The Adverse Childhood Experiences (ACE) Study

Between 1995 to 1997, over 17,000 patients in USA undergoing physical examinations completed surveys about their childhood experiences as well as current health status and behaviours. For the purpose of the study, the term 'adverse childhood experiences' was used to refer to all types of abuse, neglect and other traumatic experiences experienced by an individual before the age of 18. There are 10 types of childhood trauma measured in the ACE Study. Five are personal — physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect. The other five types relate to other family members: a parent who is an alcoholic, a mother who is a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. So a person who had been physically abused, had one alcoholic parent, and a mother who was beaten up would have an ACE score of three.


If you are interested to find out what your ACE score is, you can fill in a copy of the questionnaire used in the study.

Results of the Study

The following infographic (obtained from the United States Centers for Disease Control and Prevention website) shows the distribution of ACE scores and breakdown of various adverse childhood experiences that were reported by respondents.

ACE study results - EMDR Clinic in Melbourne

As can be seen above, there was an alarmingly high percentage of sexual and physical abuse reported by the patients. About a fifth of the respondents had parents with a mental illness, and around a quarter of respondents had parents with a substance addiction and/or experienced parental separation. However, what is more startling are the long-term effects of these adverse childhood experiences on the health and behaviours of the respondents.  


There were dramatic links found between traumatic childhood experiences and risky behaviours, psychological issues, physical illness and the leading causes of death! What the results suggested was that as the ACE score moves up from 0 to 4, there is an increase (multiplier effect) in the following:


  • Suicide attempts (those with ACE score of 4 were 12 times more likely to attempt suicide than those with score of 0)
  • Alcoholism (those with ACE score of 4 were 7.4 times more likely to become alcoholic than those with score of 0)
  • Missed work (those with ACE score of 4 were 5.5 times more likely to miss work than those with score of 0)
  • Depression (those with ACE score of 4 were 4.6 times more likely to become depressed than those with score of 0)
  • Drug use (those with ACE score of 4 were 4.7 times more likely to use illicit drugs than those with score of 0)
  • Chronic obstructive pulmonary disease (those with ACE score of 4 were 3.9 times more likely to have COPD than those with score of 0)
  • Heart disease (those with ACE score of 4 were 2.2 times more likely to have heart disease than those with score of 0)
  • Cancer (those with ACE score of 4 were almost 2 times more likely to have cancer than those with score of 0)
  • Smoking (those with ACE score of 4 were 2.2 times more likely to smoke than those with score of 0)


People with an ACE score of 6 or more were found to die 20 years earlier on average than those with score of 0. 


While the above results found in the study are already significant, the researchers found that when they interviewed patients in other locations, the ACE scores reported were actually found to be higher than in the study! Dr Rob Anda (one of the researchers) highlights this in the video below. 

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The Centers for Disease Control and Prevention (CDC) estimates that the lifetime economic costs associated with child maltreatment stand at $124 billion! So just imagine the amount that could be saved if childhood trauma could be prevented...