How might childhood trauma (PA, EA, SA, PN, EN) affect outcomes as compared to the more general ACEs?

08 August 2019 3 5K Report

I am working on epidemiological data using the Childhood Trauma Questionnaire to look at adult outcomes after childhood trauma.

There is so much inconsistency in the use of terminology in the literature, which is making life a bit difficult! My general standpoint is that since the ACEs studies (Felitti and Anda, etc) ACEs refers to a broader set of experiences, while childhood trauma refers specifically to abusive and neglectful experiences, especially in the home.

I would like to be able to discuss how childhood trauma might have different/stronger/specific effects on outcomes (esp psychiatric) compared to the broader ACEs. I cannot, however, find any obvious literature comparing the two.

I wondered whether anyone knew of references which might help me put together a brief discussion on the advantages/disadvantages of using CTQ versus ACEs. This is aside from the obvious that ACEs capture a broader range of negative experiences. I suspect that CTQ captures experiences that are more damaging, especially in terms of interruption of attachment etc. I'd like to be able to back that up with published research though.

Any help or comments would be much appreciated! :)

Richard Kensinger

Based on my own clinical research over 40 years as a BHC clinician here are my observations;

There are 6 subtypes of attachment and 5 subtypes of what I refer to as psychosocial environments PSE. And enriched produces a very secure one; a functional produces a secure one; a sterile produces an insecure-ambivalent one; a dysfunctional engenders an insecure avoidant one or a disorganized one; toxic produces rage-aggressive one.

My favorite resource is "The Developing Mind" by Daniel J Siegel.

Best, Rich

Rebecca Anne Madden

This is great, thank you Richard Kensinger

So to be clear, what you are indicating here is that different types of adverse environment are likely to produce different maladaptive attachment styles? And those attachment styles will presumably predispose an individual to different behaviours, and psychiatric vulnerabilities. Would that be about right?

Many thanks for the book recommendation, too!

Best, Rebecca

Richard Kensinger

Rebecca,

You nailed it! And w/o clinical attention attachment conflicts will endure, just as our personality does. Also refer to the works of Abraham Maslow and hierarchy of needs as well as Erik Erickson re" critical psychosocial developmental tasks.

Rich

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