ACE (Adverse Childhood Experiences)

These are stressful or potentially traumatic events that children experience before the age of 18 years. Exposure to ACEs has negative health, developmental and behavioural outcomes. Toxic stress affects gene expression via epigenetic modifications and is associated with long term brain changes and stress regulatory system.Childhood adversity is a common societal problem that increases the risk for mental and physical health problems in one’s life. ACES are stressful or traumatic events such as being physically, emotionally, or sexually abused, neglected, the death of a parent or parental divorce. The impact of ACES on health is due to toxic stress resulting from exposure to these adverse experiences in childhood. There is a strong co-relation between the number of ACES experienced by an individual and the chance of poor health outcomes later in life including high risk of heart diseases, diabetes, obesity, depression, substance abuse, poor academic achievement and even early death. There is a dose dependent relationship between ACES score and adult mental health outcomes, i.e. the higher the number of ACES, the poorer the long term outcomes.

Prevalence of ACEs - Singapore Mental Health study -2016

• Singapore residents aged 18 years and below were recruited as part of a nationwide cross-sectional epidemiological study
• Face-to-face interviews for adverse Childhood Experiences with international questionnaire and the Composite International Diagnostic Interview.
• Total of 6,126 participants and the lifetime prevalence of ACEs was a staggering 63.9%
• 13.1% had 3 or more ACEs
• A dose-response effect of ACES on mental illnesses
• Presence of even 1 ACE was associated with higher odds of having any one of the mental disorders
• Presence of 3 or more ACEs - MDD, bipolar, generalised anxiety disorders, obsessive- compulsive disorders, alcohol abuse and suicidality. 

Adverse Childhood Experiences

These are stressful or potentially traumatic events that children experience before the age of 18 years. Exposure to ACEs has negative health, developmental and behavioural outcomes. Toxic stress affects gene expression via epigenetic modifications and is associated with long term brain changes and stress regulatory system.

There are 3 types of ACS - Abuse, Neglect and household dysfunction

The effect of multiple ACEs on health from a systematic review and meta-analysis that was published in the Lancet Public health 2017: