Linking Adverse Childhood Experiences

Abstract 

I am interested in studying the ways in which adverse childhood experiences (ACEs) effect adult intimate relationships in women. My research will focus primarily on the victim of ACEs and not the perpetrators. To better understand this research question, I must provide a clear definition of trauma. I will be using ACES (adverse childhood experiences) to describe traumatic experiences.
An ACE in exposure to any of the following prior to the age of eighteen. Namely, recurrent physical abuse; recurrent emotional abuse; sexual abuse; physical neglect; emotional neglect; alcoholic or drug abuser present; an incarcerated family member; a chronically depressed individual in the household; an individual who is institutionalized or suicidal; violence between adults at home; parental separation or divorce.

I propose to study the impact of these adverse childhood experiences. More specifically, regarding intimacy and relationships for the abused as they progress as adults. My study will rely on preexisting research as well as self-report surveys where individuals reveal the presence of a childhood experience that would be regarded as traumatic by the ACEs standard.

My research will be conducted in a qualitative participatory social justice format. I will validate my findings by insuring that all my articles are peer reviewed and abide by ethical standards. This research presents a necessity for heightened sensitivity considering this is a very touchy subject and sometimes emotional for an individual to disclose. Certain issues regarding ethical standards must be addressed. I will commit to disclosing the purpose of the study to all participants, and I will not pressure participants into signing consent forms. I will be sure to avoid deceiving or exploiting participants and avoid collecting harmful information.

There is substantial research that exist which analyzes the effects of ACEs, however, my research will investigate how these traumatic experiences impact adult sexual behavior specifically. I will simultaneously examine intimate relationships overall. I am seeking to determine whether there is correlation between ACEs and asexuality in adults. I am also seeking to determine if childhood trauma can cause nymphomania. I will begin by defining my terms.

Adverse childhood experiences is defined by Service Abuse and Mental Health Service Administration (SAMHSA) as being stressful or traumatic events, including abuse and neglect. They may also include household dysfunction such as witnessing domestic violence or growing up with family members who have substance use disorders. ACEs are strongly related to the development and prevalence of a wide range of health problems throughout a person's lifespan, including those associated with substance misuse. ACEs include: Physical abuse; Sexual abuse; Emotional abuse; Physical neglect; Emotional neglect; Intimate partner violence; Mother treated violently; Substance misuse within household; Household mental illness; Parental separation or divorce; Incarcerated household member (Samhsa 2018).

Intimacy is defined as being associated in close personal relations, showing a close union or very private and closely personal. A relationship is defined as being a connection, association or involvement. For my research I am defining an intimate relationship as being one that is a closely personal involvement between two individuals.

Asexuality is defined as being independent of sexual processes, especially not involving the union of male and female germ cells and free from sexual desires or sexuality. Scherrer (2008) examined asexual identity, which works across two axes. The first axis of asexuality concerns sexual desire: at one end is its non-presence, such as in those who simply define as asexual' or even sex-repulsed'. At the other end are groups such as those identifying as grey-a', who exist in the grey area' between asexuality and other sexual identities, as well as demisexuals, who feel sexual desire under certain circumstances, such as when a relationship develops. The second axis concerns romantic attraction. I intend to uncover a link between this sexuality type and ACEs.

It is important to note that through my research I have discovered that proponents of asexuality vehemently deny a link between their current sexuality and the presence of ACEs. I do however intend to look more closely to determine if these links do in fact exist despite adamant denial from certain asexual individuals. I want to inquire about the passionate response to deny this assertion.

Nymphomania is defined as being an abnormally excessive and uncontrollable sexual desire in women. In the 19th century nymphomania was recognized as a disease with organic symptoms and causes according the article referenced by Gronnen, 1994. This article does not list these causes of nymphomania and I will attempt to uncover these causes in my research and determine if ACEs is a cause for nymphomania.
Women who have experienced ACEs have reported risky sexual behaviors, including early intercourse, having had 30 or more sexual partners, and perceiving themselves to be at risk for HIV/AIDS. Sexual minorities who experience ACEs also demonstrate earlier sexual debut according to a 2015 study (SAMHSA 2018).

Inadequate research exist that investigate sexual well-being of sexual minority women in a dating relationship who experiences sexual abuse. Most research examines experiencing child sexual abuse (CSA) and then experiencing Adolescent and adult sexual victimization (AASV). CSA can cause negative health outcome in women. Women who experience CSA are at more risk of victimization. This causal relationship may increase the negative psychological and sexual sequelae of CSA (Crump, 2017). Women who have experienced both childhood and adulthood sexual assault report more sexual anxiety and difficulty experiencing orgasm. Compared to women who experienced trauma only as an adult. Lemieux and Byers found that CSA and adult sexual assault (ASA), had negative effects on sexual well-being but made no contribution to revictimization.

On average, sexual minority women with and without a history of CSA or SA describe sex as being a positive experience. Sexual minority women (SMW) who experienced CSA that involved penetration or attempted penetration, report poorer sexual well-being in the following areas. Lower sexual desire, lower sexual satisfaction, and more frequent negative automatic thoughts. This is 3 out of 7 independent variables in this research and it indicates that CSA affects some but not all aspects of sexual well-being. Research found that fondling had no effect on sexual well-being (Crump, 2017)

67% of SMW with a history of CSA had also experienced AASV. CSA results in greater exposure to social and individual factors that increase a women's risk for AASV such as, substance abuse problems and insecure attachment. SMW may have difficulty leaving unhealthy situations or even identifying them in the first place.

Many men and women are victims of childhood trauma. I am curious as to what impact this has on these individuals when they become adults. Some questions that I will answer through my research include: Do these experiences had adverse effects on people as adults? Are those who experience childhood trauma likely to inflict trauma upon a child? Is there intergenerational continuity in adverse childhood experiences? How did this experience influence quality of life?

Answering these questions will be meaningful for the individuals being studied because it will help them understand themselves more and potentially provide an explanation for certain circumstances. In what ways does trauma during childhood impact an individual's intimacy as an adult? To properly address this research topic, I must first study the prevalence of childhood trauma.

45% of children in the United States experience one ACE. 1 in 10 children experience 3 or more ACEs and in most regions the prevalence of ACEs is higher in black and Hispanic populations nationwide (Child Trends 2018). 61% of black non-Hispanic children have experienced one ACE compared to 40% white non-Hispanic children and 23% Asian non-Hispanic children.

Asians have the lowest rate of ACEs nationally. Research has found that the highest risk for negative outcomes are consistent in those who have experiences multiple ACEs. Some studies suggest that the experience of four or more ACES is a threshold above which there is a particularly higher risk of negative physical and mental health outcomes (Felitti et al, 1998).

Economic hardship is the most common adverse childhood experience which is reported for 25 to 26 percent of children regardless of age. Divorce is the second-most-common ACE experienced by children in each age group. About equal numbers of children ages birth to five have lived with someone who has an alcohol or drug problem, or have lived with someone with mental illness. Living with someone with an alcohol or drug-use problem is reported among 12 percent of 6- to 11-year-olds and 15 percent of 12- to 17-year-olds. One in seven 12- to 17-year-olds (14 percent) was the victim of, or witness to, neighborhood violence.

According to the Crimes against Children Research Center. 1 in 5 girls are victims of childhood sexual abuse (CSA). 20% of adult females recall an instance of CSA. Children are most vulnerable to experience CSA between the ages of 7-13. A Bureau of Justice Statistics report shows 1.6 % (sixteen out of one thousand) of children between the ages of 12-17 were victims of rape/sexual assault (Lalor 2010).
The consequences of sexual abuse are devastating.

A child who is the victim of prolonged sexual abuse usually develops low self-esteem, a feeling of worthlessness and an abnormal or distorted view of sex. The child may become withdrawn and mistrustful of adults, and can become suicidal (Lalor 2010). My research is intended to focus on what is considered to be an abnormal or distorted view of sex'. In majority of cases where there is credible evidence that a child has been penetrated, only between 5 and 15% of those children will have genital injuries consistent with sexual abuse (Lalor 2010).

Children who had an experience of rape or attempted rape in their adolescent years were 13.7 times more likely to experience rape or attempted rape in their first year of college (Lalor 2010). This statistic supports the assertion that childhood sexual trauma is connected to traumatic experiences later in life. Studies suggest that sexual abuse of children is an international problem (Finkelhor 1994). It is important to note that America is not the only country that is faced with this issue and this shows that this is a nationwide issue which should illicit a nationwide plan of action to combat.

Child sexual abuse (CSA) includes a broad range of behaviors, which can be perpetrated across a broad range of intra familial and extra familial relationships, and there is considerable variability in the duration and frequency of the abuse (Paine & Hansen, 2002). The longer the abuse occurs, the more detrimental the impact on these children. The more brutal the abuse is, the more the child will suffer in the long run.

Findings are consistent in indicating that the presence of ACEs can have devastating consequences on children as they progress into adulthood. Instances vary depending on societal circumstances whether a child is at risk for experiencing ACEs. Worldwide recognition of child abuse dates back to the 1960s with the coining on the phrase battered child syndrome. This came about because of the widespread prevalence of unexplained bruises and broken bones on children in hospitals. In the 70's and 80's there was substantial development in the literature surrounding preventative methods for these situations. Childhood sexual abuse has the greatest impact on sexual behavior patterns in adulthood compared to all other forms of abuse.

Several sociological theories examine patterns of behavior related to adverse childhood experiences. A question that is not often addressed in the research is on implications that these experiences have are sexual and intimate relationships and how they may impact sexual behavior patterns as adults. Attachment theory discusses a person's ability to form attachments and the ways that this is influenced by an individual's socialization as a child.

Developed by Bowlby in 1973, attachment theory contributes that kids develop behavior patterns based on the relationship they have with a primary care giver. Infants form attachment that makes a child feel safe, secure and protected (Grady 2017). The quality of this relationship based of infant needs and caregiver responsiveness. Depending on the relationship models by the caregiver, the child will look for similar attachments in future relationships.

Three organized patterns and one unorganized pattern of caregiving. One is secure attachments and the rest are insecure attachments. Children develop attachment security when they view caregivers as empathetic and they receive the attention that they need on a consistent basis. This is organized because the child knows what to expect. These secure attachments are necessary for emotional development and these people retain stable views of relationships and quality level of self-esteem.

Insecure attachment has 3 categories. Anxious, avoidant, and disorganized (Grady, 2017). Children develop insecurities when they are neglected, abused. Insecurely attached people view intimate relationships as threatening and make efforts to avoid feelings of vulnerability. Kids who develop anxiety have likely experienced an upbringing with caregivers who are unpredictable.

Individuals who experience a disorganized upbringing have had a primary caregiver who is frightening, and the child is unsure how to respond. These kids do not fall into one behavior pattern therefore are labeled disorganized. People who experience insecure attachments are more likely that kids with secure upbringing to experience challenges emotionally, behaviorally and in intimate relationships. There are several theories linking ACEs and adult behavior patterns.

A study conducted by CDCP and Kaiser Permanente shows that child maltreatment and household disfunction were common and these factors led to a series of health and social problems (Fetlitti et al, 1998). Study supports that this encourages high risk behavior as coping mechanisms. Negative consequences are amplified when the trauma is not validated by the victim and family and these consequences decrease when the victim and family acknowledge the trauma.

There is research which supports that children who experience ACEs will not have negative outcomes. There is extensive research on the concept of resilience which is positive adjustment. This can be influenced by extracurricular activities and achedemic achievements. Some children show a strong ability to adapt to adversity. Early family bonding reduces chances of committing violent crime (Werner 1993).

Resilience is conceptualized as the focus on positive outcomes during youth.
Peer relationships are important in adolescent development specifically when young people begin to spend more time with peers than family. Peer are social influences and can provide support. It is said that these relationships can increase self-esteem and help adolescent develop necessary coping skills. Research suggest that strong peer relationship have a more positive affect on youth from lower functioning families. At time these relationships act as substitutes for that social support.

School completion is linked to better quality of life. School engagement is shown to be connected to perceived importance of school. Feeling close to school may result in more positive school behaviors (Finn 1993). School disengagement is associated with dropping out.

References

• Cormier, L. A., & O'Sullivan, L. F. (2018). Anti-climactic: Investigating how late adolescents perceive and deal with orgasm difficulty in the context of their intimate relationships. Canadian Journal of Human Sexuality, 27(2), 111“122. https://doi.org/10.3138/cjhs.2018-001
• Crump, Lyndsay, and E. Sandra Byers. 2017. Sexual Well-Being of Sexual Minority Women in Dating Relationships Who Have Experienced Childhood Sexual Abuse and/or Adolescent and Adult Sexual Victimization. Canadian Journal of Human Sexuality 26 (2): 163“73
• Felitti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V., & Koss, M. P. (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American journal of Preventive Medicine 14(4), 245-258.
• Finkelhor, D. (1994). The international epidemiology of child sexual abuse. Child Abuse & Neglect, 18, 5, 409-417.
• Finn, J. D. (1993). School engagement and students at risk. Washington DC: National Center for Education Statistics.
• Grady, M. D., Levenson, J. S., & Bolder, T. (2017). Linking Adverse Childhood Effects and Attachment: A Theory of Etiology for Sexual Offending. Trauma, Violence & Abuse, 18(4), 433-444
• Lalor, K., & McElvaney, R. (2010). Child Sexual Abuse, Links to Later Sexual Exploitation/High-Risk Sexual Behavior, and Prevention/Treatment Programs. Trauma, Violence & Abuse, 11(4), 159“177. https://doi.org/10.1177/1524838010378299
• Moses, J., & Villodas, M. (2017). The Potential Protective Role of Peer Relationships on School Engagement in At-Risk Adolescents. Journal of Youth & Adolescence
• Paine, M.L. & Hansen, D.J. (2002). Factors influencing children to self-disclose sexual abuse. Clinical Psychology Review, 22, 271-295
• Scherrer, K., (2008), ?Coming to an asexual identity: negotiating identity, negotiating desire',
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• Werner, E. E. (1993). Risk, resilience, and recovery: Perspectives from the Kauai longitudinal study. Development and Psychopathology, 5(4), 503“515.
• https://www.samhsa.gov/capt/practicing-effective-prevention/prevention-behavioral-health/adverse-childhood-experiences

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