Uncovering Adverse Childhood Experiences (ACEs) from Clinical Narratives within the Electronic Health Record

Abstract

Adverse Childhood Events (ACEs) are potentially traumatic events that occur in childhood (e.g., sexual abuse and maternal violence). Clinical research highlights the significant impact ACEs have on youth's mental health similar to other youth-related issues like traditional bullying and cyberbullying. However, research focused on the intersection of these two are limited. We report the results from a qualitative study that used electronic health record (EHR) data and clinical narratives from Parkview Behavioral Health hospital (n=719) to better understand the presentation of ACEs in patients who indicated cyber/bullying contributed to their inpatient hospital admission. Our deductive thematic analyses on the clinical narratives/notes and diagnoses highlight the connection of ACEs with cyber/bullying and other clinical diagnoses like depression, anxiety, PTSD, and ADD/ADHD. Additionally, our results point to potential impacts of the gender spectrum and other non-ACE indicators like adoption and the need for Department of Child Services (DCS). The outcome of this study provides distinct computational and clinical design guidelines for better collaborative decision making in healthcare, including the need for ACEs screening as standard-of-care within acute mental health settings. CAUTION: This paper includes graphic contents about adverse childhood traumas and events.