Nature or Nurture??

Whenever someone approaches me, and asks me what I believe makes people the way they are, Nature or Nurture, I usually reply both.  Having a background in Psychology and focusing mainly on trauma, it’s very difficult for me to differentiate between the two, in regards to which affects a person more.  Nature and Nurture both play a role in creating the person you are today.  But Adverse Childhood Experiences (ACE) definitely play a huge role in shaping how you perceive your reality!

Thank you to my dear friend and colleague, Bubba Castoria, for breaking down how ACE’s really contribute to growing up, and distinguishing the way people react.  Your environment makes a profound impact on how you grow up.  Children who are abused, typically engage in much riskier behaviors as teens and adults than children who have not been abused.  And have a much higher rate of teenage pregnancy, substance abuse, and other unhealthy coping mechanisms.  Plus, children who are raised on violent households tend to base their future relationships on the family dynamic they grew up in.

Whether we want to admit it or not, our early years make a tremendous impact on development. Both positive and negative experiences shape who we will become as an adolescent and ultimately as an adult.

As a mental health counselor, I work significantly more with Adverse Childhood Experiences (ACEs) than anything else. ACEs include, but are not limited to the following: emotional abuse, physical abuse, sexual abuse, domestic violence, substance use, mental illness, separation/divorce, criminal activity, emotional neglect, and physical neglect (Centers for Disease Control and Prevention, 2016). To be considered an ACE, the event has to have occurred during the individual’s first eighteen years of life in their household. The event could have happened directly to the individual, or they could have witnessed it in their household.

I do not want you to feel shocked if you thought of your own past experiences while reading the above list of ACEs. The majority of people have encountered at least one ACE during their childhood. One of the largest ACE studies ever called the CDC-Kaiser Permanente Study (1995-1997) collected data from 17,337 participants in southern California. Approximately 64% of the total participants experienced at least one ACE with 12.5% experienced four or more. For a closer look at specific types of trauma and gender breakdown, feel free to check out the graphs below.

Prevalence of ACEs by Category for CDC-Kaiser ACE Study Participants by Sex, Waves 1 and 2.

ACE Category




Percent (N = 9,367)

Percent (N = 7,970)

Percent (N = 17,337)

Emotional Abuse 13.1% 7.6% 10.6%
Physical Abuse 27% 29.9% 28.3%
Sexual Abuse 24.7% 16% 20.7%
Mother Treated Violently 13.7% 11.5% 12.7%
Household Substance Abuse 29.5% 23.8% 26.9%
Household Mental Illness 23.3% 14.8% 19.4%
Parental Separation or Divorce 24.5% 21.8% 23.3%
Incarcerated Household Member 5.2% 4.1% 4.7%
Emotional Neglect3 16.7% 12.4% 14.8%
Physical Neglect3 9.2% 10.7% 9.9%

ACE Score Prevalence for CDC-Kaiser ACE Study Participants by Sex, Waves 1 and 2.

Number of Adverse Childhood Experiences (ACE Score)

Percent(N = 9,367)

Percent (N = 7,970)

Percent (N = 17,337)

0 34.5% 38.0% 36.1%
1 24.5% 27.9% 26.0%
2 15.5% 16.4% 15.9%
3 10.3% 8.5% 9.5%
4 or more 15.2% 9.2% 12.5%

Source: Centers for Disease Control and Prevention, Kaiser Permanente. The ACE Study Survey Data [Unpublished Data]. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2016.

ACEs carry nasty long-term consequences with them as well. Individuals who have even one ACE are at higher risk for the following: alcoholism and alcohol abuse, chronic obstructive pulmonary disease, depression, fetal death, health-related quality of life, illicit drug use, ischemic heart disease, liver disease, poor work performance, financial stress, risk for intimate partner violence, multiple sexual partners, sexually transmitted diseases, smoking, suicide attempts, unintended pregnancies, early initiation of smoking, early initiation of sexual activity adolescent pregnancy, risk for sexual violence, and poor academic achievement. If that list was not bad enough, ACEs are considered “dose-response.” Essentially, the more ACEs an individual experiences, their risk for these consequences increases.

What I want you to take away from this:

  • The high prevalence of ACEs. Sadly, the majority of individuals have experienced at least one. This does not include ACEs that may go unreported.
  • One event can have devastating, long-term effects. The memories become etched into one’s psyche. The individual carries that weight with them for the rest of the time they walk on this planet. They will also use these memories to shape behaviors, communication, emotion management, and coping strategies. One moment can last a lifetime.
  • We have a better understand of ACEs now. The body of literature surrounding this topic grows daily. The mental health field continues to develop a stronger understanding about the connections between ACEs and their effects. This includes how to prevent them and treat individuals with a history of ACEs. Mental health professionals receive more and more specialized training on trauma-informed care on how to specifically address ACEs.
  • Help is out there. Individuals who have experienced ACEs are far from alone. Please reach out for support. The longer the effects go untreated, the worse they become. Tap into your support network. Call a hotline. Talk to a professional.

It will get better.

Centers for Disease Control and Prevention. (2016, June 14). Violence Prevention. Retrieved November 19, 2017, from CDC:

Please don’t forget to check out my blogThe Caring Counselor” as I embark on my self-care journey at . I started it up in hopes of helping others with their self-care. Feel free to check it out for self-care tips, personal reflections, and guest writers.


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