adverse Childhood Experiences Can Influence Adult Well-Being and Quality of Life

Abstract

Abstract Background: Adverse childhood experiences (ACEs) have emerged as a critical public health concern in the US in recent years. Prior studies have found that ACEs have a negative impact on adult mental and physical health. However, these studies have not controlled for health-related variables (e.g., smoking), only demographics; have not used a conceptual model; and some important outcomes have not been previously studied (i.e., disability, stress in adulthood, life satisfaction). Objectives: This study aimed to further assess the impact of ACEs on adult well-being and quality of life and to utilize a conceptual model based on the ACE pyramid in this assessment. Methods: Data from the 2016 Behavioral Risk Factor Surveillance System (BRFFS) from four states (N=15,109) was used in this study. ACEs include 11 items reflecting child abuse and household dysfunction that are retrospectively recalled by adults. The occurrence of each ACE is summed to create a total score. The impact of ACEs (none vs. 4+) was assessed through multivariate logistic regression. Results: Those with 4+ ACEs were significantly more likely to have depression (aOR= 5.39, 4.51/6.44, p<.001), cognitive impairments (aOR=2.30, 1.8/2.9, p<.001), monetary stress (aOR=2.47, 1.6/3.8, p<.001) and poor life satisfaction (aOR=3.12, 2.4/4.0, p<.001) compared to those with no ACEs. Even when health-related variables were controlled for in addition to demographics, ACEs continued to have a strong impact on mental health, weight status, health risk behaviors, and quality of life measures. Conclusion: ACEs have an incredibly significant impact on adult well-being and quality of life above and beyond many health-related factors. Efforts to prevent, identify and decrease the deleterious effects of these traumatic experiences are urgently needed. Future research should focus on addressing the effects of such interventions and improving effective resilience strategies for children of all ages.