Using the ACE to Determine Abuse
Was it abuse? Was it really that bad? I don't know. Other people had it way worse than I did. My parents were doing the best they could. These are common sentiments in people who experienced maltreatment in childhood. These people, as adults, are more likely to doubt their experiences; this tendency toward self doubt is a consequence of the abuse.
The Adverse Childhood Experiences Study (ACE) assesses the association between childhood mistreatment and later health and wellbeing. This tool can be used to help validate and quantify survivor's experiences as certain experiences have measurable results.
Finding your ACE score is as simple as adding up your answers to the following questions (count one for each item you answer 'yes' to). I have highlighted several items to stress the fact that these relatively common issues are a big deal- they can and do have lasting (lifelong) impacts on our health and wellbeing. Be gentle on yourself as this can be hard.
While you were growing up, during your first 18 years of life:
1. Did a parent or other adult in the household often or very often swear at you, insult you, put you down, or humiliate you? OR Act in a way that made you afraid that you might be physically hurt?
2. Did a parent or other adult in the household often or very often push, grab, slap, or throw something at you? OR Ever hit you so hard that you had marks or were injured?
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? OR Attempt or actually have oral, anal, or vaginal intercourse with you?
4. Did you often or very often feel that no one in your family loved you or thought you were important or special? OR Your family didn't look out for each other, feel close to each other, or support each other?
5. Did you often or very often feel that you didn't have enough to eat, had to wear dirty clothes, and had no one to protect you? OR Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
6. Were your parents ever separated or divorced?
7. Was your mother or stepmother often or very often pushed, grabbed, slapped, or had something thrown at her? OR Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? OR Ever repeatedly hit at least a few minutes or threatened with a gun or knife?
--> Note: this item can apply to caregivers of all genders, though women and femmes are more likely to experience intimate partner violence (abuse from a partner or spouse).
8. Did you live with anyone who was a problem drinker or an alcoholic or who used street drugs?
--> Note: alcoholic is not a clinical term (I'll compose a separate piece of alcohol use disorder in the future as misusing alcohol and other drugs is common in trauma survivors), however, you get the gist of the item... We can see how mis-using legal substances (versus "street drugs"), such as prescription medication, could have a similar impact...
9. Was a household member depressed or mentally ill or did a household member attempt suicide?
10. Did a household member go to prison?
--> Note: we can see how a household member getting arrested and going to jail or having ongoing legal issues can have a similar impact (people with more financial resources are better able to access effective legal help and thus less likely to have to go to jail or prison).
Take a breath. What it was like to complete the questionnaire? This can be hard but it can also be empowering. Consider this. Research shows that a score of 4 or more indicate a higher than average likelihood of negative health outcomes.
For example, those of us who experienced 4 or more of the items above...
- are significantly (80%) more likely to have at least one psychiatric disorder (such as anxiety, depression, PTSD, and disordered eating) by age 21
- are significantly more likely to develop attention and memory problems
- are significantly more likely to engage in "high risk" sexual behavior, which can result in unwanted pregnancy, sexually transmitted infections, sexual assault, and trauma
- are significantly more likely to experience medical problems (such as improper brain development, heart, lung, and liver disease, cancer, high blood pressure, high cholesterol, and bone fractures)
- are significantly (12 times) more likely to attempt suicide
That's the tough truth. The good news is, much of this is treatable and we can stop the cycle from being passed down. Our quality of life can improve and we can feel better than ever as we progress in our recovery. Our recovery begins once we recognize just how hard things have been and begin to express our truth and give ourselves the support we deserve.
I work with these issues day in and day out. It is my privilege to walk alongside my clients on this path of healing. Counseling is a place to dispel the shame of the past and unlock new levels of health and wellbeing. You can do this. Send me a message if you want to talk.