1 - (SYM 106) Examining Adverse Childhood Experiences and Adult Health in a Family Practice Setting

Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur during childhood but can have long-term negative consequences in adulthood. Recent studies suggest that ACEs contribute to the later development of mental illness in adulthood. Resiliency refers to the ability of an individual to cope with adversity and trauma and adapt to challenges or change. Resiliency may be an important protective factor that can have implications for primary care services provided to adults with a history of adversity in childhood.

The purpose of the current study was to examine the relationship between Adverse Childhood Experiences (ACEs), adult health, and resiliency in a family practice setting. A total of 182 adults receiving care in a family practice setting completed a set of questionnaires consisting of the ACEs, Connor-Davidson Resiliency Scale, Primary Care PTSD Screen, the Center for Epidemiologic Studies Depression Scale-Revised-10, and Generalized Anxiety Disorder-7. Relationships between ACEs, adult health and resilience were analyzed using bivariate statistics. Regression analyses were used to assess the protective effect of resiliency. Statistical significance was set at p< .05 using SAS software, Version 9.4.

ACEs scores were categorized into two groups: no ACEs (n=51) and at least one ACE (n=130). Nearly 72% of patients reported at least one ACE while almost 25% reported 4 or more ACEs. Significant differences were found between the two groups for anxiety (p< 0.001), depression (p< .001) and PTSD (p< 0.001). Linear regression analyses indicated that resilience was significant in predicting anxiety (p< .001), and depression (p< .001), and logistic regression analyses revealed PTSD was also significant (p < .001). There was a linear association between ACEs with chronic pain (p< .001) and hypertension (p=.03) only.

Our findings support Trauma-Informed Care implementation including provider education on ACEs screening, risk identification, and building patient resiliency in a family practice setting.