Development and Evaluation of a Short Adverse Childhood Experiences Measure

Abstract

Introduction Clinicians require tools to rapidly identify individuals with significant childhood adversity as part of routine primary care. The goal of this study was to shorten the 11-item Behavioral Risk Factor Surveillance System Adverse Childhood Experiences (ACEs) measure and evaluate the feasibility and validity of this shortened measure as a screener to identify adults who have experienced significant childhood adversity. Methods Statistical analysis was conducted in 2015. ACE item responses obtained from 2011–2012 Behavioral Risk Factor Surveillance System data were combined to form a sample of 71,413 adults aged ≥18 years. The 11-item Behavioral Risk Factor Surveillance System ACE measure was subsequently reduced to a two-item screener by maintaining the two dimensions of abuse and household stressors and selecting the most prevalent item within each dimension. Results The screener included household alcohol and childhood emotional abuse items. Overall, 42% of respondents and at least 75% of the individuals with four or more ACEs endorsed one or both of these experiences. Using the 11-item ACE measure as the standard, a cut off of one or more ACEs yielded a sensitivity of 99%, but specificity was low (66%). Specificity improved to 94% when using a cut off of two ACEs, but sensitivity diminished (70%). There was no substantive difference between the 11-and two-item ACE measures in their strength of association with an array of health outcomes. Conclusions A two-item ACE screener appropriate for rapid identification of adults who have experienced significant childhood adversity was developed.

Prevalence and correlates of transactional sex among women of low socioeconomic status in Portland, OR

“…We used the 11-item Adverse Childhood Experiences (ACEs) questionnaire to assess experiences of emotional, physical, and sexual abuse (2 items); physical and emotional neglect; parental separation or divorce; and, household substance use, mental illness, partner violence, and incarceration prior to age 18 [25]. To assess the cumulative effects of ACE, we tallied the number of ACE endorsed by each participant to create a continuous variable ranging from zero to eleven.…”

The Impact of Punitive Immigrant Laws on the Health of Latina/o Populations

“…; Wade et al . ). Self‐reported health status, as measured by the CDC BRFSS, has been especially well studied in relation to mortality (Idler and Benyamini ).…”

Prevalence and Correlates of Transactional Sex Among Women of Low Socioeconomic Status in Portland, Oregon

“…We used the 11-item Adverse Childhood Experiences (ACEs) questionnaire to assess experiences of emotional, physical, and sexual abuse (2 items); physical and emotional neglect; parental separation or divorce; and, household substance use, mental illness, partner violence, and incarceration prior to age 18. 21 To assess the cumulative effects of ACE, we tallied the number of ACE endorsed by each participant to create a continuous variable ranging from zero to eleven. We also inquired about sexual intimate partner violence in the prior 12 months.…”