Shanta R. Dube

TL;DR: The graded relationship of the ACE score to 18 different outcomes in multiple domains theoretically parallels the cumulative exposure of the developing brain to the stress response with resulting impairment in multiple brain structures and functions.

TL;DR: A powerful graded relationship exists between adverse childhood experiences and risk of attempted suicide throughout the life span, and alcoholism, depressed affect, and illicit drug use, which are strongly associated with such experiences, appear to partially mediate this relationship.

TL;DR: The results suggest that exposure to ACEs is associated with increased risk of depressive disorders up to decades after their occurrence, and early recognition of childhood abuse and appropriate intervention may play an important role in the prevention of depressive Disorders throughout the life span.

TL;DR: The persistent graded relationship between the ACE score and initiation of drug use for 4 successive birth cohorts dating back to 1900 suggests that the effects of adverse childhood experiences transcend secular changes such as increased availability of drugs, social attitudes toward drugs, and recent massive expenditures and public information campaigns to prevent drug use.

TL;DR: The study provides strong evidence that ACEs are interrelated rather than occurring independently, and collecting information about exposure to other ACEs is advisable for studies that focus on the consequences of a specific ACE.