Comparison of the ACE-Q and CTES: A study of childhood trauma and perinatal depression.

Early adverse life events (EALs) are associated with irritable bowel syndrome (IBS). Exposure to EALs as assessed by the Adverse Childhood Experiences (ACE) questionnaire is associated with greater disease prevalence, but ACE has not been studied in gastrointestinal disorders. Study aims were to: (i) Estimate the prevalence of EALs in the IBS patients using the ACE questionnaire; (ii) Determine correlations between ACE and Early Trauma Inventory Self Report-Short Form (ETI-SR) scores to confirm its validity in IBS; and (iii) Correlate ACE scores with IBS symptom severity. A total of 148 IBS (73% women, mean age = 31 years) and 154 HCs (59% women, mean age = 30 years) completed the ACE and ETI-SR between June 2010 and April 2015. These surveys measured EALs before age 18 in the domains of physical, sexual, and emotional abuse, and general trauma. IBS and abdominal pain severity was measured by a 20-point scale (0 = none, 20 = worst symptoms). The ACE score increased the odds of having IBS (odds ratio [OR] = 2.05, 95% confidence interval [CI]: 1.21-3.48, p = 0.008). Household mental illness (p < 0.001), emotional abuse (p = 0.004), and incarcerated household member (p = 0.019) were significant predictors of IBS. Adverse childhood experiences and ETI-SR scores were strongly correlated (r = 0.59, p < 0.001). ACE, but not ETI-SR, modestly correlated with IBS severity (r = 0.17, p = 0.036) and abdominal pain (r = 0.20, p = 0.015). The ACE questionnaire is a useful instrument to measure EALs in IBS based on its use in large studies, its ability to measure prevalence across different EAL domains, and its correlation with symptom severity.

Introduction: Adverse childhood experiences (ACEs), such as witnessing domestic abuse or experiencing physical/sexual abuse, are associated with poorer long-term health outcomes, including acquired cardiovascular disease. This study offers the first investigation of ACEs in adults with congenital heart disease (CHD). Methods: In this cross-sectional study, adult CHD outpatients completed the ACE Questionnaire, the Relationship Scales Questionnaire, the Perceived Stress Scale, and a 0 - 100 linear analogue scale of quality of life. Total scores on the ACE Questionnaire range from 0 - 10 (a point for each ACE reported) and scores ≥ 4 are associated with poorest health outcomes. We performed correlations, t-tests, and analyses of variance to explore relationships between ACE Questionnaire scores and demographics, medical variables, and other survey scores. Results: A total of 100 patients were enrolled in the study (40 ± 13 years; 60% female). Ninety percent had defects of moderate or great complexity and 79% were categorized as American Heart Association anatomy + physiology stage B, C or D (i.e., some degree of symptoms and/or functional impairment). Total scores on the ACE Questionnaire ranged from 0 - 9, with a mean of 2.6 ± 2.5; 30% reported ≥ 4 ACEs. The most frequently reported ACEs were parental divorce (46%), emotional abuse (42%), and parental substance abuse problem (32%). ACE Questionnaire scores did not differ as a function of age, sex, defect complexity, or anatomy + physiology stage. However, total ACE score was significantly correlated with all 4 relationship styles (secure, preoccupied, dismissive and fearful; p-values &lt; 0.05). Quality of life scores were lower among those with elevated ACEs, although this did not reach statistical significance (69 vs. 76, p = 0.07). Conclusion: It is well accepted that adults with CHD face many health-related challenges throughout their lives. This study serves as an important reminder to providers that many patients will also experience other significant (and potentially traumatic) stressors in childhood. Further research is needed to determine whether the impact of ACEs on adults with CHD extends beyond relationship and stress outcomes and also includes cardiac morbidity and mortality.

Adverse Childhood Experiences: Research, Effects, and Tools for Change

The Adverse Childhood Experiences (ACE) Questionnaire has been used increasingly in survey research to identify respondents at elevated risk of later maladjustment. The value of the ACE count in this crowdsourcing sample (N = 2,430) was contrasted with dimensional child abuse and neglect risk indicators in regard to self-reported sexual aggression. Respondents completed the Revised Sexual Experiences Survey (SES-SFP), ACE Questionnaire, and five dimensional indices of childhood neglect (Assessing Environments III), exposure to intimate partner violence (Violent Experiences Questionnaire-Revised), and sexual (Sexual Abuse & Assault Self-Report), physical (Physical Abuse Self-Report), and emotional abuse (VEQ-R). A focal question in this analysis was whether self-reported sexual aggression would be more strongly associated with specific forms of child abuse and neglect over a broader count of different ACE exposures. ACE items linked most closely to sexual aggression included sexual abuse, physical neglect, domestic violence, and family incarceration. A count of elevations (> 1 SD) on the dimensional child abuse and neglect indices provided the stronger risk indicator in the analysis. Dimensional sexual (r = .48) and physical (r = .47) abuse scores were strongly associated with sexual aggression among the men. The greatest risk of adult sexual assaultive behavior was posed by the co-occurrence of any two forms of the dimensional child abuse and neglect indicators. These results emphasized the value of traditional child abuse and neglect indices as risk indicators of sexual aggressiveness.

The Adverse Childhood Experience (ACE) Questionnaire is one of the most widely used assessments for trauma exposure and adversity experienced during the first 18 years of life (Felitti et al., 1998; Kia-Keating et al., 2019). While the ACE Questionnaire has shown to have good reliability and validity, inconsistencies have been demonstrated for the test-retest form of reliability (MacKenzie et al., 2005; Pinto et al., 2014; Zanotti et al., 2018). To address the lack of consensus on the test-retest reliability of the ACE Questionnaire and the appropriateness for use with adolescents, the current study examined test-retest reliability of the ACE measure for a small group of adolescents in residential treatment. Participants (n = 20) completed the ACE during week 1 and were later assessed at week 9. The test-retest reliability of the ACE was very high (r = 0.913), thereby supporting the overall reliability of the ACE questionnaire and its effectiveness in identifying baseline trauma. However, the results indicate that adolescents might not fully understand their past trauma experiences prior to receiving trauma-focused treatment. Potential explanations of unreliable reporting of ACEs, counseling implications and recommendations for multiple administrations are discussed.

Client and Provider Discomfort With an Adverse Childhood Experiences Survey

AimThis study was conducted to determine the effect of childhood adverse experiences on the risk of postpartum posttraumatic stress disorder (PP‐PTSD) and postpartum depression (PPD).MethodsThis descriptive study was conducted with 417 mothers between 1 March and 30 April 2022. Data were collected using a demographic and obstetric information form, the Adverse Childhood Experiences Questionnaire (ACE), City Birth Trauma Scale (CityBiTS) and Edinburgh Postpartum Depression Scale (EPDS) through the Google Forms platform.ResultsThe mothers participating in the study had a mean age of 30.47 ± 4.21 years, 65.9% (n = 275) had at least one ACE, 10.3% (n = 43) met all of the DSM‐5 PTSD criteria according to the CityBiTS, and 91.8% (n = 383) had at least one traumatic stress symptom. Correlation analysis revealed weak positive associations between number of ACEs and CityBiTS score (p < 0.001, r = 0.328) and EPDS score (p < 0.001, r = 0.291) and a moderate positive association between CityBiTS and EPDS scores (p < 0.001, r = 0.601). PP‐PTSD was found to be a partial mediator variable between ACE and PPD.ConclusionThe presence of ACE in mothers was found to increase the risk of developing PPD, both alone and when combined with traumatic birth experience. Therefore, we believe that screening for a history of ACE during pregnancy, investigating traumatic birth experiences in the postpartum period, closer follow‐up of mothers with both ACE and traumatic birth experiences and increasing support systems will be beneficial in the prevention and early diagnosis of PPD.

175 The association between adverse childhood experiences and postpartum depression

Centers for Disease Control and Prevention Investments in Adverse Childhood Experience Prevention Efforts

The Adverse Childhood Experiences Questionnaire (ACE-Q) screens for adverse childhood experiences (ACEs), which are linked to increased disease risk. Although pediatric studies report no adverse effects of ACE-Q use, primary care data is limited. This study examined adult patients’ experiences with ACE-Q screening in primary care. Adults (18+) at a primary care center in London, Ontario, completed the ACE-Q and a follow-up questionnaire evaluating ACE screening experience. Correlations assessed relationships between ACE-Q scores and follow-up responses. Among 260 participants, 81% reported at least one ACE. Most (82%) felt comfortable discussing stressful childhood experiences with their healthcare provider. Higher ACE scores were associated with increased discomfort (rs = −0.166, P = 0.007), feeling upset by the ACE-Q (rs = 0.173, P = 0.005), and greater interest in learning about ACEs (rs = 0.177, P = 0.004). Overall, ACE-Q screening in primary care was generally well-received, with most patients recognizing its relevance despite some discomfort. These findings highlight the potential for integrating ACE screening into routine primary care to address long-term health risks. Further research is needed to confirm findings and optimize screening practices.

BackgroundThe prevalence of Adverse Childhood Experiences (ACEs) in psychotic patients ranges from 45 to 91%. Some authors argue that the risk of developing psychosis is higher in subjects who were exposed to multiple types of ACEs and that trauma multiplicity has a negative clinical impact in psychosis, while others argue that specific types of trauma are related to specific features of disease, taking away importance at the dose-response hypothesis.Most of the studies about ACEs and schizophrenia have been conducted in North America or Western Europe and there is a lack of information on this topic in developing regions, excluding the possibility of finding regional differences in ACEs frequency and its consequences. The present research provides information about the prevalence of ACEs in schizophrenic patients and in a control sample, and explores the clinical impact of trauma multiplicity in a schizophrenic adult population of Argentina.MethodsAn observational, multicentric and cross-sectional study was conducted at three different hospitals located in Buenos Aires. One hundred patients with schizophrenia and 50 subjects without a mental disease were recruited. Information about adverse childhood experiences was obtained from the Spanish version of the Adverse Childhood Experiences questionnaire (ACE-Q). Clinical severity of schizophrenia was measured with the Positive and Negative Syndrome Scale (PANSS) and with the hallucination subscale of the Psychotic Symptom Rating Scale (PSYRATS), suicidal behavior with the Columbia-Suicide Severity Rating Scale (C-SSRS), treatment adherence with the Drug Attitude Inventory (DAI-10), global functioning with the Global Assessment Functioning Scale (GAF), theory of mind with the Hinting Task test and emotional processing with the Reading the mind in the eyes test.To analyze the impact of trauma multiplicity on clinical variables of schizophrenia, the patient sample was divided into 2 groups according to the number of ACEs suffered. As a cut-off point, a statistical criterion corresponding to the median number of ACEs was chosen and the sample was divided between those who suffered 0–4 ACEs and those with 5 or more ACEs. Statistical analysis was carried out using SAS software.ResultsThe prevalence of at least one ACE in schizophrenic patients was almost double in comparison with the control group (92% vs 54%). Patients with trauma multiplicity showed a PANSS-N score lower than the group with lower number of ACEs (0–4 ACEs= 24.51 ± 5.17 vs. ≥ 5 ACEs= 21.04 ± 4.22; p= <0.001). PSYRATS score was higher in patients with 5 or more ACEs (0–4 ACEs= 6 points, Q1-Q3: 3–18 vs. ≥ 5 ACEs= 12 points, Q1-Q3: 5–23; p= 0.042). Patients with 5 or more ACEs scored higher in death ideation (0–4 ACEs= 22 (40.00%) vs. ≥ 5 ACEs= 28 (62.22%); p= 0.027). The prevalence of suicidal attempts was also higher (0–4 ACEs= 22 (40.00%) vs. ≥ 5 ACEs= 27 (60.00%); p= 0.047), as well as the median number of suicide attempts (0–4 ACEs= 0 (0–1) vs. ≥ 5 ACEs= 1 (0–2); p= 0.039). Also, women with 5 or more ACEs showed higher suicidal ideation score (0–4 ACEs= 0 (0–1) vs. ≥ 5 ACEs= 2 (0–4); p= 0.035). No other clinical variables under study showed differences between the groups.DiscussionTrauma multiplicity is associated with less negative symptoms, greater suicidal behavior and auditory hallucinations resistant to antipsychotic therapy. Further studies should be done to determine if this might be a specific endophenotype of schizophrenia. The high prevalence of ACEs in our study could be explained by the questionnaire applied, as it includes a large number of ACEs in comparison with others and it could also be linked to regional and cultural characteristics, as there is little information about ACEs prevalence of in South America.

Exposure to adverse childhood experiences (ACEs) is associated with adverse impacts on subsequent generations. The extent to which caregiver ACEs are associated with their child's ACE score is unclear. To meta-analytically examine the association between caregiver and child ACE score. Potential moderators of this association were explored. Systematic searches were conducted using MEDLINE, Embase, PsycINFO, and CINHAL from 1998, the year the ACEs questionnaire was published, to February 19, 2024. Inclusion criteria were that the ACEs questionnaire was completed for both caregiver and child, an effect size was available, and the study was published in English. Variables extracted included sample size and magnitude of association between caregiver ACEs and child ACEs, mean caregiver and child age, sex (% female), race and ethnicity, and informant of ACEs. Seventeen samples (4872 caregiver-child dyads) met inclusion criterion. Results revealed a large pooled-effect size between caregiver and child ACEs (r = 0.33; 95% CI, 0.25-0.41; P < .001), such that higher caregiver ACEs score was associated with higher child ACEs score. This association was stronger among studies with younger caregivers and studies that utilized caregiver-report compared with child self-report of ACEs. Many studies were conducted in North America with female caregiver samples, limiting generalizability beyond these populations. Caregiver ACEs were strongly associated with child ACEs. Prevention and intervention efforts for caregivers should be trauma informed and focused on bolstering protective factors that may break cycles of intergenerational risk.

Questioning the use of adverse childhood experiences (ACEs) questionnaires

BackgroundAdverse childhood experiences (ACEs) are associated with increased risk for a wide range of negative health outcomes, in-cluding sexual dysfunctions. There is a growing interest to advance the science of ACEs to improve the lives of children and families worldwide.Participants and procedureThe purpose of the present study was to explore the extent to which ACEs occur in patients with sexual dysfunctions in Armenia. To this end, the ACE questionnaire was used to assess the presence of adverse experiences from 85 female patients with sexual dysfunctions and 155 sex- and age-adjusted controls.ResultsMore than two-thirds of the patients (74.1%) had been exposed to one or more ACEs and 27.2% had been exposed to four or more ACEs. In the control group, these numbers were 56.1% and 18.1% respectively. Patients had significantly higher ACE scores (M = 2.06, SD = 1.95) than the control group (M = 1.65, SD = 2.50). Parental divorce and witnessing mother being abused (treated violently) were the most prevalent adversities in the patients.ConclusionsThe presence of multiple adverse childhood experiences in the patient group suggests that psychogenic factors are likely involved in sexual dysfunctions. ACEs Aware initiatives in Armenia aimed at screening for childhood adversities can improve the treatment of sexual dysfunctions and ultimately improve health and wellbeing.

Adverse childhood experiences and dissociation among Italian public psychology service users