Improving the Adverse Childhood Experiences Study Scale

Finkelhor, David; Shattuck, Anne M.; Turner, Heather A.; Hamby, Sherry

doi:10.1001/jamapediatrics.2013.420

Cited by 422 publications

(357 citation statements)

References 40 publications

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“…59 These experiences affect childhood health and well-being beyond any physical injuries incurred, leading to mental, physical, and behavioral problems. 28,60,61 Although not unexpected, given the negative impact of poverty on childhood physical health and emotional wellbeing, [62][63][64][65] the fact that economic hardship was so commonly cited as a stressor was significant nonetheless. These stressors involved witnessing parent financial struggles; and the lack of resources (ie, hunger, homelessness, and poor-quality clothing) caused by family financial struggles.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent study, researchers strengthened the association between ACEs and mental health symptoms by adding such measures to the ACE index and removing parental separation/divorce and incarceration of a household member. 28 Thus, the original index might be improved by considering a wider array of adverse experiences. More comprehensive childhood adversity measures exist but may not reflect inner-city youth experiences, as these measures were designed from interviews with mostly white, middle to upper middle class youth from rural and suburban communities.…”

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Adverse Childhood Experiences of Low-Income Urban Youth

Wade¹,

et al. 2014

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BACKGROUND AND OBJECTIVE: Current assessments of adverse childhood experiences (ACEs) may not adequately encompass the breadth of adversity to which low-income urban children are exposed. The purpose of this study was to identify and characterize the range of adverse childhood experiences faced by young adults who grew up in a low-income urban area. METHODS: Focus groups were conducted with young adults who grew up in low-income Philadelphia neighborhoods. Using the nominal group technique, participants generated a list of adverse childhood experiences and then identified the 5 most stressful experiences on the group list. The most stressful experiences identified by participants were grouped into a ranked list of domains and subdomains. RESULTS: Participants identified a range of experiences, grouped into 10 domains: family relationships, community stressors, personal victimization, economic hardship, peer relationships, discrimination, school, health, child welfare/juvenile justice, and media/technology. Included in these domains were many but not all of the experiences from the initial ACEs studies; parental divorce/separation and mental illness were absent. Additional experiences not included in the initial ACEs but endorsed by our participants included single-parent homes; exposure to violence, adult themes, and criminal behavior; personal victimization; bullying; economic hardship; and discrimination. CONCLUSIONS: Gathering youth perspectives on childhood adversity broadens our understanding of the experience of stress and trauma in childhood. Future work is needed to determine the significance of this broader set of adverse experiences in predisposing children to poor health outcomes as adults.

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Section: Discussionmentioning

confidence: 99%

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Adverse Childhood Experiences of Low-Income Urban Youth

Wade¹,

et al. 2014

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“…Other studies specifically focused on identifying ACEs in children in real time and reported that major childhood adversities, including growing up in poverty, peer rejection and lack of friends, poor school performance, property crime, and witnessing community violence, are associated with increased lifelong risk for negative life events and negative health outcomes as well. Measuring childhood adversities during childhood has been shown to offer improvements to the original ACE scale by examining more short-term behavioral and emotional symptoms that may serve as a link between ACEs and long-term health problems (8,9).…”

Section: Childhood Adversity: Definition and Scopementioning

confidence: 99%

Adverse childhood experiences and trauma informed care: the future of health care

et al. 2015

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Adverse childhood experiences (ACEs) are related to shortand long-term negative physical and mental health consequences among children and adults. Studies of the last three decades on ACEs and traumatic stress have emphasized their impact and the importance of preventing and addressing trauma across all service systems utilizing universal systemic approaches. Current developments on the implementation of trauma informed care (TIC) in a variety of service systems call for the surveillance of trauma, resiliency, functional capacity, and health impact of ACEs. Despite such efforts in adult medical care, early identification of childhood trauma in children still remains a significant public health need. This article reviews

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“…Deliberately limited to household effects, ACEs exclude important factors taking place outside the home, such as bullying (Lereya et al, 2015) and racial discrimination (Slack et al, 2016). Researchers have therefore proposed amending the original ten measures to include a range of other harmful exposures, such as racism, witnessing community violence, living in an unsafe neighbourhood, bullying, a history of foster care, parental death, food scarcity, parents always arguing, peer rejection, low socioeconomic status, poor academic performance and having no good friends (Finkelhor et al, 2013;Wade et al, 2016). Extending the scope of ACEs in this way seems to provide a more accurate representation of the prevalence of adversity, especially for people living in deprived and ethnically diverse areas (Cronholm et al, 2015).…”

Section: Can Aces Help Us Understand These Effects?mentioning

confidence: 99%

Capability and adversity: reframing the “causes of the causes” for mental health

Smith

2018

Palgrave Commun

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Scotland is well known for having the worst health in Western Europe, with the country's premature mortality mainly driven by suicide and substance misuse, rather than physical illness. These problems only emerged relatively recently, and a similar profile of premature mortality, sometimes called "diseases of despair", can be seen in other societies at different times. But what is "despair" in this context, and how might it exert its effects? Studies of the impact of Adverse Childhood Experiences (ACEs) on adult health consistently reveal a similar profile of morbidity, which is thought to relate to the effects of unremitting, unsupported, "toxic" stress. As models of childhood adversity expand to include a wider range of causes and powerful mitigating factors, there is a need to understand why some life events and circumstances are especially harmful. This paper argues that socioeconomic factors, childhood adversity, attachment, resilience and "toxic" stress are all consistent with a broader concept of human potential: Nussbaum's "capabilities approach" to human development. Incorporating our understanding of health and wellbeing in the broader frame of capabilities strengthens our understanding of adversity-related harm, and might also point towards new ways of repairing the social and individual damage they cause.

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Improving the Adverse Childhood Experiences Study Scale

Abstract: Our understanding of the most harmful childhood adversities is still incomplete because of complex interrelationships among them, but we know enough to proceed to interventional studies to determine whether prevention and remediation can improve long-term outcomes.

Cited by 422 publications

References 40 publications

Adverse Childhood Experiences of Low-Income Urban Youth

Adverse Childhood Experiences of Low-Income Urban Youth

Adverse childhood experiences and trauma informed care: the future of health care

Capability and adversity: reframing the “causes of the causes” for mental health

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