The theme of this year's symposium was the prevention of the onset and progression of mental illness, and I was very interested to see how they would cover this topic. Aside from some dialogue about resiliency, we in the mental health field don't talk much about prevention. I noted that attendance at the meeting was smaller than it usually is, which is a shame, because the prevention issue is a thought-provoking one. If health care research looks at ways to prevent illnesses like cancer, diabetes and substance use disorders, why doesn't it also address ways to prevent mental illnesses like depression and bipolar disorder?
At the symposium, I was most interested by the speaker who discussed the results of a research project that involved interviewing more than 17,000 people across the country-the "Adverse Childhood Experiences (ACE) Study: Bridging the gap between childhood trauma and negative consequences later in life." According to the ACE Study website, the project is
"an ongoing collaboration between the Centers for Disease Control and Prevention [CDC] and Kaiser Permanente. Led by Co-Principal Investigators Robert F. Anda, MD, MS, and Vincent J. Felitti, MD, the ACE Study is perhaps the largest scientific research study of its kind, analyzing the relationship between multiple categories of childhood trauma (ACEs), and health and behavioral outcomes later in life."
The study defines an ACE as exposure to any of the following nine conditions or situations at home prior to age 18:
- Recurrent physical abuse
- Recurrent emotional abuse
- Contact sexual abuse
- Emotional or physical neglect
- One or no parents at home
- Violent treatment of the mother at home
- A household member who abuses alcohol and/or drugs
- A household member who is in prison
- A household member who is chronically depressed, mentally ill, institutionalized or suicidal
If a person was exposed to one of these ACE categories, that qualifies as one "point" in the study. So, a total ACE score of zero (0) would mean that the person reported no exposure to any of the ACEs above. And a score of nine (9) would mean the he or she was exposed to all forms of the childhood trauma listed. The data shows that the higher the ACE score, the higher the incidence of depression. It shows the same correlation between ACE scores and smoking, substance use, heart disease, weight gain and suicide.