The Adverse Childhood Experiences (ACEs) Pyramid--Centers for Disease Control and Prevention (CDC)

Association between ACEs and Negative Outcomes--CDC and Kaiser ACEs Study

Adverse Childhood Experiences (ACEs) are stressful or traumatic events outside of the child’s control whose negative effects can be long lasting and severe. ACEs include such things as physical and emotional abuse and neglect, sexual abuse, violence, substance misuse or mental illness in the household, parental separation, and death or incarceration of a household member. But ACEs also include more subtle and prevalent adverse experiences including economic hardship and discrimination.

In terms of ACEs and mental health, the public health impact of childhood adversity is evident in the very strong association between childhood adversity and depressive symptoms, antisocial behavior, and drug use during the early transition to adulthood. These findings, coupled with evidence that the impact of major childhood adversities persists well into adulthood, indicate the critical need for prevention and intervention strategies targeting early adverse experiences and their mental health consequences.

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MAMH Perspective

Central to MAMH’s mission is promoting prevention and early intervention to address mental health challenges. Preventing adverse childhood experiences is fundamental to prevention efforts and an opportunity to intervene at the earliest opportunity to mitigate increased risk of mental health conditions over one’s lifetime. MAMH recommends that Massachusetts policy makers coalesce around building a comprehensive plan to screen children and families for ACE risk, implement early childhood mental health and family strengthening programs, and further develop evidence-based interventions to reduce ACEs and their impact.


of study participants reported physical abuse


of study participants reported sexual abuse


of study participants reported two or more ACEs


of study participants reported four or more ACEs