Child Adverse Experices (ACE) and Adult Health
Childhood Abuse: The Hidden Impact on Adult Mental Health
Federal law defines child abuse as:
“Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation”; or
“An act or failure to act which presents an imminent risk of serious harm.”
How Widespread Is Child Abuse?
In 2022, an estimated 558,899 children were confirmed victims of abuse or neglect in the U.S.—a rate of about 8 in every 1,000 children. These were only the confirmed cases. In reality, child welfare agencies investigated the safety of over 7.5 million children that year, and approximately 3 million were the subject of formal child protective services (CPS) investigations.
The outcomes are often devastating. In 2022 alone, 1,990 children died as a result of abuse or neglect. Nearly 45% of these deaths were infants under the age of one.
Abuse takes many forms:
Neglect: 74.3%
Physical abuse: 17%
Sexual abuse: 10.6%
Psychological maltreatment: 6.8%
And the reality is even more sobering: nearly 1 in 4 U.S. children will experience some form of abuse or neglect before the age of 18.
While you may have heard the phrase “a case of child abuse is reported every 10 seconds,” it’s important to clarify that this number comes from CPS referrals. Referrals may include multiple children and not all are substantiated. Still, the figure illustrates just how widespread the concern really is.
Abuse That Goes Unreported
Even these staggering numbers don’t capture the full picture. In my private practice and during my years at a community mental health clinic, I’ve found that the vast majority of clients experienced some form of abuse or neglect as children—yet many of these cases were never reported to CPS.
Why Survivors Seek Therapy
Clients rarely come to therapy saying, “I was abused as a child.” Instead, they often present with struggles like:
Depression
Anxiety
Problems with alcohol or drugs
Addictions to food, sex, or other behaviors
Relationship difficulties
Sleep issues
Low self-confidence
A general sense of dissatisfaction with life
Through the therapeutic process, it often becomes clear that these issues are linked to unresolved childhood trauma.
The ACE Study: Documenting the Link
The landmark Adverse Childhood Experiences (ACE) Study, which followed more than 17,000 people, documented how strongly early trauma is linked to adult health outcomes. Higher ACE scores correlate with:
Increased risk of substance abuse
Greater likelihood of chronic physical health conditions
Higher rates of depression and anxiety
A shortened life expectancy
You can measure your own ACE score [insert link if you’d like to recommend a resource].
Moving Forward
The relationship between childhood trauma and adult well-being is profound—and tragically, still under-acknowledged. Abuse doesn’t just shape childhood; it leaves lasting imprints that can echo throughout a lifetime.
The good news: healing is possible. Through awareness, therapy, and supportive relationships, survivors can reclaim their sense of self and move toward a healthier future.
This is a subject I’ll continue to revisit in future posts.