Posts Tagged ‘ACEs’

CTE as a Protective Factor for Mental Health Part 2: The role of hope and positive childhood experiences to buffer the impacts of childhood trauma

Wednesday, May 8th, 2024

The protective factors for mental health inherent to Career Technical Education (CTE) may offer opportunities to improve mental health and overall outcomes for learners, solidifying CTE’s role in not only preparing learners for the workforce but also for life. In part two of this four-part blog series, Senior Communications Associate and Mental Health Educator Jodi Langellotti shares research on the power of hope and positive childhood experiences (PCEs) to buffer the negative effects of adverse childhood experiences (ACEs).

In the first blog in this series, we discussed how 80% of our most common health, social, and behavioral challenges are a direct result of trauma experienced in childhood. This trauma,  also referred to as adverse childhood experiences (ACEs), results in changes in the developing brain that can result in challenges with focus, attention, emotional regulation, executive functioning skills, and more. The original ACEs study from the mid-1990s showed that ACEs are common, they are interrelated, and that those who experience more trauma in childhood, as evidenced by a higher ACE score, are at greater risk for negative life outcomes including disease, mental health challenges, incarceration, substance use challenges, and more.

The Life Progression of Adversity

Recreated by the author based materials from the ACE Interface Master Trainer Training

When we look at the life progression of those who are affected by ACEs and the resulting disrupted brain development, traits, and behaviors, we see a significant increase in the risk of early substance use as a coping mechanism (see chart above). For example, nicotine found in cigarettes and vape products can reduce anxiety and help to increase focus and attention. For someone challenged with attention problems and/or anxiety, smoking or vaping may improve those conditions and be an attractive coping mechanism despite the known associated health risks. This increases the person’s risk for chronic smoking-related health problems later in life, like cancer, chronic obstructive pulmonary disease, and emphysema.

Even if a young person does not turn to substance use as a coping mechanism, there is still a significant risk of negative outcomes as a result of the changes in brain development as depicted in the image below. When those with ACEs have children, the risk of transmitting that adversity to their children is significantly higher when they continue to suffer from the impact of the adversities they have faced.

The Role of Hope and Support

When people feel that they have hope and support, the negative effects of adversity are significantly reduced. In the chart below, you can see that the percentage of respondents who experienced poor mental health for half of the last 30 days drops drastically when they felt they had hope and were supported, regardless of how much adversity they have experienced. This important factor, the role of hope, is often left out of ACE conversations and presentations though it is the primary reason that a person’s individual ACE score is not predictive of their individual life outcomes. Both ACEs and the role of hope and support have a dose-response relationship, the greater the dose, whether it be toxic stress or hope and support, the greater the impact. 

Recreated by the author based on materials from the ACE Interface Master Trainer Training

In 2019, new research on resilience and positive childhood experiences (PCEs) through Johns Hopkins University lead by principal researcher Dr. Christina Bethell provided statistical evidence that hope and support can buffer the negative effects of adverse childhood experiences.

The study, conducted with over 7,000 participants aged 18+, involved asking participants a variety of questions about childhood trauma, their mental health, and the health of their relationships. It is important to note, that the questions regarding trauma were not limited to the 10 ACE categories and therefore were more reflective of additional modern-day forms of trauma one may experience. 

The findings of the PCEs study identified seven positive childhood experiences or protective factors that have a lifelong beneficial, ripple effect on mental health and overall life outcomes.

These PCEs can be categorized as taking place within the home and within the community, to include the school community:

Within the home

Within the community

The PCEs study showed that positive experiences have a similar dose-response relationship as adverse experiences – the more positive experiences, the better the chance for positive mental and relationship health despite the level of adversity or trauma experienced. The PCEs study confirmed that positive childhood experiences can buffer adverse childhood experiences thereby reducing the neurological, emotional, and behavioral impact of ACEs.

Source: Pinetree Institute

The Role of Career-connected Learning on Learner Hope and Engagement

In a report released in September 2023, Gallup reported that there is a direct connection in the number of career-connected learning (CCL) opportunities experienced and a learner’s engagement and hope. This study, performed in the spring of 2023 by Gallup and New Hampshire Learning Initiative (NHLI), surveyed more than 9,600 students in fifth through 12th grades across 28 schools in 13 districts throughout New Hampshire. Significant findings include:

Looking Ahead

In the next blog in this series, we will discuss the importance of relationships in buffering the effects and intergenerational transmission of adversity and the inherent aspects of CTE that serve as protective factors for mental health.

Future blogs in this series will discuss:

Resources

Much of the information in this blog is from the author’s training as an Adverse Childhood Experiences Master Trainer through ACE Interface with Dr. Robert Anda and Laura Porter and through her volunteer work within the community mental health space.

Jodi Langellotti, senior policy associate

By Jodi Langellotti in Meeting the Needs of All Learners
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CTE as a Protective Factor for Mental Health Part 1: The role of childhood adversity on mental health and development

Wednesday, May 1st, 2024

The protective factors for mental health inherent to Career Technical Education (CTE) may offer opportunities to improve mental health and overall outcomes for learners, solidifying CTE’s role in not only preparing learners for the workforce but also for life. In part one of this four-part blog series, Senior Communications Associate and mental health educator Jodi Langellotti will outline the research around adverse childhood experiences and the resulting changes in brain growth and development that can have lifelong consequences.

The State of Youth Mental Health

In 2023 the Centers for Disease Control (CDC) released the Youth Risk Behavior Survey Data Trends 2011-2021 Report showing the ten-year trend in responses to the National Youth Risk Behavior Survey (YRBS) administered every two years to high school students across the nation on a variety of health and behavior topics including safety, alcohol, tobacco and drug use, and mental health and suicidality.

Over the course of the last ten years, the percentage of high school students who have experienced persistent feelings of sadness or hopelessness and who have either seriously considered suicide, made a suicide plan or attempted suicide has continued to increase. Suicide is the third leading cause of death for adolescents aged 15-19,1 and in 2020, emergency room visits for suicide attempts increased 31% for youth ages 12 to 17.2

 

As school districts work to reduce their student-to-counselor ratio and increase their mental health services and programming, the conversation often drifts to the new and additional things schools must do to combat the student mental health crisis. In reality, there are certain aspects of school and work-based programs and relationships, like those found within Career Technical Education (CTE), that are already having a positive impact on student mental health.3 With some increased understanding and intentionality, CTE can serve as a protective factor for students with life-long positive benefits on their mental health.

The Original ACE Study

A major risk factor for life-long mental illness and mental health challenges is trauma experienced during childhood, more commonly referred to as adverse childhood experiences (ACEs).4 A growing body of research starting with the original ACEs study in the mid-1990s now shows that 80% of our most common health, social, and behavioral problems, including mental illness and suicidality, are caused by ACEs.5

The ACEs study remains the largest study of its kind, having surveyed over 17,000 participants aged 19-94 on trauma experienced in childhood, health behaviors, disease and disease risk, mental health, substance use, and other health and social problems. ACE study participants were mostly middle-class, White individuals who were generally well-educated (the majority of participants having completed high school with some having completed at least some postsecondary coursework). Participants also had access to some of the best healthcare in the country at the time through Kaiser Permanente. 

Completed in partnership with the Department of Preventative Medicine in San Diego, Kaiser Permanente, and the CDC of Georgia with co-principal investigators Dr. Robert Anda and Dr. Vicent Felitti, the ACEs study looked at 10 categories of trauma experienced in childhood organized into three groups:

For part of the study, participants completed a questionnaire, indicating if they had experienced any of the 10 categories of adversity at least once during their childhood. For each positive answer, regardless of the frequency or duration they experienced the trauma associated with the category, they received one point for a total possible ACE score of 10. 

The Findings of the ACE Study

The findings of the original ACE study paired with subsequent research found that:

Population Attributable Risk

Since the ACE study, epidemiologists have calculated the percentage of the national population who is struggling with a variety of health and social problems directly caused by the adversities they experienced in childhood. The diagram below shows some various health and social problems represented as pie pieces in the chart. In the center, the gray oil slick shows the percentage of the population who are experiencing the given challenge as a direct result of ACEs. Epidemiologists call this the population-attributable risk.

If we look at the pie piece for recent depression in the lower right of the pie chart, we see that for 40% of the people struggling with recent depression, their depression is a direct result of the adversities they faced in their childhood.

Historical Approaches 

Historically, we often try to reduce the number of people suffering with any of the health, social, and behavioral problems represented in the pie pieces in two primary ways:

While these approaches may help reduce the percentage of the population challenged by a specific issue, without addressing the root cause, we are often just shifting the challenge that people are facing, moving the oil around the slide, versus reducing the percentage of the population who are suffering.

In order to reduce the size of the oil slick, i.e. the percentage of the population who are experiencing negative outcomes from the adversities they have faced in childhood, we must drill a hole in the center of the pie chart, where it says “ACEs”, by buffering the impact of ACEs and eventually reducing the intergenerational transmission of ACEs. If we address the root cause, then our historical approaches will be more impactful in reducing the percentage of the population who is suffering with any number of health, social, and behavioral issues because of ACEs.

Looking Ahead

In the next blog in this series, we will discuss research on positive childhood experiences (PCEs) and how they can buffer the negative impact of ACEs and reduce the intergenerational transmission of adversity. 

Future blogs in this series will discuss:

For additional information on ACEs check out Adverse Childhood Experiences: Prevention for Action, Centers for Disease Control https://www.cdc.gov/violenceprevention/pdf/ACEs-Prevention-Resource_508.pdf 

Much of the information in this blog is from the author’s training as an Adverse Childhood Experiences Master Trainer through ACE Interface with Dr. Robert Anda and Laura Porter and through her volunteer work within the community mental health space.

Jodi Langellotti, senior communications associate

By Jodi Langellotti in Meeting the Needs of All Learners
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