Adverse Childhood Experiences (ACEs) and Community Physicians: What We've Learned.

Abstract

The prevalence of childhood trauma, as measured by the Adverse Childhood Experiences (ACE) Study questionnaire, has been studied in a wide variety of community settings. However, little is known about physicians' familiarity with and use of the ACE questionnaire or the prevalence of childhood trauma in the physician community. To survey a convenience sample of community-based physicians and resident physicians to assess for familiarity with and use of the ACE questionnaire in clinical practice and to measure the prevalence of their own ACEs. An electronic survey was created and disseminated that included demographic questions, questions about physician awareness and use of the ACE questionnaire in clinical practice, and the 10-point ACE questionnaire. Most physicians surveyed (81%) reported they had never heard of the ACE questionnaire. Even fewer (3%) reported using the questionnaire in clinical practice. Most physicians (55.5%) reported no personal history of ACEs. Physicians reporting a history of childhood trauma reported a wide range of ACE scores (1-9). Compared with men, women reported a statistically higher number of ACEs (p < 0.001). In this sample of community physicians, familiarity with and clinical use of the ACE questionnaire was low. Most physicians surveyed reported no personal history of childhood trauma. Of physicians reporting a history of childhood trauma, women were disproportionately affected. Physicians in this study reported a lower prevalence of ACEs than the population they serve. Physicians must become better educated and actively address the effects of ACEs on their patients and on themselves.