W-8 Personality Disorders and Childhood Trauma

Personality Disorders and Childhood Trauma

1-What is one thing that stands out to you the most about ACEs research?

The most intriguing aspect of adverse childhood experiences (ACEs) is that children born of mothers that have experienced ACEs are likely to experience significant developmental challenges (Rariden et al., 2021). Initially, I would have imagined that ACEs only affect the development of the child experiencing them but may not have a profound effect on the offspring in the future. Current evidence indicates that ACEs have an effect not only on the individual experiencing them but their offspring in the future and this is more prominent when the ACEs are seen to be occurring in that individual. Mothers that have had at least four incidences of ACEs are likely to bear children with a five-time risk for compromised emotional and physical health within the first eighteen months of life (Rariden et al., 2021).

2-Why is the ACEs assessment instrument/tool so important in psychiatric mental health care?

ACE assessment instruments/tools play a critical role in psychiatric mental healthcare because they provide the care team with objective information on the possible root cause of current behaviors picked from childhood. For instance, behavioral problems, poor academic performance, and increased incidences of missed school days may have a foundation on the childhood experiences of an individual. The ACE tools allow the identification of specific childhood experiences including sexual assault, emotional abuse, physical abuse, physical neglect, substance abuse, parental separation, emotional neglect, maternal violence, as well as mental illness within the household (Rariden et al., 2021). Identifying the actual childhood experiences for an individual from among these allows the care team to design a care plan that aligns with the specific needs of that individual aligning with the childhood experience. For instance, an individual that experienced parental separation will require a different type of therapy from an individual that experienced sexual assault. The ACE tools are therefore an essential element of enabling individualization of care based on childhood experiences (Rariden et al., 2021).

3-What are the barriers to responding to the ACEs research?

A key barrier in the utilization of ACEs in both research and practice is the comfort of patients/participants. ACE use in clinical or research work implies having to inquire from individuals about their lived experiences some that have imposed significant trauma on them at emotional and physical levels. Equally, the delicate parent-child relationships may be significantly affected by the inquiry especially when patients/participants are required to live through those experiences via narration. Other barriers in the utilization of ACEs include time constraints especially because these tools are time intensive. The researcher/clinician has to invest sufficient time to develop trust and an empathetic relationship with the patient/participant if the inquiry has to be effective (Rariden et al., 2021).

4-Consider borderline personality as a biological response to trauma; what are the best options for treatment and why?

Borderline personality disorders (BPD) present with both environmental and genetic factors (Cattane et al., 2017). These environmental factors are largely linked to ACEs. The effective treatment and management of BPDs are to ensure concurrent pharmacological and non-pharmacological therapies. The pharmacological treatment focuses on reversing or re-establishing the biological (neural-based) changes and imbalances enforced by the trauma response (Rariden et al., 2021). On the other hand, the non-pharmacological therapies are designed to enable the individual to gradually find comfort in discussing their ACEs and using such narration as part of overcoming the trauma. The non-pharmacological therapies are a training platform where the individual learns to live beyond the past experiences while recognizing their vulnerability from both a genetic and environmental aspect (Rariden et al., 2021).

References

Cattane, N., Rossi, R., Lanfredi, M., & Cattaneo, A. (2017). Borderline personality disorder and childhood trauma: Exploring the affected biological systems and mechanisms. BMC psychiatry, 17(1), 221. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1383-2

Rariden, C., SmithBattle, L., Yoo, J. H., Cibulka, N., & Loman, D. (2020). Screening for Adverse Childhood Experiences: Literature Review and Practice Implications. The Journal for Nurse Practitioners.