Introduction
Childhood is a critical period in human development in which adverse childhood experiences and positive childhood experiences have significant impacts on mental and physical health in adolescence and adulthood. Adverse childhood experiences (ACEs) are events caused by perceived intentional physical and emotional threats that victimize children and have the potential to cause trauma, and they include instances of abuse, neglect, parental conflict, and exposure to substance abuse (Karatekin and Hill). Alternatively, positive childhood experiences (PCEs) can be described as early experiences that are beneficial, such as having a positive relationship with trusted adults, living in a good neighborhood, and having a strong social support system (Daines, et al.). The accumulation of ACEs, depending on the scenario and severity, can increase risk and cause negative long-term effects on mental and physical health during adolescence and adulthood, while PCEs are associated with positive effects on mental and physical health during adolescence and adulthood (Daines, et al.). This essay will closely examine the consequences of ACEs and PCEs while contextualizing the stories of Jane Zietlow, Jane “Sabra” Hammond, and Chastity Hargrove with the effect of ACEs and PCEs.
The Effects of ACEs
Exposure to multiple ACEs has been shown to have a strong association with a variety of negative mental and physical health issues in the individual’s future. Those with high ACE scores have been shown to struggle with a variety of issues, such as anxiety and depression (Daines, et al.). This onset of mental health issues affects how individuals process and express their emotions, respond to stressful factors in their environment, and form new relationships which can often lead to instances of social isolation and suicidal ideation (Daines, et al.). Many of these issues are caused by the effect of ACEs on brain chemistry; a 2005 study found that mental health issues caused by ACEs begin with changes to the neurobiology of children (Anda, et al.). For example, women who were sexually abused as children experienced reductions in amygdala and hippocampus volume and suffered decreases in their verbal declarative memory (Anda, et al.). This alteration of brain chemistry is significant as victims of ACEs begin to think, act, and communicate differently, leading to measurable negative effects on adolescent and adult health outcomes. The effects of ACEs on mental health are prevalent in the story of Jane Zietlow.
Zietlow was born in California and experienced several hardships in her early childhood. Her mother had an affair and left her family before becoming paralyzed from the waist down and overdosing on sleeping pills, and as a result, her father became an alcoholic and committed suicide. Although Zietlow was later adopted by a family from Pennsylvania, Zietlow says,
“those scars go deep and the abandonment and those things last a long time, forever” (00:10:55 – 00:11:00).
Her mental health continued to be affected by the ACEs she experienced in her childhood, and her mental health state can be attributed to the long-standing, deep ‘scars’ her parents and biological family caused.
Moreover, ACEs are also linked to several physical health issues, including an elevated risk of developing chronic diseases such as heart disease, diabetes, asthma, metabolic regulation abnormalities, hyperlipidemia, and hypertension (Anda, et al.). This may be attributed to a concept known as “toxic stress”. Toxic stress is defined as the “extreme, frequent, or extended activation of the stress response” (Hornor 192-193), and because of the severity of this response, it may induce physiological dysfunction across several biological systems during childhood and continue into adolescence and adulthood. For instance, once stress reaches a level of “toxicity” it continuously activates the hypothalamic-pituitary-adrenal axis, resulting in the deterioration of brain structures and modifications to their functions (Hornor).
The Effects of PCEs
In contrast to the detrimental effects of ACEs, positive childhood experiences have been shown to promote mental and physical health during adolescence and beyond. Let’s consider the story of Sabra Hammond, for example.
Hammond was born in 1956 in Long Island, NY. Growing up, Hammond had a great childhood. She had a strong relationship with her parents and friends, she described her hometown as “heaven” and a “great big world” (00:07:40), and her health was seen as a priority from a young age. When describing one of her pivotal childhood experiences, she says,
“I can remember when I was a little girl, maybe five or six years old, and my then future cousin-in-law, at a Passover Seder, showed me that his hands were all red, and he said, “See those? That’s dilation. Alcohol dilates your blood vessels,” because he was a medical student at the time or he was a pre-med student at the time. And the next year I came up to him and I said, “Show me that your blood vessels are dilated in your hands” (00:03:05 – 00:03:42).
Her curiosity and fascination caused her cousin-in-law to say,
“You don’t know it yet, but you’re going to be a doctor”, to which she “actually took that to heart and thought that was always true” (00:03:43 – 00:03:50).
Evidently, Hammond’s childhood featured many PCEs because of her strong social support system and connections. Her experience with her cousin-in-law stemmed directly from the positive environment she was fortunate enough to live in, inspiring her to pursue medicine. As a result of this accumulation of PCEs and her family’s stability and emphasis on promoting positive well-being, Hammond took several paths and had the opportunity to explore her interests before becoming a physician and prioritizing her and her family’s health and well-being.
Children like Hammond with better social support systems and more stability from an early age also have a decreased risk of negative mental health issues, reduced chronic health issues, higher self-confidence, and a greater foundation for forming meaningful emotional connections throughout adolescence and adulthood (Daines, et al.).
The Mitigation of ACEs by PCEs
While ACEs and PCEs each have their effects on health outcomes during adolescence and adulthood, research suggests that PCEs can offset the effects of ACEs, inducing resilience in the child (Daines, et al.). Resiliency Theory suggests that PCEs have the potential to counteract the negative effects of ACE and result in an overall positive outcome, protecting the child from poor health outcomes in the future (Crandall, et al.). The story of Chastity Hargrove exemplifies this dynamic.
Hargrove was primarily raised in Newton Grove, North Carolina. When discussing her early childhood, Hargrove says,
“My parents got married and they both had lots of issues. I’m not going to cry, but I was raised by my grandparents for the majority of my life. When I was about three, I went to live with them. Before that, I lived with my mom and dad, but my dad was a drug addict, dealer, mama was a drug addict. So, [life] could have been a lot different for me, but I went to live with my grandparents when I was three, and life with them was wonderful” (01:15 – 01:47).
After being faced with several ACEs, Hargrove’s life significantly improved under the care of her grandparents; she was able to participate in open discussions, form a growth mindset, pursue pharmacy, and learned to understand the position her parents were in. Since her childhood, Hargrove developed a health-oriented mindset she stresses with her family, where she tries to eat better, exercise, and develop positive mental and physical health habits. The positive factors in Hargrove’s life, after she moved in with her grandparents, represent the offset of ACEs by PCEs and Resiliency Theory, as she was able to overcome the initial hardships she faced through the development of a strong social support system among other PCEs.
Conclusion
Adverse childhood experiences and positive childhood experiences are central to each individual’s childhood, and each has the potential to impact future health outcomes either negatively or positively. Resiliency Theory supports the notion that PCEs can counter ACEs and provide a positive foundation for children as they enter adolescence and adulthood, and the stories of Jane Zietlow, Jane “Sabra” Hammond, and Chastity Hargrove provide evidence of the aforementioned ideas.
References
Anda, R. F., et al. “The Enduring Effects of Abuse and Related Adverse Experiences in Childhood.” European Archives of Psychiatry and Clinical Neuroscience, vol. 256, no. 3, 2005, pp. 174–186., https://doi.org/10.1007/s00406-005-0624-4.
Crandall, AliceAnn, et al. “Aces and Counter-Aces: How Positive and Negative Childhood Experiences Influence Adult Health.” Child Abuse & Neglect, vol. 96, 2019, https://doi.org/10.1016/j.chiabu.2019.104089.
Daines, Chantel L., et al. “Effects of Positive and Negative Childhood Experiences on Adult Family Health.” BMC Public Health, vol. 21, no. 1, 2021, https://doi.org/10.1186/s12889-021-10732-w.
Hammond, Jane “Sabra”. Interview with Maddy Kameny. 27 June 2018 (Y-0028). Southern Oral History Program Collection (#4007), Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill.
Hargrove, Chastity. Interview with Shelby Smith. 15 July 2019 (Y-0101). Southern Oral History Program Collection (#4007), Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill.
Hornor, Gail. “Childhood Trauma Exposure and Toxic Stress: What the PNP Needs to Know.” Journal of Pediatric Health Care, vol. 29, no. 2, 2015, pp. 191–198., https://doi.org/10.1016/j.pedhc.2014.09.006.
Karatekin, Canan, and Maria Hill. “Expanding the Original Definition of Adverse Childhood Experiences (Aces).” Journal of Child & Adolescent Trauma, vol. 12, no. 3, 2018, pp. 289–306., https://doi.org/10.1007/s40653-018-0237-5.
Zietlow, Jane. Interview with Emma Miller. 20 May 2019 (Y-0080). Southern Oral History Program Collection (#4007), Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill.