Childhood trauma is not itself a diagnosis. It describes frightening, harmful or neglectful experiences before the age of 18: abuse, neglect, or growing up in a household affected by violence, substance misuse, serious mental illness or separation. Researchers call these adverse childhood experiences, or ACEs.
Key points
- Childhood trauma is not a diagnosis. It is an experience that can raise the risk of later difficulties.
- Around 29.0% of adults in England and Wales, some 13.6 million people, report abuse before age 18.
- The ACE score counts how many of ten categories of adversity a person reports. It was built for population research and predicts nothing about an individual.
- People reporting four or more ACEs have higher rates of several health problems, but most do not develop them.
- One trusted adult in childhood is associated with better adult mental wellbeing among people reporting high adversity.
Symptoms
- Shame, self-blame or a negative view of oneself; emotions that shift quickly or are hard to settle.
- Intrusive memories, nightmares or flashbacks; difficulty trusting people, trouble in close relationships.
- Avoiding places or conversations that revive memories; drinking or drug use to manage feelings; constant alertness, broken sleep.
Causes and risk factors
- Abuse, neglect, or a household affected by violence, substance misuse, serious mental illness or separation.
- Rates are higher where there is poverty, parental substance misuse or domestic abuse, but it occurs in every kind of household.
- The data on outcomes are retrospective and associational, not proof of individual cause.
Treatment
- There is no NICE guideline on childhood trauma itself; treatment follows the guideline for whatever condition is diagnosed, most often PTSD (NG116).
- Trauma-focused CBT, typically 8 to 12 sessions, or EMDR more than three months after the event.
- Extra time to build trust should be allowed for people with additional needs, by adding sessions.
When to speak to a professional
- Memories, nightmares or flashbacks intrude on daily life; you avoid places or people to keep memories away.
- Low mood, anxiety or anger has lasted more than a few weeks, or you drink or use drugs to manage feelings.
If you need help now: Samaritans, call 116 123, free, 24/7. Shout, text SHOUT to 85258. NHS 111, then choose the mental health option. Call 999 if anyone is in immediate danger.