Articles of Interest: Adverse Childhood Experiences, Their Effects on Mental Health, and the Connection to Legal System Involvement

This month marks the 20^th anniver­sary of the land­mark U.S. Supreme Court deci­sion in Roper v. Simmons. In a series of posts antic­i­pat­ing the April 2025 release of DPI’s report com­mem­o­rat­ing the 20^th Anniversary of the Roper deci­sion and its impli­ca­tions for emerg­ing adults , we are explor­ing sci­en­tif­ic and legal devel­op­ments relat­ed to juve­niles and emerg­ing adults in the death penalty system. 

Adverse child­hood expe­ri­ences (ACEs) refer to poten­tial­ly trau­mat­ic events and cir­cum­stances that impair an individual’s sense of safe­ty and sta­bil­i­ty dur­ing child­hood (0 – 17 years). These expe­ri­ences may include abuse (phys­i­cal, emo­tion­al, or sex­u­al), wit­ness­ing vio­lence with­in the fam­i­ly or com­mu­ni­ty, and house­hold insta­bil­i­ty (incar­cer­a­tion of fam­i­ly mem­bers, parental sep­a­ra­tion, sub­stance use or men­tal health prob­lems). This phe­nom­e­non is a grow­ing con­cern in pol­i­cy con­ver­sa­tions and psy­cho­log­i­cal research because of the life­time impact of ACEs on neu­ro­log­i­cal devel­op­ment, man­i­fest­ing in the preva­lence of var­i­ous neg­a­tive men­tal health out­comes. Research also indi­cates that expo­sure to ACEs increas­es an individual’s like­li­hood of criminal activity. 

ACEs and Mental Health

One area in which the impact of adverse child­hood expe­ri­ences has been doc­u­ment­ed is in the preva­lence of depres­sion. Chapman et al. (2004) exam­ined the rela­tion­ship between the total num­ber of ACEs expe­ri­enced and the preva­lence of depres­sive dis­or­ders. They looked at both life­time his­to­ry and recent occur­rence of a depres­sive dis­or­der, uti­liz­ing respons­es from a large ACE Study sur­vey. This study found a strong rela­tion­ship between the num­ber of ACEs and the prob­a­bil­i­ty of life­time and recent depres­sive dis­or­ders, with child­hood emo­tion­al abuse specif­i­cal­ly pos­ing the great­est threat. Finding a strong pos­i­tive cor­re­la­tion between ACEs and depres­sive dis­or­ders sug­gests child­hood mal­treat­ment intro­duces a trick­le-down effect of neg­a­tive impacts on men­tal health through­out the lifespan. 

A sim­i­lar devel­op­men­tal out­come was dis­cov­ered in the rela­tion­ship between ACEs and alco­hol abuse. Dube and col­leagues (2002) exam­ined eight dif­fer­ent adverse expe­ri­ences, find­ing each one was asso­ci­at­ed with a high­er risk of alco­hol abuse in adult­hood. Further, they found a strong rela­tion­ship, par­al­lel­ing that found for depres­sive dis­or­ders, between the num­ber of ACEs and adult alco­hol use. This sug­gests that child­hood trau­ma may expo­nen­tial­ly alter an individual’s life tra­jec­to­ry regard­ing alco­hol. For exam­ple, com­pared to adults who had no adverse expe­ri­ences in child­hood, those who expe­ri­enced at least four ACEs were three times as like­ly to report alco­hol prob­lems lat­er in life. 

Finally, post-trau­mat­ic stress dis­or­der (PTSD) has also been doc­u­ment­ed as a poten­tial neg­a­tive men­tal health out­come of ACEs. Messman-Moore and Bhuptani (2017) reviewed PTSD and its co-occur­ring dis­or­ders relat­ed to child mal­treat­ment, estab­lish­ing child­hood abuse and neglect increase the risk for cur­rent and life­time PTSD in adulthood. 

The var­i­ous men­tal health chal­lenges result­ing from ACEs do not exist in iso­la­tion, but instead often bridge the path from trau­ma to engage­ment with the jus­tice sys­tem. These con­se­quences can influ­ence behav­iors that increase the like­li­hood of arrest and incar­cer­a­tion, cre­at­ing an unfor­tu­nate feed­back loop between expe­ri­ences of trau­ma and the carceral system. 

The rela­tion­ship between ACEs and the jus­tice sys­tem is fur­ther enhanced when focus­ing on how trau­ma-impact­ed men­tal health issues can devel­op into more sus­tained per­son­al­i­ty dis­or­ders. Approximately 80% of the adult prison pop­u­la­tion meets the diag­nos­tic cri­te­ria for anti­so­cial per­son­al­i­ty dis­or­der, which requires a pre-exist­ing diag­no­sis of con­duct dis­or­der before age 15, empha­siz­ing the long-term risk of vio­lence and aggres­sion result­ing from these ear­ly childhood experiences. 

The Roper v. Simmons Supreme Court deci­sion, estab­lish­ing the 18-year age min­i­mum for death penal­ty eli­gi­bil­i­ty, prompt­ed a dis­cus­sion of mal­treat­ment, child devel­op­ment, and cul­pa­bil­i­ty among researchers and legal experts. Haney, Baumgartner, and Steele (2022) argue that indi­vid­u­als engag­ing in acts of vio­lence with the poten­tial for cap­i­tal pun­ish­ment out­comes gen­er­al­ly rep­re­sent a group that has been exposed to numer­ous risk fac­tors, adverse child­hood expe­ri­ences, and trau­mas, espe­cial­ly at an ear­li­er age in their lives. According to Haney et​.al., ​“This means that a siz­able sub-group of mem­bers of the late ado­les­cent class [those aged 18 – 20] who are sub­ject to the death penal­ty are like­ly to be even more neu­ro­log­i­cal­ly, cog­ni­tive­ly, and emo­tion­al­ly imma­ture than the base­lines estab­lished in the research we have cit­ed.” Haney con­cludes that this age group is there­fore ​“even less culpable[.]” 

ACEs Among Death Row Prisoners: A Current Example 

The South Carolina case of Mikal Mahdi, who was sen­tenced to death in 2006, demon­strates the rela­tion­ship between ACEs and the legal sys­tem, as his attor­neys plead with the Supreme Court to con­sid­er the sub­stan­tial influ­ence his child­hood expe­ri­ences had on his brain devel­op­ment and behav­ior. Mr. Mahdi was aban­doned by his moth­er at age four, wit­nessed the kid­nap­ping and attempt­ed homi­cide of his moth­er by his father at age eight, suf­fered from depres­sion and sui­ci­dal thoughts, and spent most of his life in jail envi­ron­ments, includ­ing a large por­tion in soli­tary con­fine­ment. Mr. Mahdi’s case is a pow­er­ful exam­ple of the con­nec­tions among abuse, men­tal ill­ness, and the carceral system. 

Mr. Mahdi is sched­uled to be exe­cut­ed in South Carolina on April 11, 2025, and has cho­sen fir­ing squad as his method of exe­cu­tion. David Weiss, Mr. Mahdi’s attor­ney, offered a state­ment on his client’s deci­sion: ​“When we think of Mikal choos­ing his method of exe­cu­tion, we’re remind­ed of the tor­ment­ed child who, at nine years old, told his teacher that he want­ed to shoot him­self. Or, on anoth­er occa­sion, to elec­tro­cute him­self. Or, anoth­er time, to hang himself.”