Adverse Childhood Experiences and Adverse Community Experiences (ACEs) are two elements contributing to our nation’s myriad public health and social crises.
The prevalence of ACEs in our society and low resiliency of our population are factors contributing to our epidemic proportions of :
- Drug overdoses
- Obesity
- Suicide
- Teenage Pregnancy
- Unintended Pregnancies
- Substance Use Disorders
- Alcohol Use Disorders
- Diabetes
- Homelessness
- Depression
- Lung Cancer
- Liver Disease
- Sexual Risk Behavior
- Ischemic Heart Disease
- and so much more…
LEARN ABOUT ADVERSE CHILDHOOD EXPERIENCES
Watch these videos to learn more about Toxic Stress, Adverse Childhood Experiences, and their impact on long term health.
ACE SCORE
What is your ACE Score?
What is your Resiliency Score?
Find out by taking the tests below!
You can also print this out and fill it out or share it with others!
DEFINING TRAUMA?
The Substance Abuse and Mental Health Services Administration (SAMHSA) developed this conceptual definition after an extensive literature review of decades of research, the current definitions, and consultation with an expert panel.
“Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life-threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach, p. 7
NOW WHAT?
You have some understanding of the story of trauma and toxic stress and its relation to overall health. There is much to learn and understand, yet now you have been “trauma-informed”… what does that even mean? The Substance Abuse and Mental Health Services Administration provided guidance in SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach, published in July 2014. In this publication, they offer a definition, develop the Three “E’s”, the Four “R’s”, and Six Principles of Trauma-Informed Care.
The Three “E’s” of Trauma: Event(s), Experience of Event(s) and Effect
EVENTS and circumstances may include the actual or extreme threat of physical or psychological harm or severe life-threatening neglect for a child that imperils healthy development.
The individual’s EXPERIENCE of the events or circumstances helps determine whether it is a traumatic event.
The long-lasting adverse EFFECTS of the event are critical. These effects may occur immediately or may have a delayed onset. The duration of the effects can be short to long term.
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach, p. 8
The Four “R’s”: Key Assumptions in a Trauma-Informed Approach
Trauma-Informed individuals, organizations, and communities are those that…
REALIZES the widespread impact of Trauma…
understands there are many paths to RECOVERY from trauma...
RECOGNIZES the signs and symptoms of trauma in patients, families, staff, oneself and others and…
RESPONDS by fully integrating trauma-informed policies, procedures, and practices, and actively seeks to resist re-traumatization…
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach, p. 9
Six Key Principles of a Trauma-Informed Approach
Safety
Trustworthiness and Transparency
Peer Support
Collaboration and Mutuality
Empowerment, Voice and Choice
Cultural, Historical, and Gender Issues
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach, p. 10
GET INVOLVED
All across the US there are various local efforts to combat ACEs in our community. They engage in Trauma-Informed Community Development (TICD). In Crawford County, Pennsylvania, Peace4Crawford was formed to counter this public health crisis.
Peace4Crawford is a trauma-informed initiative, based in the Crawford County System of Care (SOC) Partnership, promoting social change in Crawford County, heading toward a trauma-informed community.
The SOC is a framework involving collaboration across the community for the purpose of creating a seamless, integrated, and coordinated system of supports for children, youth, and families that is family and youth-driven, strength-based, and trauma-informed. The SOC helps children, youth, and families function better at home, in school, in the community, and throughout life. It is comprised of professional agencies involved in the health and well being of the community, family partners, and youth partners.
LOCAL TICD EFFORTS
Peace4Crawford is a trauma-informed initiative, based in the Crawford County System of Care (SOC) Partnership, promoting social change in Crawford County, heading toward a trauma-informed community.
LINKS
Centers for Disease Control (CDC) on Adverse Childhood Experiences
The CDC is a leader in advancing the science of trauma and toxic stress. They note that “Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur in childhood. ACEs can include violence, abuse, and growing up in a family with mental health or substance use problems. Toxic stress from ACEs can change brain development and affect how the body responds to stress. ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. However, ACEs can be prevented.
Preventing ACEs can help children and adults thrive and potentially:
- Lower risk for conditions like depression, asthma, cancer, and diabetes in adulthood.
- Reduce risky behaviors like smoking and heavy drinking.
- Improve education and employment potential.
- Stop ACEs from being passed from one generation to the next.”
Harvard University Center on the Developing Child
The Center on the Developing Child’s diverse activities align around building an R&D (research and development) platform for science-based innovation, and transforming the policy and practice landscape that supports and even demands change. We do this because society pays a huge price when children do not reach their potential, because half a century of policies and programs have not produced breakthrough outcomes, and because dramatic advances in science are ready to be used to achieve a promising future for every child.
READ
Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study.
Childhood Abuse, Household Dysfunction and Indicators of Impaired Worker Performance in Adulthood.
Methodological Issues
The Health and Social Impact of Growing Up With Alcohol Abuse and Related Adverse Childhood Experiences: The Human and Economic Costs of the Status Quo.
Growing up with Parental alcohol abuse: Exposure to Childhood Abuse, Neglect and Household Dysfunction.
Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression.
Cumulative childhood stress and autoimmune disease.
Epidemiology of Adverse Childhood Experiences and Depressive Disorders In a Large Health Maintenance Organization Population.
Adverse Childhood Experiences and Frequent Headaches in Adults.
Insights into causal pathways for ischemic heart disease: Adverse Childhood Experiences Study.
Adverse Childhood Experiences and Self- reported Liver Disease: New Insights into a Causal Pathway.
Adverse Childhood Experiences and the Risk of Lung Cancer.
Adverse childhood events as risk factors for negative mental health outcomes.
Relationship Between Multiple Forms of Childhood Maltreatment and Adult Mental Health in Community Respondents: Results From the Adverse Childhood Experiences Study.
Adverse childhood experiences and hallucinations.
Adverse Childhood Experiences: Are They Risk Factors for Adult Homelessness?
Childhood residential mobility and multiple health risks during adolescence and adulthood: the hidden role of adverse childhood experiences.
The enduring effects of abuse and related adverse experiences in childhood: a convergence of evidence from neurobiology and epidemiology.
Obesity: Problem, Solution, or Both?
Health-Related Outcomes of Adverse Childhood Experiences.
Health-related quality of life among adults who experienced maltreatment during childhood.
The Effects of Childhood Stress on Health Across the Lifespan.
The Relationship of Adverse Childhood Experiences to Adult Health; Turning Gold into Lead.
The Impact of Adverse Childhood Experiences on Health Problems: Evidence from Four Birth Cohorts Dating Back to 1900.
Adverse Childhood Experiences and the Risk of Premature Mortality.
The relationship of adverse childhood experiences to a history of premature death of family members.
Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study.
Child Maltreatment and Psychosis: A Return to a Genuinely Integrated Bio-Psycho-Social Model.
Adverse childhood experiences and sexual risk behaviors in women: a retrospective cohort study.
Obesity: Problem, Solution, or Both?
The Origins of Addiction: Evidence from the Adverse Childhood Experiences Study.
Childhood Abuse, Neglect and Household Dysfunction and the Risk of Illicit Drug Use: The Adverse Childhood Experience Study.
Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients.
Childhood abuse, household dysfunction and the risk of attempted suicide throughout the life span: Findings from Adverse Childhood Experiences Study.
Unintended pregnancy among adult women exposed to abuse or household dysfunction during their childhood.
Childhood Adversity and Combat as Predictors of Depression and Post-Traumatic Stress in Deployed Troops.
Acceptability of Adverse Childhood Experiences Questions for Health Surveillance in U.S. Armed Forces.
Exposure to abuse, neglect and household dysfunction among adults who witnessed intimate partner violence as children.
Insights Into Intimate Partner Violence From the Adverse Childhood Experiences (ACE) Study.
Violent Childhood Experiences and the Risk of Intimate Partner Violence in Adults: Assessment in a Large Health Maintenance Organization.
Commentary
Whitfield CL. Adverse Childhood Experiences and Trauma (editorial). American Journal of Preventive Medicine, 1998;14:361–363.
Anda RF, Butchart A, Felitti VJ, Brown DW. Building a Framework for GlobalSurveillance of the Public Health: Implications of Adverse Childhood Experiences
Preventive Medicine, 2010: 39 (1)93-98
Anda RF, Brown DW. Root causes and organic budgeting: funding health from conception to the grave Editorial Pediatric Health (2007) 1(2), 141-143
Weiss JS, Wagner SH. What explains the negative consequences of adverse childhood experiences on adult health? Insights from cognitive and neuroscience research (editorial). American Journal of Preventive Medicine, 1998;14:356–360.
Edwards, VJ, Dube SR, Felitti VJ, Anda RF. It’s OK to ask about past abuse. American Psychologist. 2007 62(4):327–328.
Overview
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study.
American Journal of Preventive Medicine 1998;14:245–258.
Felitti VJ, Anda RF; The Relationship of Adverse Childhood Experiences to Adult Health, Well-being, Social Function, and Healthcare : Lanius/Vermetten/Pain Cambridge University Press, 2010
Felitti VJ. The Relationship of Adverse Childhood Experiences to Adult Health; Turning Gold into Lead *English translation of: Felitti VJ. Belastungen in der Kindheit und Gesundheit im Erwachsenenalter: die Verwandlung von Gold in Blei. Z psychsom Med Psychother 2002; 48(4): 359-369.
Middlebrooks JS, Audage NC.The Effects of Childhood Stress on Health Across the Lifespan. U.S. Department of Health and Human Services Centers for Disease Control and Prevention.
Chronic Disease
Dube SR, Felitti VJ, Dong M, Giles WH, Anda RF. The Impact of Adverse Childhood Experiences on Health Problems: Evidence from Four Birth Cohorts Dating Back to 1900. Preventive Medicine, 2003;37(3):268–277.
Dube SR, Cook ML, Edwards VJ. Health-Related Outcomes of Adverse Childhood Experiences in Texas 2002 Preventing Chronic Disease: Public Health Research, Practice, and Policy Volume 7: NO. 3 May 2010
Autoimmune Disease
Dube SR, Fairweather D, Pearson WS, Felitti VJ, Anda RF, Croft JB. Cumulative childhood stress and autoimmune disease. Psychom Med. 2009;71, 243-250.
Health-Related Quality of Life
Corso, PS, Edwards, VJ, Fang, X, Mercy, JA.. Health-related quality of life among adults who experienced maltreatment during childhood. Am J Public Health, 2008;98:1094-1100.
Ischemic Heart Disease
Dong M, Giles WH, Felitti VJ, Dube, SR, Williams JE, Chapman DP, Anda RF. Insights into causal pathways for ischemic heart disease: Adverse Childhood Experiences Study. Circulation, 2004;110:1761–1766.
Liver Disease
Dong M, Anda RF, Dube SR, Felitti VJ, Giles WH. Adverse Childhood Experiences and Self- reported Liver Disease: New Insights into a Causal Pathway. Archives of Internal Medicine, 2003;163:1949–1956.
Chronic Obstructive Pulmonary Disease
Lung Cancer
Brown DW, Anda RF, Felitti VJ, Edwards VJ, Malarcher AM, Croft JB, Giles WH. Adverse Childhood Experiences and the Risk of Lung Cancer. BMC Public Health. 2010;10:20.
Frequent Headaches
Anda RF, MS, Tietjen G, Schulman E, Felitti VJ, Croft J. Adverse Childhood Experiences and Frequent Headaches in Adults. Headache2010; 50: 1473-1481.
Early Death
Brown DW, Anda RF, Tiemeier H, Felitti VJ, Edwards VJ, Croft JB, Giles WH. Adverse Childhood Experiences and the Risk of Premature Mortality American Journal of Preventive Medicine, Volume xx, Number x
Health Risks
Alcohol Abuse
Anda RF, Whitfield CL, Felitti VJ, Chapman D, Edwards VJ, Dube SR, Williamson DF. Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatric Services, 2002;53(8):1001–1009.
Felitti VJ. The Origins of Addiction: Evidence from the Adverse Childhood Experiences Study English version of the article published in Germany as: Felitti VJ. Ursprünge des Suchtverhaltens – Evidenzen aus einer Studie zu belastenden Kindheitserfahrungen. Praxis der Kinderpsychologie und Kinderpsychiatrie, 2003; 52:547-559.
Dube SR, Anda RF, Felitti VJ, Croft JB, Edwards VJ, Giles WH. Growing up with Parental alcohol abuse: Exposure to Childhood Abuse, Neglect and Household Dysfunction. Child Abuse and Neglect, 2001;25(12):1627–1640.
Drug Abuse
Dube SR, Felitti VJ, Dong M, Chapman DP, Giles WH, Anda RF. Childhood Abuse, Neglect and Household Dysfunction and the Risk of Illicit Drug Use: The Adverse Childhood Experience Study. Pediatrics, 2003;111(3):564–572.
Obesity
Williamson DF, Thompson, TJ, Anda, RF,. Dietz, WH, Felitti VJ. Body Weight, Obesity, and Self-Reported Abuse in Childhood. International Journal of Obesity, 2002;26:1075–1082.
Felitti VJ. Letters to the Editor. The Permanente Journal/ Fall 2010/ Volume 14 No. 3
Felitti VJ, Jakstis K, Pepper V, Ray A. Obesity: Problem, Solution, or Both? The Permanente Journal/ Spring 2010/ Volume 14 No. 1
Sexual Risk Behavior
Hillis SD, Anda RF, Felitti VJ, Marchbanks PA. Adverse childhood experiences and sexual risk behaviors in women: a retrospective cohort study. Family Planning Perspectives, 2001;33:206–211.
Smoking
Edwards, VJ, Anda RF, Gu D, Dube, S R, Felitti, VJ. Adverse childhood experiences and smoking persistence in adults with smoking-related symptoms and illness*. Permanente Journal 2007;11:5–7.
Anda RF, Croft JB, Felitti VJ, Nordenberg D, Giles WH, Williamson DF, Giovino GA. Adverse childhood experiences and smoking during adolescence and adulthood. Journal of the American Medical Association, 1999; 282:1652–1658.
Mental Health
Edwards VJ, Holden GW, Felitti VJ, Anda RF. Relationship Between Multiple Forms of Childhood Maltreatment and Adult Mental Health in Community Respondents: Results From the Adverse Childhood Experiences Study Am J Psychiatry 160:8, August 2003 1453- 1460
Cabrera OA, Hoge CW, Bliese PD, Castro CA, Messer SC. Childhood Adversity and Combat as Predictors of Depression and Post-Traumatic Stress in Deployed Troops Am J Prev Med 2007;33(2):77–82
Chapman DP, Dube SR, Anda RF. Adverse childhood events as risk factors for negative mental health outcomes. Psych Annals
Depression/Depressed Affect
Chapman DP, Anda RF, Felitti VJ, Dube SR, Edwards VJ, Whitfield CL. Epidemiology of Adverse Childhood Experiences and Depressive Disorders In a Large Health Maintenance Organization Population. Journal of Affective Disorders, 2004;82:217–225.
Anda RF, Whitfield CL, Felitti VJ, Chapman D, Edwards VJ, Dube SR, Williamson DF. Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatric Services, 2002;53(8):1001–1009.
Edwards VJ, Holden GW, Felitti VJ, Anda RF. Relationship Between Multiple Forms of Childhood Maltreatment and Adult Mental Health in Community Respondents: Results From the Adverse Childhood Experiences Study Am J Psychiatry 160:8, August 2003 1453- 1460
Hallucinations
Whitfield CL, Dube SR, Felitti VJ, Anda RF. Adverse childhood experiences and hallucinations. Child Abuse and Neglect. 2005;29(7):797-810.
Psychosis
Read J, Fink PJ, Rudegeair T, Felitti V, Whitfield CL. Child Maltreatment and Psychosis: A Return to a Genuinely Integrated Bio-Psycho-Social Model. Clinical Schizophrenia & Related Psychoses October 2008; 235-254.
Neurobiology
Anda RF, Felitti VJ, Walker J, Whitfield, CL, Bremner JD, Perry BD, Dube SR, Giles WH. The enduring effects of abuse and related adverse experiences in childhood: a convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neurosciences 2006; 56(3):174–86.
Weiss JS, Wagner SH. What explains the negative consequences of adverse childhood experiences on adult health? Insights from cognitive and neuroscience research (editorial). American Journal of Preventive Medicine, 1998;14:356–360.
Suicidality
Dube SR, Anda RF, Felitti VJ, Chapman D, Williamson DF, Giles WH. Childhood abuse, household dysfunction and the risk of attempted suicide throughout the life span: Findings from Adverse Childhood Experiences Study. JAMA 2001;286:3089–3096.
Work Absenteeism
Anda RF, Felitti VJ, Fleisher VI, Edwards VJ, Whitfield CL, Dube SR, Williamson DF. Childhood Abuse, Household Dysfunction and Indicators of Impaired Worker Performance in Adulthood. The Permanente Journal, 2004;8(1):30–38.
Methodological Issues
Age Cohort Differences
Dube SR, Felitti VJ, Dong M, Giles WH, Anda RF. The Impact of Adverse Childhood Experiences on Health Problems: Evidence from Four Birth Cohorts Dating Back to 1900. Preventive Medicine, 2003;37(3):268–277.
Assessment of Mediating Pathways
Anda RF, Felitti VJ, Fleisher VI, Edwards VJ, Whitfield CL, Dube SR, Williamson DF. Childhood Abuse, Household Dysfunction and Indicators of Impaired Worker Performance in Adulthood. The Permanente Journal, 2004;8(1):30–38.
Dong M, Giles WH, Felitti VJ, Dube, SR, Williams JE, Chapman DP, Anda RF. Insights into causal pathways for ischemic heart disease: Adverse Childhood Experiences Study. Circulation, 2004;110:1761–1766.
Anda RF, Chapman DP, Felitti VJ, Edwards V, Williamson DF, Croft JP, Giles WH. Adverse Childhood Experiences and Risk of Paternity in Teen Pregnancy. Obstetrics and Gynecology, 2002;100(1):37–45.
Dube SR, Anda RF, Felitti VJ, Chapman D, Williamson DF, Giles WH. Childhood abuse, household dysfunction and the risk of attempted suicide throughout the life span: Findings from Adverse Childhood Experiences Study
. JAMA 2001;286:3089–3096.
Basis for Ace Score
Dong M, Anda RF, Felitti, VJ, Dube SR, Williamson DF, Thompson TJ, Loo CM. Giles WH. . The Interrelatedness of Multiple Forms of Childhood Abuse, Neglect, and Household Dysfunction. Child Abuse and Neglect, 2004;28(7):771–784.
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study
.
American Journal of Preventive Medicine 1998;14:245–258.
Bias Assessment (under construction)
Consistency by Birth Cohort
Dube SR, Felitti VJ, Dong M, Giles WH, Anda RF. The Impact of Adverse Childhood Experiences on Health Problems: Evidence from Four Birth Cohorts Dating Back to 1900. Preventive Medicine, 2003;37(3):268–277.
Interrelation of ACEs
Dong M, Anda RF, Felitti VJ, Duba SR, Williamson DF, Thompson TJ, Looa CM, Giles WH. The interrelatedness of multiple forms of childhood abuse,neglect, and household dysfunction Child Abuse & Neglect 28 (2004) 771–784
Dube SR, Anda RF, Felitti VJ, Croft JB, Edwards VJ, Giles WH. Growing up with Parental alcohol abuse: Exposure to Childhood Abuse, Neglect and Household Dysfunction. Child Abuse and Neglect, 2001;25(12):1627–1640.
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study
. American Journal of Preventive Medicine 1998;14:245–258.
Dong M, Anda RF, Felitti VJ, Dube SR, Giles WH. The Relationship of Exposure to Childhood Sexual Abuse to Other Forms of Abuse, Neglect and Household Dysfunction during Childhood. Child Abuse and Neglect, 2003;27(6):625–639.
Severity Frequency of Violent Experience
Anda RF, Felitti VJ, Chapman DP, Croft JB, et al. Abused boys, battered mothers, and male involvement in teen pregnancy. Pediatrics, 2001;107(2):e19.
Test-Retest Reliability (under construction)
Reproductive Health/Sexual Behavior
Fetal Death
Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Marks JS. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial outcomes, and fetal death. Pediatrics. 2004; 113(2):320-327.
Promiscuity
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study
.
American Journal of Preventive Medicine 1998;14:245–258.
Sexual Risk Behaviors in Women
Hillis SD, Anda RF, Felitti VJ, Nordenberg D, Marchbanks PA. Adverse childhood experiences and sexual risk behaviors in women: a retrospective study. Family Planning Perspectives, 2001; 33:206-211
Sexually Transmitted Diseases
Hillis SD, Anda RF, Felitti VJ, Nordenberg D, Marchbanks PA. Adverse childhood experiences and sexually transmitted diseases in men and women: a retrospective study. Pediatrics, 2000;106(1):E11.
Teen Pregnancy
Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Marks JS. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial outcomes, and fetal death. Pediatrics. 2004; 113(2):320-327.
Anda RF, Chapman DP, Felitti VJ, Edwards V, Williamson DF, Croft JP, Giles WH. Adverse Childhood Experiences and Risk of Paternity in Teen Pregnancy. Obstetrics and Gynecology, 2002;100(1):37–45.
Anda RF, Felitti VJ, Chapman DP, Croft JB, et al. Abused boys, battered mothers, and male involvement in teen pregnancy. Pediatrics, 2001;107(2):e19.
Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Macaluso M, Marks JS. TheProtective Effect of Family Strengths in Childhood against Adolescent Pregnancy and Its Long-Term Psychosocial Consequences. Permanente Journal 2010; 14: 18-27.
Unintended Pregnancy
Dietz PM, Spitz AM, Anda RF, Williamson DF, McMahon PM, Santelli JS, Nordenberg DF, Felitti VJ, Kendrick JS. Unintended pregnancy among adult women exposed to abuse or household dysfunction during their childhood. Journal of the American Medical Association, 1999;282:1359–1364.
Special Populations
Children of Alcoholics
Anda RF, Whitfield CL, Felitti VJ, Chapman D, Edwards VJ, Dube SR, Williamson DF. Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatric Services, 2002;53(8):1001–1009.
Dube SR, Anda RF, Felitti VJ, Croft JB, Edwards VJ, Giles WH. Growing up with Parental alcohol abuse: Exposure to Childhood Abuse, Neglect and Household Dysfunction. Child Abuse and Neglect, 2001;25(12):1627–1640.
Child Sexual Abuse Victims
Dong M, Anda RF, Felitti VJ, Dube SR, Giles WH. The Relationship of Exposure to Childhood Sexual Abuse to Other Forms of Abuse, Neglect and Household Dysfunction during Childhood. Child Abuse and Neglect, 2003;27(6):625–639.
Dube SR, Anda RF, Whitfield, CL, Brown DW, Felitti VJ, Dong M, Giles WH. Long-Term Consequences of Childhood Sexual Abuse by Gender of Victim . American Journal of Preventive Medicine. 2005;28:430–438.
Veterans
Cabrera OA, Hoge CW, Bliese PD, Castro CA, Messer SC. Childhood Adversity and Combat as Predictors of Depression and Post-Traumatic Stress in Deployed Troops Am J Prev Med 2007;33(2):77–82
Robinson R, Davis JD, Krueger M, Gore K, Freed MC, Kuesters P, Dube S, Engel CC. Acceptability of Adverse Childhood Experiences Questions for Health Surveillance in U.S. Armed Forces. Military Medicine. 2008; 173, 9:853
Victimization and Perpetration
Whitfield CL, Anda RF, Dube SR, Felitti VJ. Violent Childhood Experiences and the Risk of Intimate Partner Violence in Adults: Assessment in a Large Health Maintenance Organization. Journal of Interpersonal Violence, 2003;18(2):166–185.
Dube SR, Anda RF, Felitti VJ, Edwards VJ, Williamson DF. Exposure to abuse, neglect and household dysfunction among adults who witnessed intimate partner violence as children. Violence and Victims, 2002:17(1):3–17.
Anda, RF, Felitti, VJ, Brown, DW, Chapman, D, Dong, M, Dube, SR, Edwards, VJ, Giles, WH. (2006) Insights Into Intimate Partner Violence From the Adverse Childhood Experiences (ACE) Study. In PR Salber and E Taliaferro, eds. The Physician’s Guide to Intimate Partner Violence and Abuse, Volcano, CA: Volcano Press; 2006.
Other Health and Social Issues
Prescription Drug Use
Anda RF, Brown DW, Felitti VJ, Dube SR, Giles WH. Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients. BMC Public Health. 2008 Jun 4;8:198.
Residential Mobility
Dong M, Anda RF, Felitti VJ, Williamson DF, Dube SR, Brown DW, Giles WH. Childhood residential mobility and multiple health risks during adolescence and adulthood: the hidden role of adverse childhood experiences. Archives of Pediatrics and Adolescent Medicine.2005;159:1104-1110.
Premature death of family members
Anda RF, Dong M, Brown DW, Felitti VJ, Giles WH, Perry GS, Edwards VJ, Dube SR. The relationship of adverse childhood experiences to a history of premature death of family members. BMC Public Health 2009; 9:106.
Homelessness
Hernmani DB, Slusser ES, Struleninig EL, Link BL. Adverse Childhood Experiences: Are They Risk Factors for Adult Homelessness? American Journal of Public Health February 1997, Vol. 87, No. 2
Reports
Anda RF, Brown DW Adverse Childhood Experiences and Population Health in Washington: The Face of a Chronic Public Health Disaster Results from the 2009 Behavioral Risk Factor Surveillance System (BRFSS)July 2, 2010
Anda RF, Brown DW. Adverse Childhood Experiences and Population Health in Washington: The Face of a Chronic Public Health Disaster: Results from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) Executive Summary and Selected Policy Excerpts. Prepared for the Washington State Family Policy Council. July 2, 2010
These links need organizing but may still be worth examining!
Commentary
Whitfield CL. Adverse Childhood Experiences and Trauma (editorial). American Journal of Preventive Medicine, 1998;14:361–363.
Anda RF, Butchart A, Felitti VJ, Brown DW. Building a Framework for GlobalSurveillance of the Public Health: Implications of Adverse Childhood Experiences
Preventive Medicine, 2010: 39 (1)93-98
Anda RF, Brown DW. Root causes and organic budgeting: funding health from conception to the grave Editorial Pediatric Health (2007) 1(2), 141-143
Weiss JS, Wagner SH. What explains the negative consequences of adverse childhood experiences on adult health? Insights from cognitive and neuroscience research (editorial). American Journal of Preventive Medicine, 1998;14:356–360.
Edwards, VJ, Dube SR, Felitti VJ, Anda RF. It’s OK to ask about past abuse. American Psychologist. 2007 62(4):327–328.
Overview
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study.
American Journal of Preventive Medicine 1998;14:245–258.
Felitti VJ, Anda RF; The Relationship of Adverse Childhood Experiences to Adult Health, Well-being, Social Function, and Healthcare : Lanius/Vermetten/Pain Cambridge University Press, 2010
Felitti VJ. The Relationship of Adverse Childhood Experiences to Adult Health; Turning Gold into Lead *English translation of: Felitti VJ. Belastungen in der Kindheit und Gesundheit im Erwachsenenalter: die Verwandlung von Gold in Blei. Z psychsom Med Psychother 2002; 48(4): 359-369.
Middlebrooks JS, Audage NC.The Effects of Childhood Stress on Health Across the Lifespan. U.S. Department of Health and Human Services Centers for Disease Control and Prevention.
Chronic Disease
Dube SR, Felitti VJ, Dong M, Giles WH, Anda RF. The Impact of Adverse Childhood Experiences on Health Problems: Evidence from Four Birth Cohorts Dating Back to 1900. Preventive Medicine, 2003;37(3):268–277.
Dube SR, Cook ML, Edwards VJ. Health-Related Outcomes of Adverse Childhood Experiences in Texas 2002 Preventing Chronic Disease: Public Health Research, Practice, and Policy Volume 7: NO. 3 May 2010
Autoimmune Disease
Dube SR, Fairweather D, Pearson WS, Felitti VJ, Anda RF, Croft JB. Cumulative childhood stress and autoimmune disease. Psychom Med. 2009;71, 243-250.
Health-Related Quality of Life
Corso, PS, Edwards, VJ, Fang, X, Mercy, JA.. Health-related quality of life among adults who experienced maltreatment during childhood. Am J Public Health, 2008;98:1094-1100.
Ischemic Heart Disease
Dong M, Giles WH, Felitti VJ, Dube, SR, Williams JE, Chapman DP, Anda RF. Insights into causal pathways for ischemic heart disease: Adverse Childhood Experiences Study. Circulation, 2004;110:1761–1766.
Liver Disease
Dong M, Anda RF, Dube SR, Felitti VJ, Giles WH. Adverse Childhood Experiences and Self- reported Liver Disease: New Insights into a Causal Pathway. Archives of Internal Medicine, 2003;163:1949–1956.
Chronic Obstructive Pulmonary Disease
Lung Cancer
Brown DW, Anda RF, Felitti VJ, Edwards VJ, Malarcher AM, Croft JB, Giles WH. Adverse Childhood Experiences and the Risk of Lung Cancer. BMC Public Health. 2010;10:20.
Frequent Headaches
Anda RF, MS, Tietjen G, Schulman E, Felitti VJ, Croft J. Adverse Childhood Experiences and Frequent Headaches in Adults. Headache2010; 50: 1473-1481.
Early Death
Brown DW, Anda RF, Tiemeier H, Felitti VJ, Edwards VJ, Croft JB, Giles WH. Adverse Childhood Experiences and the Risk of Premature Mortality American Journal of Preventive Medicine, Volume xx, Number x
Health Risks
Alcohol Abuse
Anda RF, Whitfield CL, Felitti VJ, Chapman D, Edwards VJ, Dube SR, Williamson DF. Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatric Services, 2002;53(8):1001–1009.
Felitti VJ. The Origins of Addiction: Evidence from the Adverse Childhood Experiences Study English version of the article published in Germany as: Felitti VJ. Ursprünge des Suchtverhaltens – Evidenzen aus einer Studie zu belastenden Kindheitserfahrungen. Praxis der Kinderpsychologie und Kinderpsychiatrie, 2003; 52:547-559.
Dube SR, Anda RF, Felitti VJ, Croft JB, Edwards VJ, Giles WH. Growing up with Parental alcohol abuse: Exposure to Childhood Abuse, Neglect and Household Dysfunction. Child Abuse and Neglect, 2001;25(12):1627–1640.
Drug Abuse
Dube SR, Felitti VJ, Dong M, Chapman DP, Giles WH, Anda RF. Childhood Abuse, Neglect and Household Dysfunction and the Risk of Illicit Drug Use: The Adverse Childhood Experience Study. Pediatrics, 2003;111(3):564–572.
Obesity
Williamson DF, Thompson, TJ, Anda, RF,. Dietz, WH, Felitti VJ. Body Weight, Obesity, and Self-Reported Abuse in Childhood. International Journal of Obesity, 2002;26:1075–1082.
Felitti VJ. Letters to the Editor. The Permanente Journal/ Fall 2010/ Volume 14 No. 3
Felitti VJ, Jakstis K, Pepper V, Ray A. Obesity: Problem, Solution, or Both? The Permanente Journal/ Spring 2010/ Volume 14 No. 1
Sexual Risk Behavior
Hillis SD, Anda RF, Felitti VJ, Marchbanks PA. Adverse childhood experiences and sexual risk behaviors in women: a retrospective cohort study. Family Planning Perspectives, 2001;33:206–211.
Smoking
Edwards, VJ, Anda RF, Gu D, Dube, S R, Felitti, VJ. Adverse childhood experiences and smoking persistence in adults with smoking-related symptoms and illness*. Permanente Journal 2007;11:5–7.
Anda RF, Croft JB, Felitti VJ, Nordenberg D, Giles WH, Williamson DF, Giovino GA. Adverse childhood experiences and smoking during adolescence and adulthood. Journal of the American Medical Association, 1999; 282:1652–1658.
Mental Health
Edwards VJ, Holden GW, Felitti VJ, Anda RF. Relationship Between Multiple Forms of Childhood Maltreatment and Adult Mental Health in Community Respondents: Results From the Adverse Childhood Experiences Study Am J Psychiatry 160:8, August 2003 1453- 1460
Cabrera OA, Hoge CW, Bliese PD, Castro CA, Messer SC. Childhood Adversity and Combat as Predictors of Depression and Post-Traumatic Stress in Deployed Troops Am J Prev Med 2007;33(2):77–82
Chapman DP, Dube SR, Anda RF. Adverse childhood events as risk factors for negative mental health outcomes. Psych Annals
Depression/Depressed Affect
Chapman DP, Anda RF, Felitti VJ, Dube SR, Edwards VJ, Whitfield CL. Epidemiology of Adverse Childhood Experiences and Depressive Disorders In a Large Health Maintenance Organization Population. Journal of Affective Disorders, 2004;82:217–225.
Anda RF, Whitfield CL, Felitti VJ, Chapman D, Edwards VJ, Dube SR, Williamson DF. Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatric Services, 2002;53(8):1001–1009.
Edwards VJ, Holden GW, Felitti VJ, Anda RF. Relationship Between Multiple Forms of Childhood Maltreatment and Adult Mental Health in Community Respondents: Results From the Adverse Childhood Experiences Study Am J Psychiatry 160:8, August 2003 1453- 1460
Hallucinations
Whitfield CL, Dube SR, Felitti VJ, Anda RF. Adverse childhood experiences and hallucinations. Child Abuse and Neglect. 2005;29(7):797-810.
Psychosis
Read J, Fink PJ, Rudegeair T, Felitti V, Whitfield CL. Child Maltreatment and Psychosis: A Return to a Genuinely Integrated Bio-Psycho-Social Model. Clinical Schizophrenia & Related Psychoses October 2008; 235-254.
Neurobiology
Anda RF, Felitti VJ, Walker J, Whitfield, CL, Bremner JD, Perry BD, Dube SR, Giles WH. The enduring effects of abuse and related adverse experiences in childhood: a convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neurosciences 2006; 56(3):174–86.
Weiss JS, Wagner SH. What explains the negative consequences of adverse childhood experiences on adult health? Insights from cognitive and neuroscience research (editorial). American Journal of Preventive Medicine, 1998;14:356–360.
Suicidality
Dube SR, Anda RF, Felitti VJ, Chapman D, Williamson DF, Giles WH. Childhood abuse, household dysfunction and the risk of attempted suicide throughout the life span: Findings from Adverse Childhood Experiences Study. JAMA 2001;286:3089–3096.
Work Absenteeism
Anda RF, Felitti VJ, Fleisher VI, Edwards VJ, Whitfield CL, Dube SR, Williamson DF. Childhood Abuse, Household Dysfunction and Indicators of Impaired Worker Performance in Adulthood. The Permanente Journal, 2004;8(1):30–38.
Methodological Issues
Age Cohort Differences
Dube SR, Felitti VJ, Dong M, Giles WH, Anda RF. The Impact of Adverse Childhood Experiences on Health Problems: Evidence from Four Birth Cohorts Dating Back to 1900. Preventive Medicine, 2003;37(3):268–277.
Assessment of Mediating Pathways
Anda RF, Felitti VJ, Fleisher VI, Edwards VJ, Whitfield CL, Dube SR, Williamson DF. Childhood Abuse, Household Dysfunction and Indicators of Impaired Worker Performance in Adulthood. The Permanente Journal, 2004;8(1):30–38.
Dong M, Giles WH, Felitti VJ, Dube, SR, Williams JE, Chapman DP, Anda RF. Insights into causal pathways for ischemic heart disease: Adverse Childhood Experiences Study. Circulation, 2004;110:1761–1766.
Anda RF, Chapman DP, Felitti VJ, Edwards V, Williamson DF, Croft JP, Giles WH. Adverse Childhood Experiences and Risk of Paternity in Teen Pregnancy. Obstetrics and Gynecology, 2002;100(1):37–45.
Dube SR, Anda RF, Felitti VJ, Chapman D, Williamson DF, Giles WH. Childhood abuse, household dysfunction and the risk of attempted suicide throughout the life span: Findings from Adverse Childhood Experiences Study. JAMA 2001;286:3089–3096.
Basis for Ace Score
Dong M, Anda RF, Felitti, VJ, Dube SR, Williamson DF, Thompson TJ, Loo CM. Giles WH. . The Interrelatedness of Multiple Forms of Childhood Abuse, Neglect, and Household Dysfunction. Child Abuse and Neglect, 2004;28(7):771–784.
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study.
American Journal of Preventive Medicine 1998;14:245–258.
Bias Assessment (under construction)
Consistency by Birth Cohort
Dube SR, Felitti VJ, Dong M, Giles WH, Anda RF. The Impact of Adverse Childhood Experiences on Health Problems: Evidence from Four Birth Cohorts Dating Back to 1900. Preventive Medicine, 2003;37(3):268–277.
Interrelation of ACEs
Dong M, Anda RF, Felitti VJ, Duba SR, Williamson DF, Thompson TJ, Looa CM, Giles WH. The interrelatedness of multiple forms of childhood abuse,neglect, and household dysfunction Child Abuse & Neglect 28 (2004) 771–784
Dube SR, Anda RF, Felitti VJ, Croft JB, Edwards VJ, Giles WH. Growing up with Parental alcohol abuse: Exposure to Childhood Abuse, Neglect and Household Dysfunction. Child Abuse and Neglect, 2001;25(12):1627–1640.
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. American Journal of Preventive Medicine 1998;14:245–258.
Dong M, Anda RF, Felitti VJ, Dube SR, Giles WH. The Relationship of Exposure to Childhood Sexual Abuse to Other Forms of Abuse, Neglect and Household Dysfunction during Childhood. Child Abuse and Neglect, 2003;27(6):625–639.
Severity Frequency of Violent Experience
Anda RF, Felitti VJ, Chapman DP, Croft JB, et al. Abused boys, battered mothers, and male involvement in teen pregnancy. Pediatrics, 2001;107(2):e19.
Test-Retest Reliability (under construction)
Reproductive Health/Sexual Behavior
Fetal Death
Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Marks JS. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial outcomes, and fetal death. Pediatrics. 2004; 113(2):320-327.
Promiscuity
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study.
American Journal of Preventive Medicine 1998;14:245–258.
Sexual Risk Behaviors in Women
Hillis SD, Anda RF, Felitti VJ, Nordenberg D, Marchbanks PA. Adverse childhood experiences and sexual risk behaviors in women: a retrospective study. Family Planning Perspectives, 2001; 33:206-211
Sexually Transmitted Diseases
Hillis SD, Anda RF, Felitti VJ, Nordenberg D, Marchbanks PA. Adverse childhood experiences and sexually transmitted diseases in men and women: a retrospective study. Pediatrics, 2000;106(1):E11.
Teen Pregnancy
Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Marks JS. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial outcomes, and fetal death. Pediatrics. 2004; 113(2):320-327.
Anda RF, Chapman DP, Felitti VJ, Edwards V, Williamson DF, Croft JP, Giles WH. Adverse Childhood Experiences and Risk of Paternity in Teen Pregnancy. Obstetrics and Gynecology, 2002;100(1):37–45.
Anda RF, Felitti VJ, Chapman DP, Croft JB, et al. Abused boys, battered mothers, and male involvement in teen pregnancy. Pediatrics, 2001;107(2):e19.
Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Macaluso M, Marks JS. TheProtective Effect of Family Strengths in Childhood against Adolescent Pregnancy and Its Long-Term Psychosocial Consequences. Permanente Journal 2010; 14: 18-27.
Unintended Pregnancy
Dietz PM, Spitz AM, Anda RF, Williamson DF, McMahon PM, Santelli JS, Nordenberg DF, Felitti VJ, Kendrick JS. Unintended pregnancy among adult women exposed to abuse or household dysfunction during their childhood. Journal of the American Medical Association, 1999;282:1359–1364.
Special Populations
Children of Alcoholics
Anda RF, Whitfield CL, Felitti VJ, Chapman D, Edwards VJ, Dube SR, Williamson DF. Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatric Services, 2002;53(8):1001–1009.
Dube SR, Anda RF, Felitti VJ, Croft JB, Edwards VJ, Giles WH. Growing up with Parental alcohol abuse: Exposure to Childhood Abuse, Neglect and Household Dysfunction. Child Abuse and Neglect, 2001;25(12):1627–1640.
Child Sexual Abuse Victims
Dong M, Anda RF, Felitti VJ, Dube SR, Giles WH. The Relationship of Exposure to Childhood Sexual Abuse to Other Forms of Abuse, Neglect and Household Dysfunction during Childhood. Child Abuse and Neglect, 2003;27(6):625–639.
Dube SR, Anda RF, Whitfield, CL, Brown DW, Felitti VJ, Dong M, Giles WH. Long-Term Consequences of Childhood Sexual Abuse by Gender of Victim . American Journal of Preventive Medicine. 2005;28:430–438.
Veterans
Cabrera OA, Hoge CW, Bliese PD, Castro CA, Messer SC. Childhood Adversity and Combat as Predictors of Depression and Post-Traumatic Stress in Deployed Troops Am J Prev Med 2007;33(2):77–82
Robinson R, Davis JD, Krueger M, Gore K, Freed MC, Kuesters P, Dube S, Engel CC. Acceptability of Adverse Childhood Experiences Questions for Health Surveillance in U.S. Armed Forces. Military Medicine. 2008; 173, 9:853
Victimization and Perpetration
Whitfield CL, Anda RF, Dube SR, Felitti VJ. Violent Childhood Experiences and the Risk of Intimate Partner Violence in Adults: Assessment in a Large Health Maintenance Organization. Journal of Interpersonal Violence, 2003;18(2):166–185.
Dube SR, Anda RF, Felitti VJ, Edwards VJ, Williamson DF. Exposure to abuse, neglect and household dysfunction among adults who witnessed intimate partner violence as children. Violence and Victims, 2002:17(1):3–17.
Anda, RF, Felitti, VJ, Brown, DW, Chapman, D, Dong, M, Dube, SR, Edwards, VJ, Giles, WH. (2006) Insights Into Intimate Partner Violence From the Adverse Childhood Experiences (ACE) Study. In PR Salber and E Taliaferro, eds. The Physician’s Guide to Intimate Partner Violence and Abuse, Volcano, CA: Volcano Press; 2006.
Other Health and Social Issues
Prescription Drug Use
Anda RF, Brown DW, Felitti VJ, Dube SR, Giles WH. Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients. BMC Public Health. 2008 Jun 4;8:198.
Residential Mobility
Dong M, Anda RF, Felitti VJ, Williamson DF, Dube SR, Brown DW, Giles WH. Childhood residential mobility and multiple health risks during adolescence and adulthood: the hidden role of adverse childhood experiences. Archives of Pediatrics and Adolescent Medicine.2005;159:1104-1110.
Premature death of family members
Anda RF, Dong M, Brown DW, Felitti VJ, Giles WH, Perry GS, Edwards VJ, Dube SR. The relationship of adverse childhood experiences to a history of premature death of family members. BMC Public Health 2009; 9:106.
Homelessness
Hernmani DB, Slusser ES, Struleninig EL, Link BL. Adverse Childhood Experiences: Are They Risk Factors for Adult Homelessness? American Journal of Public Health February 1997, Vol. 87, No. 2
Reports
Anda RF, Brown DW Adverse Childhood Experiences and Population Health in Washington: The Face of a Chronic Public Health Disaster Results from the 2009 Behavioral Risk Factor Surveillance System (BRFSS)July 2, 2010
Anda RF, Brown DW. Adverse Childhood Experiences and Population Health in Washington: The Face of a Chronic Public Health Disaster: Results from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) Executive Summary and Selected Policy Excerpts. Prepared for the Washington State Family Policy Council. July 2, 2010