Psychological trauma and adversity including ACES (adverse childhood experiences)

Adverse Childhood Experiences (ACEs) research

The most common adverse childhood experiences (ACEs) measured in surveys undertaken across different countries are:

• physical abuse
• sexual abuse
• emotional abuse
• emotional neglect
• physical neglect
• exposure to domestic violence
• living with an adult experiencing mental illness
• living with an adult experiencing harmful drug and alcohol use
• parental separation or divorce
• having a household member in prison

In addition to these, the Scottish Government recognises that there are a wide range of other experiences that can impact our mental and physical health and wellbeing. For example, bereavement, bullying, coercive control, homelessness and community violence, as well as social inequalities that can influence levels of psychological trauma and adversity, including poverty and gender inequality. This is why we take a broad approach to preventing psychological trauma and adversity.

Scottish research

The 2019 Scottish Health Survey was the first time ACEs questions were included in a population-level study in Scotland. The results were published in September 2020, with a Scottish Health Survey full report and summary of the findings.

This survey provided data about the proportion of adults who report experiencing adversity in their childhood and how this relates to their current health. It found that substantial proportions of the Scottish adult population suffered some form of abuse, neglect or other adverse experience during their childhood, with 71% reporting having experienced at least one ACE and 15% experiencing four or more ACEs.

As with other ACEs surveys, the results highlight the health risks in adulthood for those of us who experienced adversity in our childhood. Adults who had experienced four or more ACEs were found to be more likely than those who experienced no ACEs to:

• be obese (39% compared to 29%)
• smoke (27% compared to 10%)
• have a limiting long-term condition (52% compared to 26%)
• have cardiovascular disease (21% compared to 14%)
• have lower mental wellbeing (average WEMWBS wellbeing score of 46.0 compared to 52.0)
• not meet the physical activity guidelines (41% compared to 32%)

The Growing Up in Scotland (GUS) study tracks the lives of representative samples of children and their families from birth, and collects information on some of the commonly measured ACEs, including parental separation and parental imprisonment.

GUS also collects information on other types of childhood adversity such as bereavement of a close family member, bullying and homelessness. Additionally, the study collects information on social inequalities, enabling the impacts of poverty to be examined. You can find out more information about how the GUS study is used on the GUS website.

Research relating to childhood adversity helps to inform the development and delivery of policy. For example, we published a summary of the links between adversity in childhood and victimisation and criminality in adulthood. This paper also includes a helpful section on resilience, identifying buffers or ‘protective factors’ that can mitigate the effects of psychological trauma and adversity. The single most common factor is having ‘at least one stable and committed relationship with a supportive parent, care giver or other adult’.

Research from the rest of the UK

A 2015 survey of adults in Wales found that people who have experienced four or more ACEs are more likely than people who had experienced fewer ACEs to:

• be a high-risk drinker or drug user
• have poorer mental health
• have heart disease, respiratory disease and type-2 diabetes
• have committed violence
• have been the victim of violence