Citation

McLennan JD, MacMillan HL, Afifi TO. Child Abuse Negl. 2019; 101: e104331.

Affiliation

Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: Tracie.Afifi@umanitoba.ca.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.chiabu.2019.104331

PMID

31887655

Abstract

Adverse childhood experiences (ACEs) are increasingly recognized as important predictors of poor health outcomes. In response, there is increasing application of ACEs questionnaires in clinical practice and population health surveys. Such efforts are often justified as approaches to identify ACEs, components of trauma-informed care, and/or measures to determine prevalence within epidemiological research. Unfortunately, such measures are often used without evaluating the strengths and limitations of the measures themselves. One of the most commonly used ACEs questionnaires is a ten-question version (ACEs-10), that is composed of two clusters - one asking about different types of child maltreatment, and the other asking select questions about household challenges. Unfortunately, both this questionnaire and its derivatives have substantial drawbacks that warrant careful consideration about their use. Problems include limited item coverage, collapsing of items and response options, a simplistic scoring approach, and the lack of psychometric assessment. These deficiencies are inconsistent with the standards expected for use of measures in healthcare services and research. Given these deficiencies, we recommend that these limitations are addressed before further use of ACEs-10, and its derivatives, for either clinical or research purposes.

Copyright © 2019 Elsevier Ltd. All rights reserved.

Language: en

Keywords

Adverse childhood experiences; Child maltreatment; Psychometrics; Universal screening