A 10-question assessment can tell you whether traumatic childhood events could affect your health as an adult. (Photo: Getty Images)
Thirty nine percent of Americans believe that they have had one or more childhood experiences that have harmed their health as adults, according to a recent poll from NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health
And those who think this way are probably correct.
Beginning in the 1980’s, Dr. Vincent Felittibegan studying how childhood experiences might affect and predict undesirable health outcomes in adults. Ultimately, Felatti and his eventual research partner, Dr. Rob Anda, developed what is now known as the ACE (or Adverse Childhood Experiences) test, a 10-question quiz whose results can serve as a predictive model for anticipating health issues in adults — ranging from obesity to thyroid disease to cancer.
The questions, which are listed below, mainly focus on issues of abuse and neglect, and can be hard to read. But the test has been validated to predict the outcome of your childhood on your health as an adult — so if you’re curious, keep reading.
You can score your test by assigning one point for each affirmative answer. The higher your score, the more likely you are to see an impact on your physical health as an adult.
Take the ACE test and read on to see what your score means.
- Before your 18th birthday, did a parent or other adult in the household often or very often swear at your, put you down, or humiliate you? OR act in a way that made you afraid that you might be physically hurt?
- Before your 18th birthday, 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?
- Before your 18th birthday, did an adult or person at least five year 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?
- Before your 18th birthday, 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?
- Before your 18th birthday, 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?
- Before your 18th birthday, was a biological parent ever lost to you through divorce, abandonment, or other reason?
- Before your 18th birthday, 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 over at least a few minutes or threatened with a gun or knife?
- Before your 18th birthday, did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
- Before your 18th birthday, was a household member depressed or mentally ill, or did a household member attempt suicide?
- Before your 18th birthday, did a household member go to prison?
Research shows that adults who had an ACE score above 4 were twice as likely to have heart disease as adults who had scores of 0; women with an ACE score of 5 or higher were four times more likely to experience depression than their peers who had a score of 0.
It does not stop there: Elevated ACE scores have been shown to significantly increase the risk of alcoholism, chronic obstructive pulmonary disease (COPD), depression, fetal death, illicit drug use, ischemic heart disease (IHD), liver disease, risk for intimate partner violence, multiple sexual partners, sexually transmitted diseases, smoking, suicide attempts, unintended pregnancies, early initiation of smoking, early initiation of sexual activity, and adolescent pregnancy, according to the Centers for Disease Control and Prevention (CDC).
The correlation between childhood events and adult outcomes is not surprising, says Art Markman, PhD, a psychologist at the University of Texas. “Significant trauma in childhood can have lasting effects in part because children are still learning about the way the world works,” he says, “Children have to be trusting of adults, because that is the only way that they can learn. When children experience negative events associated with the adults in their lives, it creates long-term stress, because they come to believe that is the way the world works. In addition, because the memories people have of their early and middle childhood are often fragmented, they may not remember a lot of the details of the trauma. So they are left with a lasting anxiety without a clear memory of the source. That can make it difficult to treat the anxiety and reduce its severity.”
Furthermore, he notes, long-term stress, such as that caused by lingering childhood difficulties, “depresses long-term immune system function, so people with long-term stress are more prone to illness than those not suffering from long-term stress. Second, people often engage in dangerous or risky behaviors when suffering from stress, which can lead to drug use, obesity, and risky sexual behavior,” just as the CDC findings show.
For many individuals, though, childhood may not have included events as obviously damaging as sexual or physical abuse, but may have been difficult in more subtle, nuanced ways.
Markman comments that in such cases, while “smaller negative events may not create posttraumatic stress disorder,” they still absolutely influence and impact the kinds of behaviors and relationships that person forms as an adult. For example, he says, “a child who learns to please a parent who is often uninvolved with the family may carry that people-pleasing tendency into his or her adult relationships. That is one reason why many therapists focus on childhood when helping adults to change the dynamics of their adult relationships.”
And it is certainly important to not overlook the ability of children and adults to build from and learn from difficult experiences. As Jack Shonkoff, MD, a pediatrician and director of the Center on the Developing Child at Harvard University, told NPR, “There are people with high ACE scores who do remarkably well,” adding that ACE scores do not take into account resilience learned as a result of such experiences.
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