“The ACE study originated in 1985 in Dr. Vincent Felitti’s obesity clinic in California. Felitti was frustrated that a number of the people in his program dropped out, even though they were successfully losing weight. Upon reviewing the history of the people who dropped out, Felitti found that many people in his clinic had a background of adverse childhood experiences, such as physical or sexual abuse. He began to wonder if obesity might be, for some people, an unconscious defense that lingered as a result of adverse childhood experiences.

“Researchers found that weight gain was indeed the way some of those who had experienced childhood abuse had attempted to protect themselves, whether consciously or unconsciously, from further incidences of abuse, and that they left Felitti’s program due to feelings of anxiety that followed their weight loss.

“The questionnaire identifies major risk factors that may lead to the development of health and social issues among people in the United States. Besides suggesting that an individual may be more likely to experience health issues later in life, this questionnaire also shows how childhood trauma affects the mortality rate: The life expectancy of an individual with an ACE score of six or more may be reduced by up to 20 years.

“Because the ACE Study suggests that there is a significant link between adverse childhood experiences and chronic disease in adulthood, including heart disease, lung cancer, diabetes, and autoimmune diseases, the questionnaire may be able to help those who have a high ACE score become more informed about their increased risk factor for health issues. It could also encourage them to seek treatment or therapy if they have not already done so.  Additionally, the study highlights how these childhood experiences influence the possible development of mental health issues in adulthood and may serve to assist mental health professionals in better understanding certain mental health concerns.

“The connection between adverse childhood experiences, social issues, and adult mental and physical health might also be used to help inform programs and health policies that support prevention of these issues and recovery from them.”

Now is your chance to answer the ACES questionnaire to find your score.

While you were growing up, during your first 18 years of life:

1. Did a parent or other adult in the household often …
Swear at you, insult you, put you down, or humiliate you?
Act in a way that made you afraid that you might be physically hurt?

Yes / No If YES  enter 1 ____

2. Did a parent or other adult in the household often …
Push, grab, slap, or throw something at you?
Hit you so hard that you had marks or were injured?

Yes / No If YES  enter 1 ____

3. Did an adult or person at least 5 years older than you ever…
Touch or fondle you or have you touch their body in a sexual way?
Try to or actually have oral, anal, or vaginal sex with you?

Yes / No If YES  enter 1 ____

4. Did you often feel that.
No one in your family loved you or thought you were important or special?
Your family didn’t look out for each other, feel close to each other, or support each other?

Yes / No If YES  enter 1 ____

5. Did you often feel that …
You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?
Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

Yes / No If YES  enter 1 ____

6. Were your parents ever separated or divorced?

Yes / No If YES  enter 1 ____

7. Was your mother or stepmother:
Often pushed, grabbed, slapped, or had something thrown at her?
Sometimes or often kicked, bitten, hit with a fist, or hit with something hard?
Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?

Yes / No If YES  enter 1 ____

8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?

Yes / No If YES  enter 1 ____

9. Was a household member depressed or mentally ill or did a household member attempt suicide?

Yes / No If YES  enter 1 ____

10. Did a household member go to prison?

Yes / No If YES  enter 1 ____

Once you are finished, add up all your ‘Yes’ answers to find out your ACEs Score.

TOTAL ____

According to ACES Too High News (n.d.):

“The study’s researchers came up with an ACE score to explain a person’s risk for chronic disease. Think of it as a cholesterol score for childhood toxic stress. You get one point for each type of trauma. The higher your ACE score, the higher your risk of health and social problems. (Of course, other types of traumas exist that could contribute to an ACE score, so it is conceivable that people could have ACE scores higher than 10; however, the ACE Study measured only 10 types.)

“As your ACE score increases, so does the risk of disease, social and emotional problems. With an ACE score of 4 or more, things start getting serious. The likelihood of chronic pulmonary lung disease increases 390 percent; hepatitis, 240 percent; depression 460 percent; attempted suicide, 1,220 percent.”

Other types of childhood trauma include racism, bullying, watching the abuse of a sibling, losing a close loved-one and/or caregiver (grandmother, mother, grandfather, etc.), homelessness, a severe accident, witnessing abuse of any family member, involuntary hospitalization, involvement with foster care, Department of Family Services, youth homes, or being in the juvenile justice system; there are still others, as Peter Levine shows below: 

“While some people are able to recover from such trauma on their own, many individuals do not. Tens of thousands of soldiers are experiencing the extreme stress and horror of war. Then too, there are the devastating occurrences of rape, sexual abuse and assault. Many of us, however, have been overwhelmed by much more “ordinary” events such as surgeries or invasive medical procedures. Orthopedic patients in a recent study, for example, showed a 52% occurrence of being diagnosed with full-on PTSD following surgery.

“Other traumas include falls, serious illnesses, abandonment, receiving shocking or tragic news, witnessing violence and getting into an auto accident; all can lead to PTSD. These and many other fairly common experiences are all potentially traumatizing. The inability to rebound from such events, or to be helped adequately to recover by professionals, can subject us to PTSD—along with a myriad of physical and emotional symptoms” Levine (2021).

Many people who come into treatment say they have never experienced trauma, and that their childhoods were good. Yet with some exploration, many often find that they did have problems with attachment and/or went through traumas, some which were horrendous after discovering what can trauma us.