Retrospective chart review‐based assessment scale for adverse childhood events and experiences

Abstract

Aim: Adverse childhood experiences (ACEs) are highly prevalent in the general population, and their lifelong impact on physical and mental health is profound. In assessing ACEs, it is vital to consider the pathways and modalities by which an individual internalizes events as an adverse experience and its effects on their biological, psychological, and social function. However, conventional assessments of ACEs are inadequate in that they do not comprehensively assess the source of the adverse event and the pathway and mode of its impact on the individual.Methods: This study developed an original scale for ACEs that classifies the source of the event and the pathway and mode of its impact on the individual from a retrospective review of medical charts. We also used this scale to investigate the ACEs in 536 patients with psychiatric disorders (depression, bipolar disorder, and schizophrenia).Results: This scale consisted of 28 items, and its reliability and validity were sufficient.We also found that 45.9% of the patients studied had at least one ACE, ranging from 43.5% to 51.5% for all disorders. Psychological trauma (bullying) from peers was the most common cause at 27.2%. Conclusion:We developed a retrospective chart review-based assessment tool for ACEs which enables the examination of the source of the events of ACEs and the pathways and modalities of their impact on the individual. The frequency of ACEs is high

Assessing adverse childhood experiences among people with mental health problems during community outreach support: A retrospective cohort study

“…Focusing on the ACE contents, the prevalence of vertical sources was high. Comparing the percentages between our study and that of inpatients [5], psychological separation (28% vs 12%), psychological invasion (13% vs 5%), and physical witness (13% vs 3%) were more than twice as high. Many service users have lived with their families after adulthood, and it is likely that at the time of service initiation, they still have di culties in family relationships.…”

“…A previous national-level study in Japan reported that 32% of the general adult population had at least one ACE [17]. Another national study, which assessed ACEs among patients who participated in a four-day inpatient program for psychiatric diagnosis using the RC-ACEE scale, reported that 46% had at least one ACE and 18% had more than two ACEs [5].…”

“…The clinical psychologist from the TOT used the Retrospective Chart Review-based Assessment Scale for Adverse Childhood Events and Experiences (RC-ACEE scale) [5]. This tool is a retrospective quanti cation of ACE information from medical records in the usual clinical setting.…”

“…It consists of 28 items and is unique in that it classi es the source of the event (parental [vertical], peer [horizontal], third-party [some other relationship], group, system, and environment) and the pathway and mode of ACEs' impact on the individual (e.g., psychological attachment, physical violence, physical sexual violence, family, environment). It has su cient inter-rater reliability and validity [5].…”

“…The World Health Organization estimated that 40% of the general adult population in high-income countries had ACEs, and the proportions of parental death, divorce, or family violence were comparatively high (11%, 10%, and 8%, respectively) [4]. In comparison, in a Japanese study of inpatients with schizophrenia, major depressive disorder, and bipolar disorder, 46% had at least one ACE and psychological trauma from peers was the most common [5]. The long-term consequences and high prevalence of ACEs reported in previous studies highlight the importance of enhancing awareness of ACEs experienced by individuals with mental health problems at the community level [6].…”