Adverse Childhood Experiences (ACEs)

What Are Adverse Childhood Experiences?

Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur before age 18. The term comes from the landmark CDC-Kaiser ACE Study, which identified strong links between childhood adversity and adult health problems, mental illness, and social difficulties.

The original ACE Study measured ten categories of childhood trauma, but the concept has expanded to include additional adversities that affect development and long-term wellbeing.

The Original Ten ACEs

Abuse:

1. Physical abuse
2. Emotional abuse
3. Sexual abuse

Neglect: 4. Physical neglect 5. Emotional neglect

Household Dysfunction: 6. Mental illness in household 7. Mother treated violently 8. Divorce or parental separation 9. Substance abuse in household 10. Incarcerated household member

Each ACE experienced counts as one point. Research shows that higher ACE scores correlate with worse health outcomes.

Growing Up with a Narcissistic Parent and ACEs

Children of narcissistic parents typically experience multiple ACEs:

Emotional abuse: Criticism, humiliation, threats, rejection.

Emotional neglect: Needs ignored, feelings invalidated, lack of nurturing.

Mental illness in household: NPD is a personality disorder; living with untreated pathology affects children.

Domestic violence: Narcissistic abuse may include witnessed or experienced violence.

Divorce: High rates of divorce in narcissistic marriages.

Substance abuse: Elevated rates of substance use among narcissists.

Children of narcissists often have ACE scores of 3-6+, putting them in high-risk categories.

How ACEs Affect Development

ACEs impact development through:

Toxic stress: Chronic stress activation changes brain architecture.

Attachment disruption: Insecure attachment affects all future relationships.

Developmental derailment: Resources that should go to development go to survival.

Learned patterns: Maladaptive coping strategies are developed.

Neurobiological changes: Brain structure and function are altered.

Epigenetic effects: Gene expression may be affected by early adversity.

Long-Term Effects of ACEs

Mental health:

• Depression (4.6x risk with 4+ ACEs)
• Suicide attempts (12x risk with 4+ ACEs)
• Anxiety disorders
• PTSD and Complex PTSD
• Personality disorders
• Substance use disorders

Physical health:

• Heart disease
• Cancer
• Autoimmune diseases
• Chronic obstructive pulmonary disease
• Liver disease
• Obesity
• Earlier death

Social outcomes:

• Lower educational achievement
• Employment difficulties
• Relationship problems
• Higher likelihood of experiencing abuse in adulthood
• Financial instability

The ACE Score as a Tool

What your ACE score tells you:

• You experienced childhood adversity
• You may be at elevated risk for certain outcomes
• Your struggles have developmental roots

What your ACE score doesn’t tell you:

• Your destiny (many high-ACE individuals thrive)
• The severity or chronicity of your experiences
• Protective factors you may have had
• Your personal resilience

Protective and Compensatory Experiences (PACEs)

Researchers have identified factors that buffer ACE effects:

Relationships:

• One stable, caring adult (not necessarily a parent)
• Feeling of belonging at school
• Supportive friends

Resources:

• Access to basic needs
• Opportunity for education
• Safe neighbourhood

Internal factors:

• Ability to identify and manage emotions
• Sense of meaning or purpose
• Belief in ability to handle challenges

Developing these factors in adulthood can still improve outcomes.

ACEs and Narcissistic Abuse in Adulthood

High-ACE individuals may be more vulnerable to adult narcissistic abuse:

• Insecure attachment patterns make trauma bonding easier
• Normalised dysfunction makes red flags harder to see
• People-pleasing developed in childhood serves the narcissist
• Low self-worth from childhood abuse is exploited
• Familiar dynamics feel “comfortable” even when harmful

Understanding this connection helps survivors avoid self-blame for their relationship patterns.

Healing from ACEs

It’s not too late: Neuroplasticity means the brain can change throughout life.

Therapy helps: Trauma-informed therapy addresses developmental wounds.

Relationships heal: Safe relationships provide corrective experiences.

Knowledge is power: Understanding ACE effects helps depersonalise struggles.

Body-based work: Somatic approaches address trauma stored in the body.

Self-compassion: ACE-related struggles aren’t character flaws—they’re predictable outcomes of predictable circumstances.

Research & Statistics

• 61% of adults report at least one ACE, and 16% report four or more (CDC-Kaiser ACE Study, Felitti & Anda)
• Individuals with 4+ ACEs have a 12-fold increase in suicide attempts compared to those with zero ACEs
• ACE scores of 4+ correlate with 4.6 times higher risk of depression and 2.4 times higher risk of smoking (Felitti et al., 1998)
• Children with high ACE scores are 32 times more likely to have learning and behavioural problems in school
• 80% of individuals with substance use disorders report childhood trauma (SAMHSA)
• High ACE scores are associated with 20 years shorter life expectancy due to cumulative health impacts (Brown et al.)
• Only 4% of the population has an ACE score of 0, while roughly 12.5% have scores of 4 or higher

For Survivors

Understanding ACEs helps survivors:

• Recognise their childhood experiences as trauma
• Understand why they struggle with certain things
• See the connection between past and present patterns
• Release self-blame for developmental impacts
• Focus healing efforts appropriately
• Interrupt intergenerational transmission of trauma

Your ACE score explains patterns—it doesn’t determine your future. Many high-ACE individuals live fulfilling lives with intentional healing work.