The List of ACEs Should Be Longer

"The list of Adverse Childhood Experiences (ACEs), developed by V. J. Felitti and a group of other researchers in 1998, comprised seven categories of adverse experience, organized into two groups: abuse (physical, psychological, or sexual) and household dysfunction ( substance abuse or mental illness of a parent, domestic violence, and imprisonment of a family member). In the nearly three decades since, the list expanded to include parental separation or divorce, and physical and emotional neglect."

"ACE screenings are now widely used in health and mental health settings, providing short cuts to a sketch of events in an individual's childhood that might have implications for current health or mental health problems. However, family circumstances and events are not the only sources of severe stress in the lives of children. A broader conceptual framework of situations and occurrences that can have traumatic impact offers a more dimensional and therefore more useful understanding of the early experiences of people we seek to help."

"I interviewed 29 formerly incarcerated youth offenders about their childhoods for my recently published book, Before Their Crimes: What We're Misunderstanding About Childhood Trauma, Youth Crime, and the Path to Healing. I asked many questions about home life, parents, school, and never asked specifically about problematic experiences, yet the open-ended recounting of childhood memories revealed the ACE scores of the people I spoke with as clearly as if they had checked the boxes on an ACE"

The original ACEs list identified abuse and household dysfunction categories and later expanded to include parental separation and neglect. ACE screenings are widely used in health and mental-health settings as brief indicators of childhood adversity linked to later health problems. Family events are not the only sources of severe childhood stress; community and systemic conditions can create trauma. Interviews with formerly incarcerated youth revealed multiple, co-occurring adverse experiences that map onto ACE scores even without prompting. A broader, dimensional framework of adverse experiences improves understanding of developmental impact and can guide policy responses when societal structures produce trauma.

Read at Psychology Today