Chapter 3 - Considerations for expanding the definition of ACEs

Abstract

The 10 adverse childhood experiences (ACEs) assessed in the original ACE Study included physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, violence against a mother, parental divorce, household member having problems with substances, household member having problems with mental illness, and incarceration of a household member (Dube et al., 2003; Felitti et al., 1998). Although the term ACEs has been more consistently used in the literature over the last two decades, there are still inconsistencies in what adverse experiences are included in ACEs research. The original list of 10 ACEs is not comprehensive and, therefore, some studies will include additional adverse experiences and/or exclude some of the original 10 ACEs while still using the term ACEs. Careful consideration for expanding the ACEs definition may be important for advancing the field. In this chapter, an overview of the original ACEs, inconsistencies in defining ACEs in research, and ACEs from a global perspective is provided. Directions for future research, including recommendations for expanding the definition of ACEs and implications on policy and practice of an expanded ACEs list, are also discussed.