Evidence for Revising the Adverse Childhood Experiences Screening Tool: a Scoping Review

SmithBattle, Lee; Loman, Deborah G.; Yoo, Jee-Hye; Cibulka, Nancy J.; Rariden, Christina

doi:10.1007/s40653-021-00358-w

Cited by 21 publications

(11 citation statements)

References 58 publications

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“…In this sense, it is a welcome addition to the ACEs’ assessment portfolio. Additional to the importance of psychometric robustness, SmithBattle et al (2022) pointed to the importance of tools being easy-to-administer and interpret, whereas Bethell et al (2017) demonstrated that few existing tools include any aspect of timing or impact of adversity. We believe that these are important considerations as it has been recently demonstrated that although, at a population level, the number of ACEs reported was negatively related to mental and physical health, this relationship did not hold at the level of the individual (Baldwin et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…As this was a feasibility study in a small cohort, we would be reluctant to suggest that the present results are a sound basis for the reduction of numbers of SITA items. Although SmithBattle et al (2022) stress the importance of ease-of-completion of ACEs tools, a larger sample(s) will be required to justify the dropping of items. For example, a visual inspection of the Supplemental Materials suggests that (for example) parental incarceration and the lack of provision of regular meals were not particularly relevant in this sample.…”

Section: Discussionmentioning

confidence: 99%

“…The number and extent of adversities being assessed have increased over the years (Bethell et al, 2017; Cronholm et al, 2015; Felitti et al, 1998) and a recent scoping review of ACE screening tools (SmithBattle et al, 2022) supported the expansion of these to include a wider range of adversities, particularly beyond family and household adversities. However, and of note, these authors also stressed the need for screening tools that are brief, and easy-to-complete, if they are to be clinically useful and acceptable to patients.…”

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confidence: 99%

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The Subjective Impact and Timing of Adversity Scale: A Feasibility Study Using Cross-Sectional and Longitudinal Data

McKay¹,

Healy²,

Chambers

et al. 2022

Assessment

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This study assessed the feasibility of a multi-domain measure of the occurrence, impact, and timing of childhood/adolescent psychological adversity exposure, the Subjective Impact and Timing of Adversity Scale (SITA). Participants were from among those who had previously participated in two waves of data collection when aged approximately 14 and 21 years. Internal consistency estimates at both online and interview stages were acceptable for all SITA domains (with the exception of parental loss). SITA domain scores correlated meaningfully with scores on other scales and psychological measures, supporting convergent validity. Those with lifetime psychiatric diagnoses scored significantly higher on SITA domains than those not meeting diagnostic threshold. There was evidence of the importance of both the subjective impact and timing of adversity with regard to psychiatric diagnoses. The study demonstrates the viability of the SITA; however, further studies are required to substantiate these findings in larger samples.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The Subjective Impact and Timing of Adversity Scale: A Feasibility Study Using Cross-Sectional and Longitudinal Data

McKay¹,

Healy²,

Chambers

et al. 2022

Assessment

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“…We mapped responses to eight statements corresponding to exposure to E-ACEs (the ninth, You have been separated from your primary caregiver through deportation or immigration , was not assessed in this survey). We included a ninth item assessing exposure to poverty , as evidence has supported including this stressor among E-ACEs (SmithBattle et al, 2022). Cumulative ACEs were measured separately using a count variable for a total number of T-ACEs (range 0–10) and E-ACEs (range 0–9).…”

Section: Methodsmentioning

confidence: 99%

“…Of those available, some studies have found Black and Latinx individuals to be at greater risk for alcohol use and misuse compared to White individuals (Fagan & Novak, 2018; Lee & Chen, 2017) while others did not find associations between ACEs and alcohol use in any group (Garrido et al, 2018; Jones et al, 2022). However, most ACE studies fail to capture community-level adversities that predominantly occur among racial/ethnic minorities (SmithBattle et al, 2022) and that are also linked to poor outcomes and substance use disorders (Hall et al, 2021; Wade et al, 2016). These expanded ACEs (E-ACEs) include experiencing racism, violence, poverty, bullying, and history of living in foster care (Wade et al, 2014).…”

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confidence: 99%

Adverse childhood experiences and alcohol use and misuse: Testing the impact of traditional and expanded adverse childhood experiences among racially/ethnically diverse youth transitioning into adulthood.

Zhen‐Duan¹,

Colombo²,

Cruz-Gonzalez³

et al. 2023

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective: Traditional adverse childhood experiences (T-ACEs), such as abuse and neglect, have been associated with an increased risk of youth alcohol use and misuse. This study aims to compare associations of T-ACEs and expanded ACEs (E-ACEs), an expanded set of ACEs that encompass community-level adversities, with alcohol use and misuse by race/ethnicity. Method: Data came from a three-wave (1998-1999, 1999-2000, 2004-2005) community-based study in Houston, including youth transitioning into adulthood. We compared associations between ACEs at Wave 1 and past-year alcohol use, abuse, and dependence at Wave 3. Results: Participants (2,391) included White (908), Black (898), and Latinx ( 585) youth (M [SD] = 14.00 [2.04]) transitioning into young adulthood (M [SD] = 19.77 [2.34]). T-ACEs were associated with higher odds of alcohol use, abuse, and dependence (OR = 1.15, 1.18, 1.24, respectively) while E-ACEs increased the odds of alcohol dependence (OR = 1.23) in the total sample. No significant differences by race/ethnicity were found. Racial/ethnic differences in increased alcohol risk were observed for some ACE items, such as bullying and use for Latinx youth (OR = 2.13) and poverty and dependence for White youth (OR = 2.01). Conclusions: T-ACEs and E-ACEs increase the risk of alcohol use and misuse. Results highlight the importance of preventing ACE exposure as a risk factor for youth alcohol use and misuse. Public policies must also focus on preventing ACEs through multilevel interventions aimed at reducing violence, bullying, and financial instability. Clinical Impact StatementConsistent with previous studies, we found that the family-level ACEs traditionally studied in the literature are associated with youth alcohol use and misuse. Additionally, our findings suggest that an expanded set of ACEs encompassing adversities particularly relevant to socioeconomically and racially/ethnically diverse populations are also associated with alcohol misuse. Racial and ethnic differences in alcohol use risk were observed for specific E-ACEs. It is imperative we expand our understanding and measurement of ACEs to include those occurring outside of the family, such as neighborhood violence and discrimination, which can detrimentally impact youth's mental health.

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Prevalence and Risk Factors of Gang Membership in a Brazilian Birth Cohort

Bauer,

Martins,

Hammerton

et al. 2024

JAMA Netw Open

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ImportanceThere is no longitudinal evidence on risk factors for gang membership in low- and middle-income countries, despite organized crime groups posing major challenges, including high homicide rates in Latin America. Furthermore, adverse childhood experiences (ACEs) have been largely overlooked in gang-related research worldwide.ObjectivesTo examine the associations of ACEs up to 15 years of age with past-year gang membership at 18 years of age and to compare crime and criminal justice involvement between gang members and non–gang members.Design, Setting, and ParticipantsThis cohort study assessed children from the 1993 Pelotas (Brazil) Birth Cohort—an ongoing population-based, prospective study. Assessments were undertaken perinatally (1993) and when the children were ages 11 (2004), 15 (2008), 18 (2011), and 22 (2015) years. All children born in 1993 were eligible (N = 5265), and 5249 (99.7%) were enrolled at birth. The study sample (N = 3794 [72.1%]) included those with complete data on ACEs. Data analyses were conducted from February to August 2024.ExposuresTwelve ACEs were assessed up to 15 years of age via child self-report and/or maternal report, including physical neglect, physical abuse, emotional abuse, sexual abuse, domestic violence, maternal mental illness, parental divorce, ever being separated from parents, parental death, poverty, discrimination, and neighborhood fear. These experiences were examined using a single adversity approach, cumulative risk, and latent classes.Main Outcomes and MeasuresThe main outcome was past-year gang membership at 18 years of age, assessed via self-report and analyzed using multivariate imputation.ResultsOf 3794 participants, 1964 (51.8%) were female and 1830 (48.2%) were male, and 703 (18.5%) were Black, 2922 (77.0%) were White, and 169 (4.5%) were coded as “other” race or ethnicity (no additional details are available to further disaggregate the other category). On the basis of the imputed data, 1.6% (SE, 0.2 percentage points) of participants reported gang membership at 18 years of age. Physical abuse (odds ratio [OR], 2.76; 95% CI, 1.27-5.98), emotional abuse (OR, 2.76; 95% CI, 1.51-5.02), domestic violence (OR, 3.39; 95% CI, 1.77-6.48), parental divorce (OR, 2.04; 95% CI, 1.17-3.54), and separation from parents (OR, 3.13; 95% CI, 1.54-6.37) were associated with an increased risk of gang membership. A dose-response association was observed, with 4 or more ACEs increasing the risk (OR, 8.86; 95% CI, 2.24-35.08). In latent class analysis, the class with child maltreatment and household challenges was associated with a higher risk of gang membership than the low-adversities class (OR, 7.10; 95% CI, 2.37-21.28). There was no robust evidence that children exposed to household challenges and social risks were at increased risk of gang membership (OR, 2.28; 95% CI, 0.46-11.25).Conclusions and RelevanceIn this prospective cohort study, ACEs, particularly child maltreatment and family conflict, were associated with gang involvement when examined individually, cumulatively, and as clusters in a high-crime environment in Brazil. These findings underscore the value of integrating the ACE framework into gang-related research and the potential to reduce gang-related crime by reducing ACEs.

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Evidence for Revising the Adverse Childhood Experiences Screening Tool: a Scoping Review

Cited by 21 publications

References 58 publications

The Subjective Impact and Timing of Adversity Scale: A Feasibility Study Using Cross-Sectional and Longitudinal Data

The Subjective Impact and Timing of Adversity Scale: A Feasibility Study Using Cross-Sectional and Longitudinal Data

Adverse childhood experiences and alcohol use and misuse: Testing the impact of traditional and expanded adverse childhood experiences among racially/ethnically diverse youth transitioning into adulthood.

Prevalence and Risk Factors of Gang Membership in a Brazilian Birth Cohort

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