- Abigail Grant, MS, Medical Family Therapy Doctoral Student, Saint Louis University School of Medicine, St. Louis, MO
The association between ACEs and physical health outcomes is well-established and evident in research and practice. However, the association between ACEs and mental health outcomes is less understood. Thus, the purpose of this presentation and systematic review is to provide an overview of the existing literature regarding ACEs and adult mental health outcomes. Additionally, the presentation will address how these negative outcomes disproportionately effect minority populations, particularly those with limited access to care. Presenters will address systemic racism as well as health and social inequities. The presenters conducted a systematic review of literature utilizing electronic databases of PubMed, PsychInfo, and Google Scholar to identify research studies that examined ACE’s and adult mental health outcomes. The selected keywords were “adverse childhood experiences” and “adult mental health outcomes”. Inclusion criteria included: 1) published between 1998 – 2020, 2) ACEs and mental health symptoms were self-report, and 3) participants were at least 18 years old. Exclusion criteria included: 1) articles published in non-English language, and 2) no new data or analyses presented. Of the 22 articles included, four themes emerged: depression and anxiety, substance use, PTSD, and general mental health. Significant associations were identified between ACEs and depressive symptoms, PTSD, and substance use. A cluster effect was identified, exhibiting an increase in negative mental health outcomes when four or more ACEs were present. A significant association between ACEs and mental health outcomes in all studies examined, suggests the importance of understanding the impact of ACEs on adult mental health. Results indicated 61% of African American children and 51% of Hispanic children experience at least one ACE compared to 40% of white children. Results identified that minority populations have less access to quality healthcare and are less likely to adhere to treatment in adulthood. Thus, the combination of experiencing more ACEs and having barriers to receiving treatment increases the risk for further comorbidities in minority populations. By collaboratively screening for ACEs and utilizing ACEs in interdisciplinary treatment teams, clinicians can treat patients from a more systemic and culturally-informed perspective.
- Identify the association between ACEs and mental and behavioral health outcomes during adulthood
- Discuss how systemic factors impact health outcomes of minority populations experiencing ACEs
- Examine how interdisciplinary treatment teams can improve quality of care for patients experiencing ACEs and physical and mental health comorbidities