Adverse Childhood Experiences (ACEs) and Trauma

ACEs research

Surveys of ACEs, undertaken across different countries, have commonly included the following adversities:

• being the victim of abuse (physical, sexual and/or emotional)
• neglect (physical and/or emotional)
• having a parent with a mental health condition
• having a member of the household in prison
• growing up in a household in which there are adults experiencing harmful alcohol and drug use
• having separated parents

In addition to these adverse experiences which are commonly measured in ACEs surveys, the Scottish Government recognises that there are a wide range of additional adverse experiences that can also negatively impact on children's healthy development – for example, bereavement, bullying, coercive control, homelessness and community violence. This is why we are taking a broad approach to addressing the wide range of adversities which can impact on children’s healthy development. This includes the related socio-economic factors that impact on levels of adversity experienced, including poverty and gender inequality.

Research relating to childhood adversity helps to inform the development and delivery of policy. For example, we published a summary of the links between childhood adversity and victimisation and criminality in adulthood. The 2019 Scottish Health Survey was the first time ACEs questions were included in a population-level study in Scotland. The results were published in September 2020, with a full report and summary of the findings.

This survey provided data about the proportion of adults who report experiencing adversity in their childhood and how this relates to their current health. It found that substantial proportions of the Scottish adult population suffered some form of abuse, neglect or other adverse experiences during their childhood, with 71% reporting having experienced at least one ACE and 15% experiencing four or more ACEs. 

As with other ACEs surveys, the results highlight the health risks in adulthood for people who experienced adversity in their childhood. The adults who had experienced four or more ACEs were statistically found to be more likely than those with no ACEs to:

• be obese (39% compared to 29%)
• smoke (27% compared to 10%)
• have a limiting long-term condition (52% compared to 26%)
• have cardiovascular disease (21% compared to 14%)
• have lower mental wellbeing (average WEMWBS wellbeing score of 46.0 compared to 52.0)
• not meet the physical activity guidelines (41% compared to 32%).

A survey of adults in Wales found that, compared to people with no or fewer ACEs, those who have experienced four or more ACEs are more likely to:

• be a high-risk drinker or drug user
• have poorer mental health
• have heart disease, respiratory disease and type 2 diabetes
• have committed violence
• have been the victim of violence

The Growing Up in Scotland (GUS) study tracks the lives of representative samples of children and their families from birth, and collects information on some of the commonly measured ACEs, including parental separation, mental disorder and parental imprisonment.

GUS also collects information on other types of childhood adversity such as bereavement of a close family member, bullying and homelessness. It also collects information on socio-economic position, enabling the impacts of poverty to be examined. You can find out more information about how the GUS study is used on the GUS website.