User:ShaferR/Adverse childhood experiences

Parental Stress and ACE’s

.“Parenting Stress”, is a term used to measure the stress which results from the unique characteristics of a child, such as a child who is rigid, reactive, and not easily adaptable, and can influence an individual’s parenting style and behavior towards their children. When chronic and unmanaged, this type of stress, can result in a negative perception of parenting responsibilities and can be a predictor of risk for child abuse, neglect, and a higher likelihood of exposure to more than one ACE. Several factors have been positively correlated with higher levels of parenting stress and ACEs, such as families with children who have health care needs (i.e., physical disabilities, developmental delay, and other mental disabilities). Single parents without an active co-parent assisting with responsibilities have also been associated with elevated levels of parent stress. Socioeconomic status plays a role as well in the chances that parenting stress rises to a level at risk for ACEs. Additional obstacles such as finding consistent and reliable transportation, the stress of bills, and living in high crime neighborhoods increases the cognitive load of parents and can drain their emotional reserves. In homes where high parenting stress is reported, children are likely to experience at least 4 ACEs by the time they become and adult. Researchers have found that in these households, ACE exposure is most commonly due to economic hardship, parental separation or divorce, parental mental illness, and household substance abuse. Research has supported the idea that education level of the parents can act as a mediator to the ACEs and plays a vital role in mitigating the chances a child will experience an ACE related to the economic hardship.

Parent’s Childhood History and ACE’s

Parent’s childhood history is another factor contributing to the chances a child experiences multiple ACEs. Parents and caregivers who were exposed to ACE’s themselves are more likely to have a lower threshold for “Parenting Stress” and are at a higher likelihood of subjecting their own children to ACE’s. Evidence has shown secondary connections between how internal and external problems manifest in children, and the experience of maternal ACE’s. This association between a parent’s own history and their developing relationship with their child can begin soon after birth. Individuals who may have never processed their own ACEs may feel disturbed by thoughts and memories of the abuse, neglect, or general dysfunction of their childhood. The converse has also been found to be true, and parents who can reference positive childhood experiences are more likely focus on these memories and recreate these experiences with their own children. Positive childhood experiences can act as a buffer to the influence of early life ACEs, so children of parents who have a history of both have been found less likely to be exposed to multiple ACEs.

Mental Health, Parenting, and ACE’s

The accumulation of childhood trauma has been well-supported by research as a possible antecedent to developing symptoms of PTSD. Exposure to ACEs can lead to an over sensitivity to stress, maladaptive reactivity, and coping, as well as gaps in how an individual is able to process social information and regulate their emotions. When adults with PTSD become parents, ACEs become more likely because the symptoms of the parent can act as a mediator, perpetuating ACEs across multiple generations. In addition to the symptoms of PTSD, the presence of other mental illness such as depression, anxiety, and substance abuse act as a significant mediator between a parents own experience with ACEs and their children’s exposure. The type of ACE experienced by the parent can also play a role in how likely a child is to experience an ACE. ACEs related to maltreatment have been found to be a strong indicator of PTSD symptoms during early parenthood. Gender differences have been found as well, with mothers who have untreated PTSD symptoms from ACEs having lower maternal-infant bonding rates. This may be partly because the physiological symptoms of PTSD skew the mother’s ability to identify their child’s distress signals, resulting in a perception by the child that they won’t be protected in the context of a threat. For children of mothers with a history of PTSD symptoms caused by ACEs, the early childhood period is a particularly high risk when compared to mothers who have depression but no PTSD symptoms. One compounding factor is that the symptoms of PTSD experienced by the mother (i.e., negative mood, fearfulness, and avoidance) can also be an obstacle to access support resources to help manage the symptoms. This interference in turn can intensify the mothers parent stress and reinforce social isolation, thus increasing their children’s risk for experiencing multiple ACEs Once a child has experienced an ACE, the parents who are struggling with their own symptoms of PTSD are less likely to seek out and make use of resources to mitigate the harm caused to their child who experienced the ACE. How variable ACE transmission is across generations depends on a complex combination of external experiences with the environment and internal interpretation for those experiences. Parents who have had more positive experiences in childhood and who have a higher ability to hold on to these memories have been shown to be more equipped to use these as resources to protect their children against experiencing ACEs.

Screening and Intervention

Since it has been indicated that there is some connection between a parents own ACEs and the likelihood their children will experience ACEs, screening for ACEs in soon-to-be parents is a worthwhile strategy, allowing clinicians to gather potentially useful information while also creating some space to educate the parents on how their early life experiences may be impacting their current functioning level. The prevention of ACE transmission across generations requires focused attention to the screening of both adverse and positive childhood experiences of parents, and how those experiences have had both consequences and benefits. One effort to standardize this kind of assessment was made by the American Academy of Pediatrics in 2014, who recommended that practitioners regularly assess for ACEs in children and parents. The AAP also established protocol to include this type of screening in routine medical practice. When screening parents to ACE in their own children, one factor to consider is how the parent’s trauma may influence their dependability as an informer of their children’s experience with ACEs. While currently parents are generally seen as the main reporters for their children during healthcare screenings, the level of trauma needs to be considered when evaluating the reliability of the parent report.

It is important to target interventions specific to parents PTSD symptoms in order to prevent ACEs in their children, however there are also several evidence based psychotherapeutic treatments that, such as Child-Parent Psychotherapy (CPP), Mom Power, and Child FIRST. We also know that the impact of parental ACEs and PTSD is not limited to postpartum, as they can have a prenatal impact on the unborn child and laboring mother. Normal experiences of pregnancy such as abdominal growth, pain, and crying newborns can act as reminders to the mother of their trauma and impact the important bonding that occurs within the first few weeks of life. Therefore, intervention strategies that begin prenatally that target ACEs, stress, and parenting skills have been shown to provide a layer of protective factors even before birth .There are several evidence-based strategies for this type of prenatal intervention such as Legacy for Children, Perinatal CPP, Minding the Baby, and the Survivor Moms’ Companion.