How Common Are ACEs? Surprising Findings from the ACE Study

by | Aug 23, 2018 | Blog | 0 comments

What Was the ACE Study?

Conducted in the late 1990s, the landmark ACE Study is one of the most notable studies to examine the nature and long-term effects of childhood trauma closely. The ACE Study evaluated 17,000+ adults to determine the mental and physical impact on those who faced adversities in their childhood home. Several unexpected and groundbreaking findings emerged from the study, which concluded that the greater the number of adversities adults faced in childhood, the more likely they were to experience mental and physical health problems throughout life.

What are ACEs, or Adverse Childhood Experiences?

The ACE Study classified adversities as anything traumatic or stressful, from physical, sexual, and emotional abuse or neglect to witnessing domestic violence or divorce between parents, experiencing family members or relatives going to jail, and living in a household where there was substance abuse. The study revealed the hidden nature of childhood adversity and the silence that surrounds it, while discovering various outcomes that were not anticipated from data previously available because of the lack of awareness and recognition of the full scale impact of childhood trauma. “I thought I would die never having told anyone about my childhood,” one ACE Study participant wrote in their questionnaire.

The Impacts of Childhood Adversity Continue into Adulthood

A remarkable discovery of the study was that childhood adversities affect adults of all backgrounds and are just as common among white, highly educated adults. Since minority children from lower-income families are most prevalent in the welfare system, it was expected that most adults who have reported childhood trauma would be from this background. But the ACE Study found otherwise. It proved that childhood trauma is exceedingly common, with 67% of participants indicating they had faced some major adversity in childhood.

The study also showed that the 10 key adversities very rarely occur in isolation, and roughly 10.5% of participants had experienced five or more Adverse Childhood Experiences, and that 13% had faced childhood domestic violence, or CDV. It also reaffirmed that childhood adversity has an inter-generational domino effect, because the dire repercussions it causes, such as substance abuse or mental illness, “may make it likelier that the next generation will experience ACEs as well.” If you suspect you may have faced childhood domestic violence, or are unsure, please use our easy, private screening tool.

What are Those Impacts?

Among dire outcomes associated with ACEs in adolescence are an increase in substance abuse and high-risk behavior, but these outcomes often persist into adulthood. There is also a heightened risk of multiple health problems in later life, such as cardiovascular disease, liver disease, chronic obstructive pulmonary disease, suicide attempts, alcohol dependence, marital problems, etc.

“If there is one common thread to many of the preventable diseases we face in the U.S., why are we not paying closer attention?” writes Dr. Dube. This has been a common thread among clinicians in recent years. As the impact of childhood adversity begins to emerge from the shadows and become more widely recognized in professional circles, the urgency to step up and start addressing the impact more proactively is growing.

The good news is that “research also suggests that humans have an innate capacity to adapt and positively transform, even after traumatic and stressful events,” given the right environment and supportive factors to help facilitate this. So the dire predictions can be reversed under the right conditions and with the right intervention strategies.

How Common Are Adverse Childhood Experiences (ACEs)?

Adverse Childhood Experiences (ACEs) are more common than many people realize. According to the Centers for Disease Control and Prevention (CDC), nearly 64% of U.S. adults report having at least one ACE. About 1 in 6 adults report four or more, which is associated with a significantly higher risk of long-term health, emotional, and behavioral challenges.

ACEs include experiences like physical or emotional abuse, neglect, parental separation, substance misuse in the home, and witnessing domestic violence. While each ACE on its own can increase vulnerability, the cumulative effect has a stronger impact: the more ACEs a person has, the greater the risk of outcomes like depression, anxiety, substance use, or chronic illness.

These findings come from large-scale studies like the original Kaiser Permanente/CDC ACE Study, which surveyed over 17,000 adults. Later research has confirmed that these patterns show up across all racial, economic, and geographic groups. However, specific communities. Particularly, those affected by systemic inequality or intergenerational trauma may face higher exposure and fewer protective supports.

Knowing how common ACEs are can help reduce shame and isolation. It also highlights the importance of early support, education, and trauma-informed care.

Unexpected Results: Dose‑Response Effects

The original ACE study revealed a strong dose‑response relationship: the more types of adversity a person experienced in childhood, the higher their risk for negative health and life outcomes as an adult. But what surprised researchers was how steep and consistent this curve was across such a wide range of issues.

For example, individuals with four or more ACEs were:

  • 2 to 4 times more likely to experience depression and suicide attempts

  • 7 times more likely to develop alcoholism

  • 3 times more likely to smoke regularly

  • 2 times more likely to have heart disease, cancer, or stroke

This means ACEs don’t just correlate loosely with outcomes; they accumulate in ways that measurably increase risk with each added experience. Even ACEs not directly related to physical harm, like emotional neglect or witnessing domestic violence, significantly raised the odds of adult dysfunction and illness.

These findings shifted the conversation around trauma: it’s not just what happens to children that matters, but how often and how many times. The impact is cumulative, and often invisible until much later in life.

Many people assume that only direct physical abuse causes lasting harm. But research, including the ACE study, shows that witnessing domestic violence—even if a child is never physically touched—can have a profound psychological and biological impact.

When a child sees, hears, or senses violence between caregivers, their brain responds as if they are personally in danger. Their stress response system activates repeatedly, especially when the violence is unpredictable. Over time, this kind of exposure can lead to:

  • Chronic anxiety or hypervigilance

  • Difficulty regulating emotions

  • Trust and attachment issues

  • Sleep problems and physical health symptoms

  • Increased risk for substance use and depression in adulthood

Witnessing violence teaches children distorted lessons about safety, conflict, and self-worth. It affects how they see themselves, others, and the world—even if no one ever laid a hand on them. This is why the ACE study and follow-up research explicitly include exposure to domestic violence as a core adverse childhood experience.

What the Numbers Mean for CDV Survivors

The numbers from the ACE study show just how widespread adverse experiences are, but for those who grew up with Childhood Domestic Violence (CDV), they offer more than statistics. They offer validation.

When nearly 1 in 4 people report exposure to domestic violence in childhood, it confirms that this experience is far more common than many realize. You are not alone. And the challenges you face now—emotional struggles, trust issues, physical symptoms, or difficulty feeling safe- are not signs of weakness. They are known responses to early toxic stress.

Understanding the data also underscores the importance of recognizing CDV as its own form of trauma. Even if you weren’t physically harmed, growing up in a violent home can shape your brain, body, and beliefs in lasting ways. Knowing this can be the first step in unlearning false guilt or shame and beginning to reconnect with a stronger sense of self.

If your ACE score is high, it doesn’t mean you’re doomed; it means your past deserves attention and care. There are concrete ways to respond:

  • Understand what ACEs affect. High scores are linked to increased risk of physical illness, mental health challenges, and substance use. Knowing this helps you connect the dots between past experiences and current struggles.

  • Learn what’s in your control. While you can’t change your childhood, you can change how you respond to its effects. That includes building supportive relationships, setting boundaries, and developing consistent routines that bring safety and calm.

  • Use tools that work for you. Not everyone connects with traditional talk therapy. Some benefit more from self-guided books, structured programs, group workshops, or worksheets that help process emotions at their own pace.

  • Start where you are. Change doesn’t need to be dramatic to be meaningful. Even small steps, like tracking triggers, naming your feelings, or writing down a few honest thoughts, can start to shift the way you relate to yourself.

  • Stay curious, not judgmental. If you find yourself repeating patterns or feeling stuck, it doesn’t mean you’ve failed. It often means a deeper wound needs attention. That realization is not a setback: it’s a signpost.

These steps are not about fixing what’s “broken.” They’re about responding to what was never your fault with steady, grounded care.

To learn more, read the full article, “How Childhood Trauma Can Affect Mental And Physical Health Into Adulthood” by Shanta R. Dube, Associate Professor at the School of Public Health at Georgia State University, on The Conversation via this link:  https://theconversation.com/how-childhood-trauma-can-affect-mental-and-physical-health-into-adulthood-77149

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