The Adverse Childhood Experience (ACE) Questionnaire is a 10-item self-report measure developed for the ACE study to identify childhood experiences of abuse and neglect. The study posits that childhood trauma and stress early in life, apart from potentially impairing social, emotional, and cognitive development, indicates a higher risk of developing health problems in adulthood.
The ACE study originated in 1985 in Dr. Vincent Felitti’s obesity clinic in California. With increasing frustration that many clients, although successful with weight loss, were dropping out of the study, he began to explore factors that they all may have in common impacting the rate in which they quit the study and program. Many of them had a history of the same factors that include some form of childhood neglect, abuse, or adverse experience.
The ACE Study aimed to identify the childhood trauma experiences. Participants uderwent a physical examination and completed the ACE Questionnaire, in order to determine whether there truly was a link between adverse experiences in childhood and health concerns, both physical and mental, later in life.
The study found that nearly 40% of participants had been exposed to two or more of the different categories, and 12.5% reported exposure to at least four categories. In other words, the study showed that adverse childhood experiences were more common than had previously been recognized or acknowledged by research and medical findings.
The questionnaire identifies major risk factors that may lead to the development of health and social issues among people in the United States. Besides suggesting that an individual may be more likely to experience health issues later in life, this questionnaire also shows how childhood trauma affects the mortality rate: The life expectancy of an individual with an ACE score of six or more may be reduced by up to 20 years.
Because the ACE Study suggests that there is a significant link between adverse childhood experiences and chronic disease in adulthood, including heart disease, lung cancer, diabetes, and autoimmune diseases, the questionnaire may be able to help those who have a high ACE score become more informed about their increased risk factor for health issues. It could also encourage them to seek treatment or therapy if they have not already done so.
Additionally, the study highlights how these childhood experiences influence the possible development of mental health issues in adulthood and may serve to assist mental health professionals in better understanding certain mental health concerns.
The connection between adverse childhood experiences, social issues, and adult mental and physical health might also be used to help inform programs and health policies that support prevention of these issues and recovery from them.
Center for Disease and Prevention. (2003). ACE Reporter: Origins and Essence of the Study. San Diego.
Dong, M, Anda, R.., Felitti, V.J., Dube, S.R., Williamson, D.F., Thompson, T.J., Loo, C.M., and Giles, W.H. (2004). The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse and Neglect, 28 (7), 771–784.
Felitti, V.J., Anda, R.F., Nordenberg, D, Williamson, D.F., Spitz A.M., Edwards, V.K., Koss, M.P., and Marks, J.S., (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventative Medicine, vol 14 (4), 245-258.
Injury Prevention and Control: Division of Violence Prevention. (2014, May 13). Retrieved from http://www.cdc.gov/violenceprevention/acestudy.
Storrs, C. (2009, October 7). Is Life Expectancy Reduced by a Traumatic Childhood? Retrieved from http://www.scientificamerican.com/article/childhood-adverse-event-life-expectancy-abuse-mortality.