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Impact of Sexual Assault & Adverse Childhood Experiences

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Trigger Warning: �

The content of this session will contain information and stories related to sexual assault and trauma.

If this content is triggering to you, please do what is necessary to receive the care you need.

If you need to step out of the room or walk around in the back of the room do not hesitate.

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Did you pick up a packet?

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What are ACE’s

ACEs occur between Ages 0-17

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What is the ACE QUIZ?

A Screening Tool that helps identify risk factors
Ten Direct Questions about 3 major areas:

Abuse, Neglect, and Household Dysfunction

Identifies occurrences before age of 18 years of age
Not copyrighted and is FREE to use

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History

How and why was the

ACE quiz developed?

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THE MYSTERY

Dr. Vincent Felitti, Chief of Kaiser Permanente’s Department of Preventative Medicine oversaw obesity research in the 1980s.

“Why have more than half of the participants in my obesity study dropped out every year for the last 5 years?”

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The Accidental Discovery

Kaiser Group which is an American integrated managed care consortium, based in Oakland, California and founded in 1945 by industrialist

Henry J. Kaiser and physician

Sidney Garfield.

Dr. Felitti sat with a patient and mistakenly asked “How much did you weigh when you were first sexually active?”

rather than

“How old were you when you became sexually active?”

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THE ANSWER

“40 pounds”

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THE NAYSAYERS

An 1990 Felitti gave a speech to the members of the North American Association for the Study of Obesity.

An expert in attendance:

“He told me I was naïve to believe my patients, that it was commonly understood by those more familiar with such matters that these patient statements were fabrications to provide a cover explanation for failed lives!”

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THE ENCOURAGER

Dr. David Williamson, an epidemiologist from the U.S. Centers for Disease Control and Prevention

“people could always find fault with a study of a couple of hundred people… but not if there were thousands, and from a general population, not a subset like an obesity program.”

“I turned to him and said, ‘That’s not a problem.’ ”

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THE FEEDBACK

1990 Dr. Felitti presented at the North American Association for the Study of Obesity

met with negativity and criticism
encouraged to do a larger study with the general population

Introduced to Dr. Roberts Anda, medical epidemiologist

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THE POPULATION AND SAMPLE

Kaiser Permanente in San Diego was a perfect place to do a mega-study.
More than 50,000 members came through
Felitti and Anda asked 26,000 of them
Of those, 17,421 agreed

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THE PARTNER

Williamson invited Felitti to meet with a small group of researchers at the Centers for Disease Control including Dr. Robert Anda, a medical epidemiologist.

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THE OPPORTUNITY

Kaiser Permanente in San Diego was a perfect place to do a mega-study.

More than 50,000 members came through the department each year, for a comprehensive medical evaluation and every one of them filled out a detailed biopsychosocial questionnaire prior to undergoing a complete physical examination and extensive laboratory tests.

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THE OPPORTUNITY cont.

Kaiser Group which is an American integrated managed care consortium, based in Oakland, California and founded in 1945 by industrialist

Henry J. Kaiser and physician

Sidney Garfield.

Felitti and Anda asked 26,000 people who came through the department “if they would be interested in helping us understand how childhood events might affect adult health,” says Felitti.

Of those, 17,421 agreed

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THE STUDY

Kaiser Group which is an American integrated managed care consortium, based in Oakland, California and founded in 1945 by industrialist

Henry J. Kaiser and physician

Sidney Garfield.

Focused on the eight major types:

3 types of abuse
5 types of family dysfunction
He later added emotional and physical neglect, for a total of 10 types of adverse childhood experiences, or ACEs.

Two Wave Study between 1995-1997; then, participants were followed for another 15 years

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THE DISCOVERIES

When the first results of the survey came in, Anda was stunned. “I wept,” he says. “I saw how much

people had suffered and I wept.”

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THE DISCOVERIES

1) A direct link between childhood trauma and adult onset of chronic disease, as well as mental illness, doing time in prison, and work issues, such as absenteeism.

2) ACEs usually didn’t happen in isolation.

3) More adverse childhood experiences resulted in a higher risk of medical, mental and social problems as an adult.

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THE DISCOVERIES

1) A direct link between childhood

trauma and adult onset of chronic disease,

as well as mental illness, doing time in prison, and work issues, such as absenteeism

2) ACEs usually didn’t happen in isolation

3) More adverse childhood experiences resulted in a higher risk of medical, mental and social problems as an adult.

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THE IMPACT

Anda and Felitti developed a scoring system for ACEs

Changed the perspective and focus of healthcare and human services

Established a foundation for continued learning, prevention, and treatment

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What is your ACE score?

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While you were growing up, during your first 18 years of life:� � 1. Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?

� 2. Did a parent or other adult in the household often or very often push, grab, slap, or throw something at you?or Ever hit you so hard that you had marks or were injured? � 3. Did an adult or person at least 5 years older than you ever touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you? �4. Did you often or very often feel that no one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?

5. Did you often or very often feel that you didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it? �

Finding Your ACE Score

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� 6. Were your parents ever separated or divorced?

� 7. Was your mother or stepmother: Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit at least a few minutes or threatened with a gun or knife? � �8.Did you live with anyone who was a problem drinker or alcoholic or who used street drugs? ��9.Was a household member depressed or mentally ill, or did a household member attempt suicide?

�10. Did a household member go to prison?

�Now add up your “Yes” answers: This is your ACE Score.��Adapted from: http://www.acestudy.org/files/ACE_Score_Calculator.pdf,

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�� Self –Reflection��What did you learn about yourself (if anything)? ��Did you have a reaction to a particular question? ��Was this difficult or easy? Why? �

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�� What thoughts and feelings did you have about ACEs before taking the quiz?��What reaction did you have during and/or after taking the quiz?��Was it easy or difficult to take?

�How would you use this quiz? ��Do you see any benefits or challenges?

Group Discussion

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60%+ participants report 1 or more ACEs

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Children who experience Childhood Sexual Abuse are 3.17 times more likely to be a victim of Sexual Assualt
Sexual Abuse is the largest risk factor of the 10 ACEs
CSA occurring before 14 increase revictimization rates by more than double in adulthood

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...to bestow on them a crown of beauty instead of ashes, the oil of joy instead of mourning,

and a garment of praise instead of a spirit of despair...

Isaiah 61:3

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The Biology of Toxic Stress

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Young girls are 4x more likely to experience sexual assault in their lifetime (RAINN)
Girl with ACE score 4-7 increase risk of having sex by age 15
Perceived risk of AIDS
Involvement in sex trafficking
and multiple partners (30+ partners)

Sexual Assault and High Risk Behaviors

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Attachment

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Romans 12:4-5

For just as each of us has one body with many members, and these members do not all have the same function, so in Christ we, though many, form one body, and each member belongs to all the others.