What is the ACE study?

Impact of Trauma

The Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being.  More than 17,000 Health Maintenance Organization (HMO) members undergoing a comprehensive physical examination chose to provide detailed information about their childhood experience of abuse, neglect, and family dysfunction.The ACE Study participants were average Americans. Eighty percent were white (including Latino), 10 percent black and 10 percent Asian. They were middle-class, middle-aged, and 74 percent were college-educated. Since they were members of Kaiser Permanente, they all had jobs and great health care. Their average age was 57.

Take the ACES Test

RESILIENCE Questionnaire
Answer each statement with one of the following answers:   Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True
1.  I believe that my mother loved me when I was little.
2.  I believe that my father loved me when I was little.
3.  When I was little, other people helped my mother and father take care of me and they seemed to love me.
4.   I’ve heard that when I was an infant someone in my family enjoyed playing with me, and I enjoyed it, too.
5.  When I was a child, there were relatives in my family who made me feel better if I was sad or worried.
6.   When I was a child, neighbors or my friends’ parents seemed to like me.
7.  When I was a child, teachers, coaches, youth leaders or ministers were there to help me.
8.  Someone in my family cared about how I was doing in school. 
9.  My family, neighbors and friends talked often about making our lives better.
10.  We had rules in our house and were expected to keep them.
11. When I felt really bad, I could almost always find someone I trusted to talk to.
12.  As a youth, people noticed that I was capable and could get things done.
13.  I was independent and a go-getter.
14.  I believed that life is what you make it. 

How many of these 14 protective factors did I have as a child and youth? (How many of the 14 were circled “Definitely True” or “Probably True”?)   _______
Of these circled, how many are still true for me? _______

Children with toxic stress live much of their lives in fight, flight or fright (freeze) mode. They respond to the world as a place of constant danger. With their brains overloaded with stress hormones and unable to function appropriately, they can't focus on learning. They fall behind in school or fail to develop healthy relationships with peers or create problems with teachers and principals because they are unable to trust adults. Some kids do all three. With despair, guilt and frustration pecking away at their psyches, they often find solace in food, alcohol, tobacco, methamphetamine, inappropriate sex, high-risk sports, and/or work and over-achievement. 

They don't regard these coping methods as problems. Consciously or unconsciously, they use them as solutions to escape from depression, anxiety, anger, fear and shame.

There was a direct link between childhood trauma and adult onset of chronic disease, as well as mental illness, doing time in prison, and work issues, such as absenteeism.

About two-thirds of the adults in the study had experienced one or more types of adverse childhood experiences. Of those, 87 percent had experienced 2 or more types. This showed that people who had an alcoholic father, for example, were likely to have also experienced physical abuse or verbal abuse. In other words, ACEs usually didn't happen in isolation.

More adverse childhood experiences resulted in a higher risk of medical, mental and social problems as an adult.

Things start getting serious around an ACE score of 4. Compared with people with zero ACEs, those with four categories of ACEs had a 240 percent greater risk of hepatitis, were 390 percent more likely to have chronic obstructive pulmonary disease (emphysema or chronic bronchitis), and a 240 percent higher risk of a sexually-transmitted disease.

They were twice as likely to be smokers, 12 times more likely to have attempted suicide, seven times more likely to be alcoholic, and 10 times more likely to have injected street drugs.

People with high ACE scores are more likely to be violent, to have more marriages, more broken bones, more drug prescriptions, more depression, more auto-immune diseases, and more work absences.

One in six people had an ACE score of 4 or more, and one in nine had an ACE score of 5 or more.