Adverse Childhood Experiences (ACEs) and the Link to Antisocial, Delinquent, and Criminal Behaviors

Abstract

Adverse childhood experiences (ACEs) are negative and powerful experiences that are linked to childhood trauma and abuse that can be passed on to own children, creating a devious cycle of ACEs. ACEs affect the development of children on an individual level (i.e., antisocial personality traits and mental health issues), physical health level (i.e., general health and diabetes), family and parental level (i.e., dysfunctional households and family violence), socioeconomic level (i.e., low family income and unemployment), peer level (i.e., antisocial and delinquent peers), school level (i.e., learning problems and low school attainment), and community/neighborhood level (i.e., high-crime levels and overcrowding). Depending on the impact and the severity of the abuse experienced by children and adolescents, the inability to positively adapt, regulate emotions, steer attitudes and skills, and foster positive personal relationships may lead to maladaptive functioning, and antisocial, violent, at-risk, and criminal behaviors. This chapter outlines ACEs within the context of antisocial, delinquent behaviors, and the link to criminal involvement.

1. Introduction

Adverse childhood experiences (ACEs) do not have a single cause, it takes on several causes and forms, as many factors contribute to ACEs, ranging from parents, family environments, personality traits, socioeconomic circumstances, the school, peers, mental health issues, physical health problems, to community/neighborhood characteristics [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15]. The crux is ACEs facilitate, simulate, and play significant roles in the maltreatment and trauma of ACEs’ victims’ lives [3, 4, 7, 10, 12, 16, 17]. Interestingly, research conducted by Zhu, Zhang, and Anme [14] found that intergenerational transmission of ACEs, focusing on maternal ACEs, has (a) a direct effect on the mother’s parenting ability (or disability), (b) is recognized by dysfunctional and fragile family lives, (c) ACEs have a strong connection to the mother’s offspring’s (i.e., children’s) behavioral challenges and problems, such as aggression, anxiety, and depression), (d) seriously affect the children’s brain development, emotional regulation, and sense of compassion, and (e) ACEs hinder the children’s psychosocial functioning with regards to insecure and poor attachments with parents, significant others, problematic romantic relationships, and displaying traits, such as unreliability and untrustworthiness.

Existing research [5, 7, 10, 11, 18] indicates a direct link to ACE victimization (i.e., childhood maltreatment and trauma) [3, 8, 11, 13, 17] and serious, violent, and chronic delinquency [5, 7, 12]. It is also common to find that ACEs are general occurrences among many children, youth, adults, and older male and female offenders [5, 8, 10, 11]. In addition, many victims of ACEs use antisocial and negative coping mechanisms (i.e., substance abuse and gang involvement) [11, 19], acting out (i.e., aggression and suicidal ideation) [1, 2, 14], and delinquent behaviors (i.e., fighting and criminality) [2, 10, 11, 12].

Victims of childhood abuse are at risk for an array of adverse short-term (i.e., physical injuries) [8, 16, 17] and long-term (i.e., mental health issues) [1, 8, 9, 14, 19, 17] outcomes, that might influence the victims’ health and well-being later in life [3, 8, 14, 17]. ACEs can have life-changing effects on victims, as indicated by the following research initiatives [1, 2, 3, 4, 5, 6, 7, 8, 14, 16, 17, 18, 19]:

Antisocial behaviors (i.e., risk-taking and challenging behaviors, such as dangerous driving and substance use/abuse) [13, 19].

Increased aggression and violent behavior [1, 2, 13, 18].

School problems (i.e., absenteeism and low academic achievements) [1, 2, 13, 17, 18].

Peer problems (i.e., antisocial, and negative peer associations) [7, 13, 18].

Contact with social work and/or social work interventions are linked to ACEs and trauma [1, 4].

Being placed in foster care, or at out-of-home care facilities due to dire and dysfunctional home environments are linked to ACEs [1, 4, 13, 14].

Developmental processes (i.e., cognitive ability, cognitive processes, social cognition, perception processes, and interpretation ability) [1, 3, 6, 14, 17].

Education needs and problems (i.e., attention and concentration problems and low school commitment) [1, 4, 20].

Physical health (i.e., chronic health issues such as headaches, fatigue, and physical inactivity) [4, 8, 16].

Personal issues regarding ACEs victims include a sense of self and identity; attachment issues; adaptation problems; feelings of hopelessness, helplessness, and rejection; abandonment; high levels of self-criticism; low self-control; low self-worth; low self-esteem; and a skewed sense of belonging) [1, 3, 6, 7, 11, 13, 14, 17].

Mental health problems (i.e., anxiety, depression, emotional regulation problems, and suicidal ideation and attempts) [2, 3, 4, 8, 14].

Future involvement in the criminal justice system/involvement in crime [1, 4, 6, 7, 8, 11, 12].

When more than one (cumulative or compounded) ACEs are experienced, toxic stress (related to prolonged ACEs and the body and the brain’s stress responses) may impact the child/adolescent’s ability to develop and function completely [8, 21]. ACEs correlate with various negative outcomes, such as alcoholism, smoking, obesity, mental illness, depression, risky sexual behavior, adolescent pregnancy, homelessness, suicidal behavior, delinquent behavior, and a youth’s likeliness of serious, violent, and chronic delinquency and criminality [11, 22]. Recurrent exposure to ACEs may enhance the risk of delinquent outcomes and the internalizing of behaviors (i.e., anger and depression) during adolescence [5, 21].

Sadly, and in contrast, research [1, 9, 12, 13, 18] illustrates that children need a family environment characterized by caring, nurturing, loving, stable, and supportive parent/caregiver-child relationships. In addition, parents should be involved in their children’s lives, and monitor and supervise their children [7, 11, 12, 13]. At the same time, Ward [12] and Huijsman et al. [6] summarized that the family is the most significant socializing environment for a child where conventional norms, values, self-regulation, self-control, feelings of guilt, remorse, responsibility, and prosocial socializing practices are learned.

2. Defining adverse childhood experiences (ACEs)

Adverse Childhood Experiences (ACEs) are direct or indirect adverse, negative, stressful, and traumatic incidents during childhood and adolescence with detrimental effects during life [7, 22, 23, 24, 25]. ACEs encompass different forms of child abuse (i.e., physical, psychological, sexual abuse, and neglect), household dysfunction, and household instability (i.e., exposure to intimate partner violence, family/parental toxic stress, trauma, parental criminality, mental health issues, violence, divorce, family substance use, and familial imprisonment) [4, 22, 23, 24, 25]. Research [1, 6, 8, 10, 11, 14, 18] furthermore recaps that childhood maltreatment and trauma are related to the abandonment and rejection of children (by the parents), uninvolved parents, parental substance abuse, domestic violence, parental separation or divorce, parental ACEs, anxiety, depression, mental illness, and suicidal behaviors. The ACEs recoil and have a direct impact on the child’s development [14, 17], identity and sense of self [3, 8], and functioning [1, 3, 8, 14, 17].

Perez, Jennings, and Baglivio [11] developed an Adverse Childhood Experiences Score to measure ACEs related to the presence or the absence of emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, witnessing household violence, household substance abuse, household mental illness, and household member imprisonment.

Wang [25] concludes that ACEs are toxic stimuli that may enhance different negative coping strategies for boys (i.e., emotions linked to crime, such as anger and frustration) and girls (i.e., internalized responses, such as anxiety, depression, substance abuse, and self-destructive behaviors).

3. ACEs during childhood and adolescence

ACEs are divided into individual, parental/family, socioeconomic, school, peers, physical health, mental health, and community/neighborhood factors.

3.1 Individual factors

Child abuse is a common denominator identified in research as the main factor linked to ACEs [11, 12, 13, 14, 16, 18, 24, 26]. Well-known ACEs include physical abuse [11, 26], emotional and psychological abuse [11, 26], sexual abuse [11, 17, 26], abandonment and neglect [24, 26, 27, 28], and unplanned teenage or adolescent pregnancies [27, 29].

Other individual ACEs involve a lack of self-control [7, 30], delinquent attitudes [7], tolerant views about delinquency [7], impulsivity [11, 30], poor social skills [28], early onset of dating and engaging in risky sexual behaviors and promiscuity [15, 17, 24, 28, 30, 31], social isolation [15], and difficulty to form and maintain relationships [21].

3.2 Parental/family factors

A confluence of parental and family factors are linked to ACEs, namely inadequate parenting ability [7, 26, 31], poor parenting attitudes [7, 26], previous records of child abuse [26], a dysfunctional home environment [11, 28], domestic violence at home [11, 24, 26, 28, 31], substance abuse at home [11, 13, 24, 26, 28, 30], poor parental supervision [7, 13, 30], and parent interpersonal skills deficits [13, 26].

Other factors that might play a role in ACEs include parental employment problems [13, 26, 31], parental stress [26], parent self-esteem deficits [26], parent experienced abuse as a child [26], poor parental psychological adjustment [26], unreliable parents [26], parental/sibling substance (drugs and alcohol) abuse [11, 13, 26, 29], poor parent–child attachments/bonds [13, 26, 28, 31], and uninvolved parents [7, 13, 26]. Further to this, parental (or sibling) psychological or psychiatric treatment history [26], parents who are unresponsive to the child’s needs, safety, and security [26], family poverty [13, 24, 26, 31], multigenerational poverty [24], and inadequate access to social support [26] have been listed as significant parental or family factors that may enhance exposure to ACEs.

Along with the aforementioned factors, other ACEs factors that children are exposed to incorporate the instability of the family [26], family history of prior interventions for child abuse [13, 26], family murder and suicide [24], parental separation/divorce/single parent households [12, 13, 14, 31], and parental/siblings/family imprisonment [11, 13, 24]. Lastly, exposure to overcrowded households [7, 13, 24], frequently moving [24], homelessness [13, 21, 24], food insecurity [24], parental/sibling mental health issues (i.e., depression and personality disorders) [13, 29], and an absent father figure [13, 29] might intensify children’s vulnerability to ACEs.

Research [1, 7, 11, 13, 18, 31] explains that inadequate, abusive, and uninvolved parents and dysfunctional families are prominent risk factors for children’s exposure to child maltreatment, trauma, and ACEs. In this respect, exposure to ACEs often determines victims’ involvement in antisocial (i.e., aggression and gang involvement), delinquent (i.e., running away and truancy), and violent and criminal behaviors [1, 7, 11, 13, 14]. This explains why child victims of ACEs often model, imitate, and role-play the ACEs that they have endured as children. Thus, some victims of ACEs imitate and display the learned behavior from intimate and significant others (i.e., parents and family members), initiating the cycle of ACEs, and transferring the exposure and behaviors learned from their parents and family to their own lives [7, 10, 12, 13, 18].

3.3 Out-of-home care/placement

Children placed in out-of-home care (OOHC) are a marginalized and vulnerable population known to have suffered severe ACEs at home, with often, ongoing trauma and suffering at OOHC facilities [32, 33]. Commonly, children placed in OOHC are at risk of harm (i.e., abandonment and neglect) or have suffered actual harm (i.e., physical, sexual, emotional, and psychological abuse) in their home environments [17, 26, 32, 33].

According to McGrath, Gerard, and Colvin [33], OOHC children are over-represented in the criminal justice system (i.e., arrests, court contacts, and restorative justice initiatives [diversion] and incarceration). The contact with the criminal justice system is directly linked to the children’s history of trauma, abuse, abandonment, and neglect [33]. Furthermore, the care environment at the OOHC facilities is perceived as criminogenic because of the stigmatization (labeling) endured by the children in care, the criminalization of the environment, and the behavioral management techniques (linked to discipline and punishment styles) applied to the children [33].

OOHC children are often placed in an adverse OOHC facility characterized by placement instability (i.e., different placements) and disrupted education, which in turn exacerbates the child’s trauma, feelings of abandonment, hopelessness, helplessness, and social isolation. These ongoing adverse experiences have a detrimental effect on the child’s self-esteem, sense of self-worth, sense of belonging, identity, social relationships, physical health, psychological well-being, and mental health [32, 33]. The cycle of trauma, abuse, and subjection to ACEs continues with children placed at OOHC facilities.

In this regard, research [32] confirms that OOHC children display more violent, aggressive, and antisocial behaviors (i.e., hostility, anger, rage, and engagements in assault), obtain limited educational attainment, psychiatric and psychological disorders (i.e., anxiety disorders, depression, eating disorders, posttraumatic stress disorder [PTSD], poor self-esteem, and helplessness), physical injuries, engage in substance abuse, and are more susceptible to negative and criminal peer influence. These children are also more prone to be arrested for violent crimes [32, 34].

3.4 School factors

Children with toxic stress (i.e., extreme poverty and household dysfunction) struggle to concentrate, learn, concentrate, and complete schooling [24]. Research [35] demonstrates that children with three or more ACEs are five times more prone to experience school attendance problems, six times more inclined to display behavioral problems (i.e., disruptive behavior), and three times more to be expected to encounter academic failure. In addition, one in six schoolchildren attends school with four or more compounded (accumulated) ACEs [21]. ACEs generate stress which creates pressure on the brain that may result in learning problems [21]. Furthermore, children who experienced ACEs may display somatic symptoms at school such as clinging behavior, headaches, and stomach aches [21].

3.5 Peer associations

Children and adolescents who experienced ACEs often have aggressive and delinquent friends and spent time in criminogenic situations [7, 24]. Adolescents with delinquent peers are more inclined to display delinquent attitudes and to search for situations and opportunities to take part in delinquency [24]. Factors related to antisocial, negative, and criminal peers include gang involvement, truancy, acts of vandalism, substance abuse, antisocial values, and criminal thinking styles [7, 13, 18].

3.6 Socioeconomic challenges

Research [13, 24, 26, 28, 29] links ACEs and socioeconomic challenges to low parental education, unemployment, low family income, poor employability probabilities, and restricted economic opportunities. Aside from this, the following socioeconomic factors are often overlooked and/or not considered with ACE victims [4, 8, 16, 17, 20]:

Medical and hospital costs for treating injuries sustained by victims of ACEs’ physical abuse.

Being placed in foster care or out-of-home care facilities (removal from abusive and dysfunctional families).

Juvenile delinquency (arrest, adjudication, diversion, rehabilitation, and incarceration costs).

Involvement in delinquency and crime (i.e., running away, truancy, substance abuse, teenage pregnancies, inappropriate and deviant sexual behaviors, and over-sexualized behavioral problems).

Child welfare (identification of problems, assessments, referrals, and placement of the child).

Special education costs (learning disabilities and learning problems).

Productivity costs linked to mental health issues and chronic physical health problems are known to be associated with low academic achievement, unemployment, lack of skills, and incarceration.

Criminal justice system (police, courts and the correctional environment, rehabilitation costs).

Adult homelessness (indirect costs linked to the consequences of abuse and neglect of child victims and assisting with emergency shelter).

3.7 Physical health outcomes

ACEs impact individuals’ physical health by triggering a survival-mode retort that causes stress levels to escalate and ACEs raise stress hormones that weaken the immune system [11, 21]. ACEs are associated with being overweight and obese [24], and ACEs are contributors to the development of age-related diseases and general health (i.e., cancer, cardiovascular diseases, diabetes, morbidity and mortality of cancer, and respiratory diseases) [25].

3.8 Mental health issues

The negative consequences of ACEs and exposure to traumatic events incorporate a range of internalizing (i.e., depression) and externalizing (i.e., substance abuse) mental health problems [5, 17, 21]. Examples hereof include depression [11, 13, 28], depressive disorder [24], substance use disorder [11, 24, 28, 29], anxiety disorder (i.e., agoraphobia – anxiety in particular environments) [5], panic disorder (recurring panic attacks and worry about having attacks) [5], posttraumatic stress disorder [5, 13], and social phobia (strong fear in social situations) [5].

Other negative outcomes linked to ACEs and mental health issues include anger issues [11, 28, 30], low self-worth [13, 28], suicide attempts [5, 23, 24, 28], psychological distress (i.e., anxiety and sadness) [11, 13, 28], social withdrawal [11, 13, 16, 28], and eating disorders [36].

Distress experienced from traumatic events (i.e., ACEs) mentally and physically drains children and adolescents, which might lead to emotional dysregulation, impulsivity, dysfunctional information processing, inadequate empathy levels, and involvement in antisocial behavior [5]. In addition, according to Hammerton et al. [29], children with conduct problems have an increased risk of involvement in criminality, emotional disorders, not being involved in education, unemployment, and not being in training.

Research [1, 4] confirms a complex connection between ACE victims and mental illness. This complex connection is related to the abuse, neglect, trauma, harm, hardship, and adversity suffered by the victims. Additional research on the intergenerational transmission of ACEs with maternal ACEs [14] shows that exposure to early adversity might have an enduring effect on the mental illness of the offspring of the ACEs mothers. Research [14] suggests that maternal ACEs affect anxiety, depression, emotional dysregulation, compassion, hostility, and kindness in children. Apropos of this, research [2] found a strong connection between aggression and suicidality, especially in children and adolescents with alarming rates of antisocial and violent behaviors. Aggression expressed by ACE victims is a mediator between childhood maltreatment and suicide attempts [2].

3.9 Community and neighborhood

Community and neighborhood factors linked to ACEs include being afraid of/fear of the neighborhood, gangsterism, the incidence of nonviolent crime (including stealing from shops/stores, damaging property, stealing from a vehicle, stealing a vehicle, selling drugs, burgling, selling stolen goods, arson and stole from a person without the use of force), together with the occurrence of violent crime (i.e., assault, robbery, and armed robbery, kidnapping, murder, rape, stealing with use of force, carrying and the use of weapons for crime and for self-defense) [13, 29].

4. Antisocial and delinquent behavior

ACEs and trauma have diverse effects on children with adverse outcomes, such as addiction to substances, despair, depression, hopelessness, hostility, poor impulse control, problematic intimate relationships, social skills deficits, social isolation, and self-harm/self-destructive behaviors (i.e., overeating, suicide attempts, and ideation) [13, 23]. In addition, many children that endured ACEs are at risk for engaging in violence, early initiation of sexual activity, unprotected sex, promiscuous behavior, and suicide attempts [13, 24].

Notable antisocial behaviors that are linked to ACEs during childhood and adolescence include animal cruelty, begging, bullying, car cruising, criminal damage, cruelty to animals, deceitfulness, disobeying, fighting, gang involvement, insulting, loitering, littering, neighbor disputes, poor temperament, self-harm behaviors, reckless driving, rowdy behavior, sexual promiscuity, sport (i.e, football or rugby) disorder, stealing, heavy drinking/substance use, truancy (i.e., being absent from school without parents’ knowledge or permission), vandalism, and not being involved in education [11, 13, 28, 29, 30]. Additionally, behavioral problems are also associated with norm-breaking behaviors (i.e., deviance – behaviors that violate social norms, such as disrupting a class and not saying “please” and “thank you”), violations of the rights of others (i.e., discrimination founded on disability or ethnic origin), and being noncompliant and angry [5, 29].

5. Engagement in crime and reoffending behavior

There is a strong connection between collective/compounded ACEs and children, adolescents, and youths’ involvement in the criminal justice system (i.e., conflict with the law/contact with the police and arrest) and persistent offending behavior [13, 22]. Incidentally, research [23] indicates a prominent link between ACEs, antisocial behavior, involvement in violent crime, sexual offending, and domestic violence. Therefore, exposure to ACEs and trauma (compounded or a single episode) should be perceived as high-risk preceding/at-risk factors to address and/or prevent engagements in violence and contact with the criminal justice system [13, 23].

Research [13, 22] has recognized the important influence of ACEs on certain forms of delinquent and violent behaviors such as theft, dating violence, bullying, fighting, sex offending, and gang involvement. Children who have experienced emotional, physical, and/or sexual abuse and who committed childhood animal cruelty are more likely as adults to commit crimes against humans [13, 37].

Adding to this, Heide, Solomon, Sellers, and Chan [38] found that male juvenile homicide offenders were exposed to violence at home, neighborhood violence, had significant trauma, experienced poor bonds with their parents, were cruel to animals, demonstrated deceitful behavior, engaged in fire setting, and drowned or set fire to their victims. In turn, the female juvenile homicide offenders were subjected to poor parental supervision, displayed poor anger management skills, presented unhealthy sexual experiences, engaged in truant behavior (i.e., running away), and pondered about murder [38].

The male and female homicide offenders were furthermore victims of turbulent childhood experiences, prone to be influenced by antisocial, delinquent, negative, and criminal peers, acted impulsive, and engaged in violent and aggressive behaviors [38]. Both the male and female juvenile homicide offenders exhibited a history of child abuse, came from disturbing and violent home environments (i.e., parental substance abuse and violence), were raised in poverty, experienced school problems (i.e., learning problems), internalized behaviors (i.e., anxiety, depression) and showcased a history of conflict with the law (i.e., prior charges/court contacts) [38].

6. Case study: ACEs trajectories linked to antisocial, aggressive, violent, and criminal behavior

This case demonstrates the direct link between childhood maltreatment, trauma, ACEs, and antisocial and criminal behaviors. The case study concerns a criminological needs assessment (for therapy and rehabilitation directives for correctional staff). The criminologist assists the Department of Correctional Services (DCS) with volunteer criminological needs, risk assessments, and pre-parole reports for juvenile, male, and female offenders. The academic institution and the DCS Research Committee approved using the data for research purposes (with the main research topic being ‘offender assessments’). The participant consented to the assessment and voluntarily participated in the assessments. The offender was treated with dignity and respect, and anonymity and confidentiality were ensured. That is, no data presented in this case study can be directly traced to the female’s identity or personal details. This is regardless of the details and crime-related facts presented here. A semi-structured interview schedule with predetermined themes (i.e., personal, and social background, familial factors, school, peers, influences, employment, and intimate relationships) was used to collect the data, and a thematic analysis was used to identify and organize the data. In this case, the female offender will be called “Lee-Ann” (pseudonym), “the participant”, or “the offender”.

At the time of the interviews, Lee-Ann was 28 years old, serving a 12-year sentence for assault and murder and possessing an unlicensed firearm and ammunition. Lee-Ann completed Grade 8 and dropped out of school during Grade 9. When asked about her childhood years, Lee-Ann described them as “very rough, cruel, messed-up, and screwed up.” I grew up with my maternal grandmother and saw my mother twice a year. I only met my sisters when I was 17 years old. They grew up in their fathers’ families. There was no contact between my mother and father, and to this day, I have not met my father“. Lee-Ann was asked to describe her upbringing with her maternal grandmother. In this regard, she cited, “My grandmother was very strict, a hard woman, no love, and no fun. Since I was small – about 4 or 5 years old – I had to help clean the house, wash the dishes while standing on a bucket, wash the floors, and do the washing.” My grandmother said, “Nothing is free here. You work for your food and bed”. According to the offender, her grandmother meted out harsh discipline where she (Lee-Ann) was regularly beaten with a belt, slapped around, scolded, and sworn at, being called “a nothing, being useless, and a whore like your mother”, Lee-Ann was often hit by hand, and, at times, sent to bed without food as punishment. As a result of the offender’s challenging house environment, she struggled at school and failed Grade 3 and Grade 5. Lee-Ann says she was teased and bullied for failing her grades. She stated, “Three girls cornered me, called me ugly, dumb, and that I look like a whore”. A physical fight ensued between Lee-Ann and one of the girls, and two teachers had to break up the fight. Lee-Ann stated that when she arrived home, that “my grandmother had beaten me so badly, I could not sleep that night; my whole body was aching”.

In secondary school, Lee-Ann was bullied and stigmatized for failing her grades in primary school. During her one year at the secondary school, the offender was ostracized and called “awkward” (for not wearing the correct clothes). This victimization resulted in Lee-Ann “hiding in the toilet during school breaks to avoid more abuse and conflict”. The second physical fight occurred in Grade 9 when Lee-Ann befriended a Grade 11 schoolboy. “He was ‘the man’ at school, a gang leader … and handsome”. Due to the offender’s new-found friendship with this boy, a Grade 11 girl assaulted (physically abused) Lee-Ann and accused her of stealing her boyfriend. After this incident, Lee-Ann dropped out of school (during Grade 9), ran away from home, and joined the Grade 11 schoolboy’s gang. After enduring all of this, Lee-Ann confesses “From about 11 years old, many times I wanted to kill myself … setting me alight within the house or stabbing me with a knife”.

Four gang members (boys aged between 13 and 17 years) were also school dropouts and ran away from their homes. These boys resided in an abandoned and decapitated house – “the gang’s place where we met, socialized and held parties … used and sold drugs”. Lee-Ann said “I started using drugs (marijuana, methamphetamine, and hallucinogens) in Grade 8 (at 14 years) “to ease the pain, it was nice … I felt that I fit in, was not judged, loved … wanted, and appreciated. It made me forget about my mother, father, grandmother, the abuse, and my horrible school days”. During this time, Lee-Ann confirmed “I slept (sexually engaged) with four or five of the guys … I think. I had two abortions – the guys took me to this old woman who used to be a nurse, she helped me. With the first one (abortion) I was 15 years old, then again when I was 17 years old”.

“Our gang concentrated on theft, robbery, armed robbery, drug dealing, and kidnapping (for a ransom). I was involved in all of them … I started with theft and then joined the others. My trouble started when an armed robbery in a club’s parking lot went wrong. I was defending myself against two men – they were about three times my size. They were so strong and violent, the one guy picked me up and threw me on a car’s windscreen, the other one hit me with his fists, and he kicked me. Three of our (gang) guys were also badly beaten. When I got up, I grabbed the gun from the car, and I shot the guy that threw me against the windscreen”.

In Lee-Ann’s case, ACEs, such as growing up in an abusive and dysfunctional household [1, 6, 13, 14] without parents, enduring severe child maltreatment, trauma, a lack of affection, safety, security, and protection (i.e., by her mother, father, and grandmother) [3, 6, 9, 11, 12, 13] placed her at a disadvantage for a flourishing and happy childhood. Due to her dire home circumstances (i.e., abandonment, rejection, emotional and physical abuse and neglect, uninvolved and absent parents, and lack of prosocial bonds with significant others) [1, 3, 11, 12, 13], Lee-Ann was further victimized (i.e., bullying and peer rejection), at school [5, 7, 12, 19], which resulted in antisocial and deviant behaviors (i.e., suicidal ideation, substance abuse, aggression, fighting, gang involvement, and promiscuity) [1, 2, 5, 6, 8, 11, 12, 13, 19].

To evince the effect of the ACEs on Lee-Ann’s life, she joined the ‘cycle of antisocial, deviant, and criminal behavior’ [4, 5, 13] by committing severe violent crimes which can directly be traced to her childhood maltreatment, abuse, abandonment, and other ACEs [4, 7, 11, 13]. Lee-Ann learned through exposure to ACEs and other associations (i.e., delinquent, negative, and criminal friends) to display antisocial, delinquent, and criminal behaviors [1, 2, 4, 5].

7. Risk and protective factors

Risk factors associated with ACEs include early onset of offending behavior before age 20 [13, 23], child physical abuse [13, 30, 39], low intelligence [13, 30, 39], low school achievement [13, 30, 39], hyperactivity-impulsiveness [13, 30, 39], temperament [30, 39] and risk-taking behaviors [13, 30, 39]. In addition, family risk factors consist of poor parent–child bonds, poor parental supervision, harsh and inconsistent discipline, child physical abuse, aloof parents, child neglect, low parental involvement, parental conflict, broken families, parental criminality, delinquent siblings, the loss of a father and low parental education [13, 15, 30, 39]. Other familial risk factors entail an inadequate understanding of children’s needs for development, caregivers who were abused or neglected as children, young caregivers or single parents, low income, adults with low levels of education, high levels of economic and parenting stress, parents that use physical punishment for discipline, inconsistent discipline, isolation from extended family, friends, and neighbors, exposure to conflict, negative communication styles, and accepting or adapting attitudes that justify aggression and violence [15].

Child and adolescent risk indicators involve stealing, vandalism, conflict or resistance with authority figures, drinking, physical aggression, impulsiveness, advanced sexual behavior, running away from home, truanting from school, lying, and cruelty to animals [39].

Community and neighborhood risk factors include communities characterized by high rates of violence, crime, poverty, inadequate educational and economic opportunities, high unemployment rates, easy access to alcohol and drugs, insufficient community activities for young people, unstable housing, food insecurity, and elevated levels of social and environment disorder [15].

Protective factors are linked to desistance from crime, and these factors can assist children, adolescents, and youths to acquire resilience to overcome the consequences of ACEs [23, 30]. Protective factors for criminality include resilience, noncriminal peers, commitment to school and education, a meaningful, nonabusive, nonviolent, noncriminal, and a supportive family that serves as a buffer against antisocial and delinquent behaviors and criminality. An ordered and inspiring neighborhood will diminish the impact of ACEs on delinquency and involvement in crime [22]. Other factors that enable desistance from crime involve parental supervision and monitory, involved parents, stable employment, self-control, getting married, a satisfying job, joining the military, moving to a better area, and converting to religion [7, 13, 15, 23, 30].

Lastly, protective community and neighborhood factors include where families have access to economic and financial help, medical and mental health services, safe childcare, good-quality preschool, and communities where violence is not promoted or tolerated [22].

8. Conclusion

This chapter highlighted ACEs in many forms and on different levels. The most common form of ACEs is on an individual level and concerns child abuse (emotional, physical, sexual abuse, and neglect). Parental involvement, monitoring, supervision, household violence, poverty, unemployment, substance abuse, incarceration, and mental health issues are breeding grounds for children, toxic stress, and prolonged ACEs. Children placed in out-of-home facilities are jeopardized by further vulnerability, abuse, isolation, and instability, exacerbating this marginalized population’s ACEs.

School factors associated with ACEs include poor school attendance, learning problems, and academic failure, while negative and criminal peer associations are well-established as an outcome of ACEs. On a socioeconomic level, low parental education, low family income, and limited economic and employment opportunities place children further at risk for ACEs. Other negative consequences related to ACEs are physical health problems such as obesity, diabetes, and cancer and mental health issues such as anxiety, eating, depression, panic disorder and substance use disorders, and suicidal behaviors. Finally, community and neighborhood factors associated with ACEs involve attitudes tolerant of violence, substance abuse, crime, and disorder.

Antisocial and delinquent behaviors such as aggression, cruelty to animals, promiscuity, substance use, fighting, and continuous disorderly behavior are linked to pathways to crime. In addition, various risk factors were identified to address and curb ACEs. Lastly, desistance to crime and recidivism are directly linked to protective factors such as a nurturing, caring, loving, nonviolent, supportive home environment.

Acknowledgments

No acknowledgements and no funding received.

Conflict of interest

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