The DOI matches its Crossref record, with a small difference in title or year; 93 of the 97 references it cites were found in a registry or an index; 1 of the 49 sources its claims cite were checked for support.
Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults
Open accessAbstract
Background The relationship of health risk behavior and disease in adulthood to the breadth of exposure to childhood emotional, physical, or sexual abuse, and household dysfunction during childhood has not previously been described. Methods A questionnaire about adverse childhood experiences was mailed to 13,494 adults who had completed a standardized medical evaluation at a large HMO; 9,508 (70.5%) responded. Seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of these adverse childhood experiences was then compared to measures of adult risk behavior, health status, and disease. Logistic regression was used to adjust for effects of demographic factors on the association between the cumulative number of categories of childhood exposures (range: 0-7) and risk factors for the leading causes of death in adult life. Results More than half of respondents reported at least one, and one-fourth reported > or = 2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P or = 50 sexual intercourse partners, and sexually transmitted disease; and 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of…
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Claims the paper makes
50 Own result · 12 No full text of the sources · 12 Own interpretation · 10 Own method · 5 Not checked yet · 1 Partly supported · 1 Sources not found · accuracy not yet measured
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In the paper
“Longitudinal follow-up of adults whose childhood abuse was well documented has shown that their retrospective reports of childhood abuse are likely to under-estimate actual occurrence.47,48”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
What the sources say
- Partly supportedcites [47] Femina, 1990, Child abuse, Child Abuse Negl sourceExperimental — accuracy not yet measured
The Results report that eight adults with well-documented abuse in their adolescent records denied it at follow-up, and the Discussion says retrospective inaccuracies in this sample were in the direction of under-reporting. The paper limits that finding to a small sample of former delinquents and says its generalizability is uncertain; the claim does not retain that population qualifier. (LLM, conf=0.82)
- Not checked — no full text of the sourcecites [48] Williams, 1995, Recovered memories of abuse in women with documented child sexual victimization histories, J Traumatic Stress source
hedgedstates an association- Asserted: passes — The authors put it forward as true.
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- Partly supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“More than half of respondents reported at least one, and one-fourth reported Ն2 categories of childhood exposures.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Abstract
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“There was no statistically significant dose-response relationship for a history of stroke or diabetes.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Significance of Dose-Response Relationships
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“we found a strong, dose-response relationship between the number of childhood exposures and each of the 10 risk factors for the leading causes of death that we studied (P Ͻ .001).”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Significance of Dose-Response Relationships
boostedstates an association- Asserted: passes — The authors put it forward as true.
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In the paper
“The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Abstract
hedgedstates an association- Asserted: passes — The authors put it forward as true.
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In the paper
“More than half of respondents reported at least one, and one-fourth reported Ն2 categories of childhood exposures.”
- Also stated in: § Adverse Childhood Exposures · plain
“More than half of respondents (52%) experienced Ն1 category of adverse childhood exposure; 6.2% reported Ն4 exposures.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Abstract
plain- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Adverse Childhood Exposures · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and a 1.4-to 1.6-fold increase in physical inactivity and severe obesity.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Abstract
plainstates an association- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life.”
- Also stated in: § Relationships between Categories of Childhood Exposure · plain
“The relationship between single categories of exposure was significant for all comparisons (P Ͻ .001;chi-square).”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Abstract
boostedstates an association- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Relationships between Categories of Childhood Exposure · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease.”
- Also stated in: § Discussion · plain
“Disease conditions including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease, as well as poor self-rated health also showed a graded relationship to the breadth of childhood exposures.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Abstract
plainstates an association- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We also found a significant (P Ͻ .05)dose-response relationship between the number of childhood exposures and the following disease conditions: ischemic heart disease, cancer, chronic bronchitis or emphysema, history of hepatitis or jaundice, skeletal fractures, and poor self-rated health.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Significance of Dose-Response Relationships
plainstates an association- Asserted: passes — The authors put it forward as true.
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- It may state two separate claims as one. 16
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“a 2-to 4-fold increase in smoking, poor self-rated health, Ն50 sexual intercourse partners, and sexually transmitted disease;”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Abstract
plainstates an association- Asserted: passes — The authors put it forward as true.
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In the paper
“For example, among persons with no childhood exposures, 56% had none of the 10 risk factors whereas only 14% of persons with Ն4 categories of childhood exposure had no risk factors.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Childhood Exposures and Clustering of Health Risk Factors
plainstates an association- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The most prevalent of the 7 categories of childhood exposure was substance abuse in the household (25.6%); the least prevalent exposure category was evidence of criminal behavior in the household (3.4%).”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Adverse Childhood Exposures
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“By contrast, only 1% of persons with no childhood exposures had four or more risk factors, whereas 7% of persons with Ն4 childhood exposures had four or more risk factors (Table 6).”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Childhood Exposures and Clustering of Health Risk Factors
plainstates an association- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“| Mental illness | | 18.8 |”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“| Ն65 | 2,610 | 60.0 | 24.5 | 8.9 | 4.2 | 2.4 |”
- Also stated in: § Discussion · plain
“| 19-34 | 807 | 35.4 | 25.4 | 17.2 | 11.0 | 10.9 |”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
plainstates an association- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“| Psychological | | 11.1 |”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“| Mother treated violently | | 12.5 |”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“| 0 | 3,861 | 56 | 29 | 10 | 4 | 1 |”
- Also stated in: § Discussion · plain
“| Ն4 | 545 | 14 | 26 | 28 | 17 | 7 |”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
plainstates an association- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: The number of categories of adverse childhood exposure is a valid cumulative measure of adversity.
- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Similarly, the odds ratios for skeletal fractures, hepatitis or jaundice, and poor self-rated health were 1.6, 2.3, and 2.2, respectively (Table 8).”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Relationship between Childhood Exposures and Disease Conditions
plainstates an association- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“| Substance abuse | | 25.6 |”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The relationship between single categories of exposure was significant for all comparisons (P Ͻ .001;chi-square).For persons reporting any single category of exposure, the probability of exposure to any additional category ranged from 65%-93% (median: 80%); similarly, the probability of Ն2 additional exposures ranged from 40%-74% (median: 54.5%).”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Relationships between Categories of Childhood Exposure
plainstates an association- Asserted: passes — The authors put it forward as true.
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A result the paper states — it cites no source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Because adverse childhood experiences are common and they have strong long-term associations with adult health risk behaviors, health status, and diseases, increased attention to primary, secondary, and tertiary prevention strategies is needed.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
boostedstates an association- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Respondent (n ϭ 9,508) and nonrespondent (n ϭ 3,986) groups were similar in their percentages of women (53.7% and 51.0%, respectively) and in their mean years of education (14.0 years and 13.6 years, respectively).”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Comparison of Respondents and Nonrespondents
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“After second mailings of the questionnaire to persons who did not respond to the first mailing, the response rate for the survey was 70.5% (9,508/13,494).”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Survey Methods
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Respondents were slightly more likely to answer affirmatively than nonrespondents (6.1% vs. 5.4%, respectively).”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Comparison of Respondents and Nonrespondents
plainstates an association- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Without measuring these household factors as well, long-term influence might be wrongly attributed solely to single types of abuse and the cumulative influence of multiple categories of adverse childhood experiences would not be assessed.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Abstract
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: Conditions such as drug abuse, spousal violence, and criminal activity in the household may co-occur with specific forms of abuse that involve children.
None of the sources cited for this claim have been checked yet.
In the paper
“We used questions from published surveys to construct the ACE Study questionnaire.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Questionnaire Design
What the sources say
- Not checked — no full text of the sourcecites [39] Straus, 1990 source
- Not checked — no full text of the sourcecites [40] Wyatt, 1985, The sexual abuse of Afro-American and White-American women in childhood, Child Abuse Negl source
- Not checked yetcites [41] National Center for Health Statistics. Exposure to alcoholism in the family: United States, 1988. Advance Data, No. 205. U.S. Department of Health and Human Services, Washington, DC; September 30, 1991.
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Respondents were older than nonrespondents (means 56.1 years and 49.3 years) and more likely to be white (83.9% vs. 75.3%)although the actual magnitude of the differences was small.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Comparison of Respondents and Nonrespondents
plainstates an association- Asserted: passes — The authors put it forward as true.
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A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Studies of the long-term effects of childhood abuse have usually examined single types of abuse, particularly sexual abuse, and few have assessed the impact of more than one type of abuse.5,24 -28”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Abstract
What the sources say
- Not checked — no full text of the sourcecites [5] McCauley, 1997, Clinical characteristics of women with a history of childhood abuse, JAMA source
- Not checked — no full text of the sourcecites [24] Briere, 1988, Multivariate correlates of childhood psychological and physical maltreatment among university women, Child Abuse Negl source
- Not checked — no full text of the sourcecites [25] Briere, 1990, Differential adult symptomatology associated with three types of child abuse histories, Child Abuse Negl source
- Not checked — no full text of the sourcecites [26] Claussen, 1991, Physical and psychological maltreatment, Child Abuse Negl source
- Not checked — no full text of the sourcecites [27] Moeller, 1993, The combined effects of physical, sexual, and emotional abuse during childhood, Child Abuse Negl source
- Not checked — no full text of the sourcecites [28] Bryant, 1995, Suicidality in college women who were sexually and physically punished by parents, Violence Vict source
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Respondents and nonrespondents did not differ with regard to their self-rated health, smoking, other substance abuse, or the presence of common medical conditions such as a history of heart attack or stroke, chronic obstructive lung disease, hypertension, or diabetes, or with regard to marital status or current family, marital, or job-related problems (data not shown).”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Comparison of Respondents and Nonrespondents
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“For example, the American Medical Association recommends screening of women for exposure to violence at every entrance to the health system; 66 however, such screening appears to be rare.67”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
What the sources say
- Not checked yetcites [66] 1992, American Medical Association Diagnostic and Treatment Guidelines on Domestic Violence, Arch Fam Med
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition, there may be mediators of the relationship between childhood experiences and adult health status other than the risk factors we examined.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“High levels of exposure to adverse childhood experiences would expectedly produce anxiety, anger, and depression in children.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper may give no reason why it holds.
In the paper
“Although articles in the general medical literature are alerting the medical community to the fact that childhood abuse is common, 59 adolescent health care is often inadequate in terms of psychosocial assessment and anticipatory guidance.60”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
What the sources say
- Not checked — no full text of the sourcecites [60] Rixey, 1994, Family violence and the adolescent, Maryland Med J
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“For example, nicotine is recognized as having beneficial psychoactive effects in terms of regulating affect 49 and persons who are depressed are more likely to smoke.50,51”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
What the sources say
- Not checked — no full text of the sourcecites [49] Carmody, 1989, Affect regulation, nicotine addiction, and smoking cessation, J Psychoactive Drugs source
- Not checked — no full text of the sourcecites [50] Anda, 1990, Depression and the dynamics of smoking. A national perspective, JAMA source
- Not checked — no full text of the sourcecites [51] Glassman, 1990, Smoking, smoking cessation, and major depression, JAMA source
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“To the degree that behaviors such as smoking, alcohol, or drug use are found to be effective as coping devices, they would tend to be used chronically.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Many physicians may fear that discussions of sexual violence and other sensitive issues are too personal even for the doctor-patient relationship.65”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
What the sources say
- Not checked — no full text of the sourcecites [65] Sugg, 1992, Primary care physicians’ response to domestic violence. Opening Pandora’s box, JAMA source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“because it is strongly predictive of mortality.45”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > 3.4 Any category reported 52.1%
What the sources say
- Not checked — no full text of the sourcecites [45] Idler, 1990, Self-rated health and mortality in the NHANES I Epidemiologic Follow-up Study, Am J Pub Health source
boostedstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Second, some persons with health risk behaviors or diseases may have been either more, or less, likely to report adverse childhood experiences.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Moreover, these childhood exposures include emotionally sensitive topics such as family alcoholism 29,30 and sexual abuse.64”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
What the sources say
- Not checked — no full text of the sourcecites [29] Zeitlen, 1994, Children with alcohol misusing parents, Br Med Bull source
- Not checked — no full text of the sourcecites [30] Dore, 1995, Identifying substance abuse in maltreating families, Child Abuse Negl source
- Not checked yetcites [64] Tabachnick, 1997, Perceptions of child sexual abuse as a public health problem. Vermont, September 1995, Morb Mortal Wkly Rep
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, disease conditions could be either over-or under-reported by patients when they complete the medical questionnaire.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The relationship between childhood experiences and adult health status is likely to be overlooked in medical practice because the time delay between exposure during childhood and recognition of health problems in adult medical practice is lengthy.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The data about adverse childhood experiences are based on self-report, retrospective, and can only demonstrate associations between childhood exposures and health risk behaviors, health status, and diseases in adulthood.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, smoking, which is medically and socially viewed as a “problem” may, from the perspective of the user, represent an effective immediate solution that leads to chronic use.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Although articles in the general medical literature are alerting the medical community to the fact that childhood abuse is common, 59 adolescent health care is often inadequate in terms of psychosocial assessment and anticipatory guidance.60”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
What the sources say
- Not checked — no full text of the sourcecites [59] MacMillan, 1997, Prevalence of child physical and sexual abuse in the community. Results from the Ontario Health Supplement, JAMA source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Logistic regression analysis was employed to adjust for the potential confounding effects of age, sex, race, and educational attainment on the relationship between the number of childhood exposures and health problems.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Statistical Analysis
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper relies on this without support.
Conditions such as drug abuse, spousal violence, and criminal activity in the household may co-occur with specific forms of abuse that involve children.
“Conditions such as drug abuse, spousal violence, and criminal activity in the household may co-occur with specific forms of abuse that involve children.”
The paper relies on this without support.
The number of categories of adverse childhood exposure is a valid cumulative measure of adversity.
“Number of categories of adverse childhood exposure and the adjusted odds of risk factors including current smoking, severe obesity, physical inactivity, depressed mood, and suicide attempt”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Adverse childhood experiences (ACEs) were documented at baseline using the 10-item ACE Study questionnaire to measure childhood trauma, and were grouped as either “0–3” or “4+” due to the high rate of chronic health problems among individuals with scores of 4 or more 37.”
From Effects of a trauma-informed mindful recovery program on comorbid pain, anxiety, and substance use during primary care buprenorphine treatment: A proof-of-concept study (2023) · cites this paper as [37]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Both exposure to IPV and parental separation or divorce are two adverse childhood experiences (ACEs) that are linked in a dose–response relationship to adverse health consequences through the lifespan (Felitti et al., 1998).”
From Post‐separation abuse: A concept analysis (2023) · cites this paper as Felitti et al., 1998
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“There is a strong, graded link between exposure to childhood adversity and risk of negative health, social, and emotional outcomes, including several major categories of chronic disease, lung cancer, various autoimmune diseases, depression and other mental illnesses, and high-risk behaviors (e.g., Felitti et al., 1998).”
From Malleability, plasticity, and individuality: How children learn and develop in context1 (2019) · cites this paper as Felitti et al., 1998
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“on average, the life span of individuals with six or more ACEs is 20 years shorter than that of those with zero ACEs (Felitti et al., 1998).”
From Malleability, plasticity, and individuality: How children learn and develop in context1 (2019) · cites this paper as Felitti et al., 1998
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“while adults with ELS/CT experience could be at increased risk of disease with potentially immune origin (36, 53).”
From Developmental Trajectories of Early Life Stress and Trauma: A Narrative Review on Neurobiological Aspects Beyond Stress System Dysregulation (2019) · cites this paper as [53]
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In one study of more than 9,500 adults, for example, exposure to multiple forms of early life stress was associated with a 4.6-fold increase in risk of being depressed over the past year (Felitti et al., 1998).”
From From stress to inflammation and major depressive disorder: A social signal transduction theory of depression. (2014) · cites this paper as Felitti et al., 1998
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Children enter foster care with a sum of adverse childhood experiences.55–57”
From Caregiving disruptions affect growth and pubertal development in early adolescence in institutionalized and fostered Romanian children: A randomized clinical trial (2018) · cites this paper as [55]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Adverse childhood experiences, including growing up in a context of maternal substance use (74), predicts an earlier age of onset for alcohol (62, 75) and other drug use (76, 77), and increased odds for attempting suicide (78).”
From Mothering, Substance Use Disorders and Intergenerational Trauma Transmission: An Attachment-Based Perspective (2019) · cites this paper as [74]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Outcomes associated with early adversity include higher risk of type 2 diabetes, obesity, ischemic heart disease, cancers, depression, addictions, and premature mortality, as well as social outcomes including unemployment and lower educational attainment [1–8].”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [1]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Epidemiological studies have demonstrated that adverse childhood experiences, namely exposures such as neglect, abuse, caregiver mental illness, and family or community violence, predict poorer long-term outcomes across health and social domains.”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [1]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Interest in metabolic embedding of ELA stems from epidemiological [1, 69] and clinical [70] studies linking ELA to obesity, dyslipidemia, and type 2 diabetes, raising questions about possible causal pathways.”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [1]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Adverse psychosocial exposures in early life, namely experiences such as child maltreatment, caregiver stress or depression, and domestic or community violence, have been associated in epidemiological studies with increased lifetime risk of adverse outcomes, including diabetes, heart disease, cancers, and psychiatric illnesses.”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [1]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In full, ELA-induced changes may mediate epidemiological links to key diseases, including, among others, obesity, dyslipidemia, type 2 diabetes, atherosclerosis, asthma, thromboembolic events (myocardial infarction, stroke), cancer onset and progression, as well as addictions, psychopathology, and adverse social outcomes [1–6, 18].”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [1]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“These frequencies are consistent with previous studies documenting elevated rates of childhood adversity among individuals with SUD [3, 5, 9].”
From The link of adverse childhood experiences and attachment to maladaptive personality traits in adults diagnosed with substance use disorder (2025) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Adverse childhood experiences are associated with many negative adult health and health care utilisation outcomes, including cardiovascular illness, depression, suicide attempts, unhealthy substance use, obesity, lung disease, liver disease, cancer and medically unexplained symptoms such as pain or gastrointestinal problems[1–6].”
From Health care utilisation changes among Alaska Native adults after participation in an indigenous community programme to address adverse life experiences: a propensity score-matched analysis (2020) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Dose-response relationships between adverse childhood experiences (ACEs) and multiple risk factors have been documented among AIANs and non-AIANs [51,70].”
From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [70]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Rather, the overwhelming majority of studies14 have employed an empirical specification similar to that which has predominated in the literature on childhood adversity, i.e., a sum score of exposures.15–18”
From Co-occurring epidemics, syndemics, and population health (2017) · cites this paper as [17]
The cited source says what the claim attributes to it.
In the citing paper
“Much research associates CT with adverse physical and mental health outcomes (1,2)”
From Impact of Childhood Trauma on Executive Function in Adolescence—Mediating Functional Brain Networks and Prediction of High-Risk Drinking (2020) · cites this paper as [1]
The cited source says what the claim attributes to it.
In the citing paper
“Moreover, there is commonly a dose-response relationship between the number of types of adversity associated and the magnitude of the risk for depression.4-11”
From Early life adversity and the epigenetic programming of hypothalamic-pituitary-adrenal function (2014) · cites this paper as [4]
The cited source says what the claim attributes to it.
In the citing paper
“Similarly, the original ACE study [3] demonstrated that individuals exposed to multiple adverse experiences had a four- to twelve-fold increased risk for alcoholism, drug abuse, depression, and suicide attempts.”
From The link of adverse childhood experiences and attachment to maladaptive personality traits in adults diagnosed with substance use disorder (2025) · cites this paper as [3]
The cited source says what the claim attributes to it.
In the citing paper
“Exposure to ELA is associated with a clustering of health risks, with increasing exposure related to an increasing number of HRBs.32”
From Early life adversity and health-risk behaviors: Proposed psychological and neural mechanisms (2018) · cites this paper as [32]
The cited source says what the claim attributes to it.
In the citing paper
“Such an approach facilitates the synthesis of complex evidence for application, and is supported by observed dose–response effects linking cumulative early adversity to later outcomes [1, 3, 5], and by the “allostatic load” paradigm exploring pathogenic effects of cumulative all-cause stress [15].”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [1]
The cited source says what the claim attributes to it.
In the citing paper
“Dose-response relationship between number of adversities and health and social effects are observed in large epidemiological studies”
From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [1]
The cited source says what the claim attributes to it.
In the citing paper
“Adverse childhood experiences (ACEs) considerably increase the likelihood of mental illness, health risk behaviors, and chronic physical illnesses.”
From The link of adverse childhood experiences and attachment to maladaptive personality traits in adults diagnosed with substance use disorder (2025) · cites this paper as [3]
The cited source says what the claim attributes to it.
In the citing paper
“These findings are consistent with research that has supported the relationship between ACEs and further negative health consequences in the general population (Buckingham & Daniolos, 2013;Cicchetti & Handley, 2019;Felitti et al., 1998;Hughes et al., 2017).”
From Adverse childhood experiences (ACEs) and substance use disorder (SUD): A scoping review (2021) · cites this paper as Felitti et al., 1998
In the citing paper
“Also, adults who were abused as children have been shown to be at increased risk of disease with potential inflammatory origin (9, 10).”
From Childhood maltreatment predicts adult inflammation in a life-course study (2007) · cites this paper as [9]
In the citing paper
“Inflammation may be an important developmental mediator linking adverse experiences in early life to poor adult health.”
From Childhood maltreatment predicts adult inflammation in a life-course study (2007) · cites this paper as [9]
In the citing paper
“Given that the effect of stress often appears to be cumulative (2, 9, 19), we derived a cumulative exposure index for each child by counting the number of maltreatment experiences during the first decade of life (31);”
From Childhood maltreatment predicts adult inflammation in a life-course study (2007) · cites this paper as [9]
In the citing paper
“Childhood adversity has been repeatedly and robustly linked to physical and mental illness across the lifespan.”
From Developmental psychoneuroendocrine and psychoneuroimmune pathways from childhood adversity to disease (2017) · cites this paper as Felitti et al., 1998
In the citing paper
“The first study using the DAWBA-RAD section reported a very high RAD point-prevalence of 63.0% (96/153) in a sample of looked after youth in a variety of placement forms [29].”
From Mental disorders in foster children: a study of prevalence, comorbidity and risk factors (2013) · cites this paper as [29]
In the citing paper
“Compared to another study on RAD using DAWBA in high-risk foster youths [29], our estimate was quite moderate.”
From Mental disorders in foster children: a study of prevalence, comorbidity and risk factors (2013) · cites this paper as [29]
In the citing paper
“Victims of childhood physical or sexual abuse or parental neglect are at considerably greater risk for affective disorders.1-4”
From Early life adversity and the epigenetic programming of hypothalamic-pituitary-adrenal function (2014) · cites this paper as [4]
In the citing paper
“Epidemiological studies provide compelling support for the association between cumulative, adverse childhood experiences and the risk for depression.4,5”
From Early life adversity and the epigenetic programming of hypothalamic-pituitary-adrenal function (2014) · cites this paper as [4]
In the citing paper
“In humans, various forms of ELA are associated with illicit drug use later in life [21,22,23].”
From Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications (2020) · cites this paper as [21]
In the citing paper
“In addition, there are established links between ELA and obesity [21,24], however, the exact mechanisms are not understood.”
From Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications (2020) · cites this paper as [21]
In the citing paper
“Strong links between ACEs and the initiation of opioid use have been described (72, 73).”
From A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health (2019) · cites this paper as [72]
In the citing paper
“The Adverse Childhood Experiences (ACE) study from 1998 highlighted 5- to 10-fold increase in the risk of AUD and SUD following exposure to four or more ACEs in the first 18 years of life [112].”
From Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint (2020) · cites this paper as [112]
In the citing paper
“Indeed, ELA is associated with a greater likelihood of smoking cigarettes,32,43,44 abusing alcohol and drugs,32,45–47 eating a poor diet,48 and being obese.32,49”
From Early life adversity and health-risk behaviors: Proposed psychological and neural mechanisms (2018) · cites this paper as [32]
In the citing paper
“ELA has also been associated with physical inactivity, which likely also contributes to the link between ELA and obesity.32”
From Early life adversity and health-risk behaviors: Proposed psychological and neural mechanisms (2018) · cites this paper as [32]
In the citing paper
“Research has consistently found that care leavers are more likely to have experienced high levels of adverse childhood experience (ACEs) and are at significantly greater risk for negative outcomes (Felitti et al., 1998; Simkiss, 2019).”
From The relationship between spirituality and resilience and well-being: a study of 529 care leavers from 11 nations. (2023) · cites this paper as Felitti et al., 1998
In the citing paper
“The documented risks of having care experience are substantial and varied (Berlin et al., 2011; Felitti et al., 1998; Simkiss, 2019).”
From The relationship between spirituality and resilience and well-being: a study of 529 care leavers from 11 nations. (2023) · cites this paper as Felitti et al., 1998
In the citing paper
“Early life physical and sexual abuse carry with it a life-long burden of behavioral and pathophysiological problems (Felitti et al., 1998; Heim and Nemeroff, 2001).”
From Central effects of stress hormones in health and disease: understanding the protective and damaging effects of stress and stress mediators (2008) · cites this paper as Felitti et al., 1998
In the citing paper
“There are enormous individual differences in the response to stress, based upon the experience of the individual early in life and in adult life.”
From Protective and damaging effects of stress mediators: central role of the brain (2006) · cites this paper as [41]
In the citing paper
“Early life physical and sexual abuse imposes a life- long burden of behavioral and pathophysiological problems.41,42”
From Protective and damaging effects of stress mediators: central role of the brain (2006) · cites this paper as [41]
In the citing paper
“Early-life events related to maternal care in animals, as well as parental care in humans, play a powerful role in later mental and physical health, as demonstrated by the adverse childhood experiences (ACE) studies”
From Neurobiological and Systemic Effects of Chronic Stress (2017) · cites this paper as [77]
In the citing paper
“ACE have a disproportionately powerful effect on life long trajectories of health and disease, 68 and poverty contributes in its own way as well as creating circumstances for ACE, 114 which, however, occurs across all levels of socioeconomic status (SES).”
From Neurobiological and Systemic Effects of Chronic Stress (2017) · cites this paper as [77]
In the citing paper
“Boarding schools as a form of cultural genocide and source of historical trauma have had a variety of negative health impacts on Native people, such as high suicide rates, post-traumatic stress disorder, and other illnesses such as heart disease and diabetes that are connected to trauma (Brave Heart et al. 2011;Duran 2019;Felitti et al. 1998).”
From Archaeology and Social Justice in Native America (2022) · cites this paper as Felitti et al. 1998
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Abstract
“We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P Ͻ .001).”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Significance of Dose-Response Relationships
“There was no statistically significant dose-response relationship for a history of stroke or diabetes.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Exclusions from Analysis
“The mean age of the 8,506 persons included in this analysis was 56.1 years”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Exclusions from Analysis
“After these exclusions, 8,056 of the original 9,508 survey respondents (59.7% of the original sample of 13,494) remained and were included in the analysis.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Abstract
“a 1.4-to 1.6-fold increase in physical inactivity and severe obesity.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
“| | 4 or more | 523 | 26.6 | 1.3 | ( 1.1-1.6) |”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Relationship between Childhood Exposures and Disease Conditions
“Similarly, the odds ratios for skeletal fractures, hepatitis or jaundice, and poor self-rated health were 1.6, 2.3, and 2.2, respectively (Table 8).”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Discussion
“| | 4 or more | 543 | 10.7 | 2.4 | (1.8-3.3) |”
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“Our findings also differ from earlier research on the prolonged impact of childhood adversity [39].”
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Mehra, S., Salinas‐Miranda, A., Buro, A. W., Marshall, J. T., & Kirby, R. S. (2023) · Disability and health journal · doi:10.1016/j.dhjo.2023.101550 · Cited by 3
Screening for Child Abuse and Trauma During the Perinatal Period
Sperlich, M. I., & Mendel, W. E. (2023) · Springer eBooks · doi:10.1007/978-3-031-33639-3_7 · Cited by 3
Cassidy, K., & Ronis, S. T. (2023) · Sexual Abuse · doi:10.1177/10790632231213832 · Cited by 4
“…coping composite (Carver, 1997); RSES = Rosenberg self-esteem scale (Rosenberg, 1965); ACES = adverse childhood experience questionnaire (Felitti et al., 1998); Changes = changes due to the Offense; SOARS = sex offender acceptance of responsibility scales-Acceptance of sexual offense…”
Testing the structure of the BERRI using exploratory and confirmatory factor analysis
Viziteu, A., da Silva, L. C., Edbrooke-Childs, J. H., Hillman, S., Silver, M., Westlake, M. F., & Harju‐Seppänen, J. (2023) · Children and Youth Services Review · doi:10.1016/j.childyouth.2023.107353 · Cited by 3
Understanding the Religion, Mental, and Social Health Relationship
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Cleary, S. D., Candilis, P. J., Dhumad, S., Dyer, A. R., & Khalifa, N. R. (2023) · Journal of Forensic Sciences · doi:10.1111/1556-4029.15429 · Cited by 3
“The concept of ACEs was initially described by Felitti et al. [ 15 ].”
Psychometrics of psychosocial behavior items under age 6 years: Evidence from Nebraska, USA
Waldman, M. R., Raikes, A., Hepworth, K., Black, M. M., Cavallera, V., Dua, T., Janus, M., Martin-Herz, S. P., McCoy, D. C., & Weber, A. M. (2023) · Infant Mental Health Journal · doi:10.1002/imhj.22090 · Cited by 3
Yetişkinlerin Olumsuz Çocukluk Çağı Deneyimlerinin Bazı Değişkenler Açısından İncelenmesi
ARABACI, M. S., & Demircioğlu, H. (2023) · Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi · doi:10.34087/cbusbed.1285825 · Cited by 4
Adverse childhood experiences and psychotropic medication prescription among cancer patients
Montague, R., Canning, S. E., Thielking, P. D., & Qeadan, F. (2023) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2023.2296040 · Cited by 4
Alawie, F., Olivier, E., & Dupéré, V. (2024) · Journal of Early Adolescence · doi:10.1177/02724316231224812 · Cited by 5
Goldstein, E., Merrick, J., Edwards, R. C., Zhang, Y., Sinche, B., Raven, J. G., Krislov, S., Robledo, D., Brown, R., Moskowitz, J. T., et al. (2024) · The Permanente Journal · doi:10.7812/tpp/23.094 · Cited by 4
Effects of Adverse Childhood Experiences in Black Older Adults
Graham, K. L., & Paun, O. (2024) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20240109-02 · Cited by 4
Early Childhood Teachers’ Relationships with Families When Children Experience Adversity
Lewis, H. R., Lipscomb, S. T., Hatfield, B. E., Jäderholm, C. M., & Tominey, S. L. (2024) · Journal of Research in Childhood Education · doi:10.1080/02568543.2024.2314611 · Cited by 6
“…domestic violence, household member who is mentally ill or suicidal, household member with substance abuse, incarcerated household member, divorce; Felitti et al., 1998), researchers are increasingly inclusive of other types of ACEs (Barajas-Gonzalez et al., 2021; Cronholm et al., 2015; Lipscomb,…”
InfluentialCommunity-Based Mental Health Interventions for Families with Young Children
Puma, J. E., Farewell, C. V., LaRocca, D., Paulson, J. F., & Leiferman, J. A. (2024) · Springer eBooks · doi:10.1007/978-3-031-48631-9_28 · Cited by 4
Factors Associated with Delayed Care Among Women Veterans Actively Engaged in Primary Care
Clair, K. S., Bean‐Mayberry, B., Schweizer, C. A., Chanfreau‐Coffinier, C., Jackson, L., Than, C. T., Finley, E. P., Hamilton, A., & Farmer, M. M. (2024) · Journal of Women s Health · doi:10.1089/jwh.2023.0227 · Cited by 3
Sheffler, J., Meng, Z., Sachs‐Ericsson, N., Caimary, V. G., Patel, J., & Pickett, S. M. (2024) · Journal of Aging and Health · doi:10.1177/08982643241237832 · Cited by 8
“In the community older adult sample , ACEs were evaluated using a 10-item ACE questionnaire based on the original measure used by Felitti et al. (1998).”
A Short Adverse Experiences Measure Among Mothers of Young Children
Lê‐Scherban, F., Wang, A., Courts, K. A., de Cuba, S. E., Wade, R., & Chilton, M. M. (2024) · PEDIATRICS · doi:10.1542/peds.2023-063882 · Cited by 3
“1,2 3 – 7 These findings have led to considerable debate in recent years about whether and how to screen for ACEs in health-care settings and how to use the resulting information.”
BackgroundFactors Associated With Service Referrals and Uptake in Early Head Start
Carleton, R. A., DiGirolamo, A. M., McGarrie, L., et al. (2024) · Infants & Young Children · doi:10.1097/iyc.0000000000000263 · Cited by 3
“The researchers created a Family Risk Index from questions present in the Baby FACES survey, borrowing heavily from the ACEs framework (Felitti et al., 1998).”
MethodResultInfluentialMasuda, T., & Helm, S. (2024) · Children and Youth Services Review · doi:10.1016/j.childyouth.2024.107538 · Cited by 3
The effect of cognitive reappraisal and early-life maternal care on neuroendocrine stress responses
Bentele, U. U., Klink, E. S. C., Benz, A., Meier, M., Gaertner, R. J., Denk, B., Dimitroff, S. J., Unternäehrer, E., & Pruessner, J. C. (2024) · Scientific Reports · doi:10.1038/s41598-024-57106-x · Cited by 5
Capasso, A., Tozan, Y., DiClemente, R. J., & Pahl, K. (2024) · Journal of Interpersonal Violence · doi:10.1177/08862605241243372 · Cited by 3
“Our findings are consistent with the literature showing the long-term health consequences of experiencing violence in childhood (Felitti et al., 1998; Font & Maguire-Jack, 2016).”
Do Adverse Childhood Experiences Make Us More Utilitarian in Moral Dilemmas?
Wu, Z., Song, J., Chen, X., Ding, D., & Zhang, X. (2024) · Psychology Research and Behavior Management · doi:10.2147/prbm.s455057 · Cited by 5
“8,9 10–12 It is widely accepted that ACEs are best understood as risk factors.”
BackgroundMaternal depression, parenting, and child psychological outcomes in the context of maternal pain
O’Brien, J. R., Lee, A. H., Stone, A. L., Dieckmann, N. F., Zalewski, M., & Wilson, A. C. (2024) · Child Development · doi:10.1111/cdev.14106 · Cited by 3
dos Santos, L. M., Altafim, E. R. P., & Linhares, M. B. M. (2024) · Cuadernos de Educación y Desarrollo · doi:10.55905/cuadv16n4-155 · Cited by 3
Trauma-Informed Sentencing in South Australia (A Case Study)
McLachlan, K. J. (2024) · Springer eBooks · doi:10.1007/978-3-031-59290-4_9 · Cited by 3
Caetano, S., & Pereira, H. (2024) · Social Sciences · doi:10.3390/socsci13050262 · Cited by 4
A Vision for Children in America
Szilagyi, M. A., & Szilagyi, P. G. (2024) · Academic Pediatrics · doi:10.1016/j.acap.2024.06.004 · Cited by 3
Zhou, J., Zhang, M., & Hao, Z. (2024) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-024-01341-w · Cited by 3
“…of ACEs and perceived discrimination can further intensify the stress response in individuals who may already be in a state of heightened arousal, (Felitti et al., 1998; Pascoe & Smart Richman, 2009), potentially leading to the adoption of negative coping mechanisms such as problematic smartphone…”
Lemons, J., Saravanan, M., Tumin, D., et al. (2024) · Children and Youth Services Review · doi:10.1016/j.childyouth.2024.107758 · Cited by 3
Treatment Readiness in Psychiatric Residential Care for Adolescents
Diamond, G. S., Ruan‐Iu, L., Winston‐Lindeboom, P., Rivers, A. S., Weissinger, G., & Roeske, M. (2024) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-024-01393-z · Cited by 3
“The ACEs (Felitti et al., 1998) is a 10-item questionnaire used to assess patient history of experiencing potentially traumatizing events during childhood.”
Ascienzo, S., Sprang, G., & Royse, D. D. (2024) · Violence and Victims · doi:10.1891/vv-2024-0003 · Cited by 3
Sadikova, E., & Mazurek, M. O. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06321-6 · Cited by 3
Ferraro, A. C., & Maher, E. J. (2024) · British Journal of Sociology · doi:10.1111/1468-4446.13130 · Cited by 3
Draxler, J. M., Ruppar, T. M., Carbray, J. A., & Delaney, K. R. (2024) · Journal of Pediatric Health Care · doi:10.1016/j.pedhc.2024.06.018 · Cited by 3
Rajan, S., Buttar, N., Ladhani, Z., Caruso, J., Allegrante, J. P., & Branas, C. C. (2024) · JMIR Research Protocols · doi:10.2196/56249 · Cited by 4
“Research has confirmed that ACEs increase a person’s risk of poor mental health, illicit drug use, self-harm behaviors, and premature mortality [18,19].”
BackgroundMethodPulcini, C. D., Lamberson, M., Collins, S. C., et al. (2024) · Journal of Emergency Nursing · doi:10.1016/j.jen.2024.06.008 · Cited by 3
The Long-Term Physical–Psychiatric Comorbidities Related to Childhood Exposure to 9/11 Trauma
Amsel, L., Cycowicz, Y. M., Rodriguez‐Moreno, D. V., Cheslack‐Postava, K., McReynolds, L. S., Musa, G. J., & Hoven, C. W. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21080988 · Cited by 3
“Compelling evidence, including meta-analyses [66,68], underscores the linkage between childhood adversity and adverse physical, mental, and behavioral health outcomes [69–74].”
BackgroundLamela, D. J. P. D. V., Pinto, T. M., & Jongenelen, I. (2024) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2024.2383188 · Cited by 3
“Childhood maltreatment was assessed using the Adverse Childhood Experiences Study Questionnaire (ACE; Felitti et al., 1998).”
Garcia, A. R., Barnhart, S., López, D. J., & Karcher, N. R. (2024) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2024.07.924 · Cited by 3
Trauma-informed care beliefs scale-comprehensive for child welfare carers using Rasch analysis
Beehag, N., Dryer, R., McGrath, A., Krägeloh, C., & Medvedev, O. N. (2024) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.106966 · Cited by 3
“That is, the experience of a single or repeated exposure to physical, sexual, or emotional abuse; neglect; parental drug or alcohol misuse; or exposure to domestic violence (Felitti et al., 1998).”
BackgroundFrom Early Trauma to Cardiovascular Risk Among a Nationally Representative Sample of Young Adults
Parker, V. L., & Manna, A. L. (2024) · Child Maltreatment · doi:10.1177/10775595241277122 · Cited by 3
“Further, past research has shown that even experience of one adverse event may show increased risk for poor health outcomes (Felitti et al., 1998).”
Bao, C.-Q., Zhang, Q.-Y., Zou, H.-W., He, C., Yan, R., Hua, L., Lu, Q., & Yao, Z. (2024) · Biological Psychiatry: Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2024.08.014 · Cited by 6
Associations of early adversity and negative emotionality with emerging adult latent internalizing
Ponder, D. M., Cole, E., Jensen, M. R., & Vrshek‐Schallhorn, S. (2024) · Psychiatry Research Communications · doi:10.1016/j.psycom.2024.100193 · Cited by 3
Pilot study of parental alienation items in the adverse childhood experiences scale
Marsden, J., Saunders, L., & Harman, J. J. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.09.001 · Cited by 5
Reisner, S. L., Humes, E., Stevenson, M., Cooney, E. E., Adams, D., Althoff, K. N., Radix, A., Poteat, T., Mayer, K. H., Cannon, C. M., et al. (2024) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000003527 · Cited by 4
Davis, C. J., & Burrow, A. L. (2024) · International Journal of Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.107015 · Cited by 2
Hales, G. K., Debowska, A., Rowe, R., Boduszek, D., & Levita, L. (2024) · Development and Psychopathology · doi:10.1017/s0954579424001470 · Cited by 3
“The effect of multiple childhood adversities has predominantly been assessed using cumulative risk scores, which was popularized by Felitti et al. (1998).”
Hamilton, K., Dooley, K., Sihota, M., & Marriott, B. (2024) · Canadian Journal of Criminology and Criminal Justice/La Revue canadienne de criminologie et de justice pénale · doi:10.3138/cjccj-2024-0011 · Cited by 3
“…children to avoidant coping and dysfunctional problem solving through the adoption of health risk behaviour (e.g., online , inactivity, over-eating persistent social problems, and early mortality (Felitti et al. 1998; Anda et al. 2006, 2010; Cic-chetti 2013; Putnam, Harris, and Putnam 2013.”
Karaağaç, M., & İmre, O. (2024) · Journal of Interpersonal Violence · doi:10.1177/08862605241285409 · Cited by 4
“Adverse childhood experiences (ACEs) are defined as stressful or traumatic experiences such as physical, sexual, or verbal abuse, neglect, or a dysfunctional family environment (Felitti et al., 1998).”
Dalvie, S., Li, M. J., Kalmin, M. M., Cole, S. W., Stein, D. J., & SHOPTAW, S. J. (2024) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-024-00661-2 · Cited by 5
“These early life events can have far-reaching effects as they increase the risk for both mental and physical health disorders in adulthood (Elklit & Murphy, 2022; Felitti et al., 1998; Ho et al., 2020; Hogg et al., 2022).”
Crouch, E. L., Radcliff, E., Brown, M. J., & Hung, P. (2024) · Journal of Child and Family Studies · doi:10.1007/s10826-024-02928-6 · Cited by 3
DeLone, A. M., Basile, N. L., Chaney, J. M., Mullins, L. L., & Sharkey, C. M. (2024) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsae091 · Cited by 4
Zhang, H., Zhao, R., & Yao, X. (2024) · Journal of Family Violence · doi:10.1007/s10896-024-00767-z · Cited by 3
Landeghem, C. V., & Jakobson, L. S. (2024) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2024.102773 · Cited by 3
Jang, J., & Gonzales, G. (2024) · Journal of General Internal Medicine · doi:10.1007/s11606-024-09186-8 · Cited by 5
National Fatality Review Case Reporting System: Twenty Years of Data Collection
Collier, A., Dykstra, H. K., Shaw, E. C., et al. (2024) · PEDIATRICS · doi:10.1542/peds.2024-067043c · Cited by 3
The Impact of Childhood Maltreatment Timing on Adolescents’ Depression and Anxiety
Kang, J. (2024) · Families in Society The Journal of Contemporary Social Services · doi:10.1177/10443894241272258 · Cited by 3
“Other ACEs that are risk factors for depression/anxiety include childhood maltreatment and family dysfunction, such as mental illness, substance abuse, and domestic violence (Felitti et al., 1998).”
Children exposed to sibling sexual abuse: Sociodemographic and trauma symptom differences
McDowell, H., Pavlova, M., Hartwick, C., Madigan, S. L., & Racine, N. M. (2024) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.107149 · Cited by 3
Lim, M., Gaudreau, J., & Logan, N. E. (2024) · Exercise Sport and Movement · doi:10.1249/esm.0000000000000032 · Cited by 6
Understanding Mental Health Impact of COVID-19 on Puerto Rican Youth: Influence of Parental Stress
Martínez-Seda, G. M., Vélez‐Pastrana, M. C., & Nicasio, A. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21121564 · Cited by 3
Erickson, N. L., Padrutt, E. R., Buchanan, G. J. R., & Kim, H. G. (2024) · Current Psychiatry Reports · doi:10.1007/s11920-024-01565-6 · Cited by 3
Flannigan, K., Edwards, D. C., Reid, D., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0312692 · Cited by 3
Trauma‐informed practice for genetic counselors: Insights from a workshop evaluation
Schlub, G. M., & Deckker, K. D. (2024) · Journal of Genetic Counseling · doi:10.1002/jgc4.2005 · Cited by 3
Xu, H., Xu, L., Wang, Z., Xu, C., Hu, F., Cai, Y., & Wang, Y. (2024) · Scientific Reports · doi:10.1038/s41598-024-81811-2 · Cited by 3
Quinn, C. R. (2024) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-024-02169-9 · Cited by 4
“This is noteworthy since adverse childhood experiences include parental incarceration [38, 39].”
Fetal alcohol spectrum disorders: where we have come from, trends, and future directions
Price, A. D., Allely, C. S., & Mukherjee, R. (2024) · Minerva Pediatrics · doi:10.23736/s2724-5276.24.07365-8 · Cited by 3
From struggle to startup: How childhood socioeconomic status shapes entrepreneurial happiness
Cheng, Z., Wang, H., Yu, X., & Zhang, L. (2024) · Economic Modelling · doi:10.1016/j.econmod.2024.106979 · Cited by 4
Joseph, A., Massey, M., Sanders, J. E., & Mitchell, B. D. (2024) · Urban Education · doi:10.1177/00420859241293106 · Cited by 4
“…physical, or sexual abuse, physical or emotional neglect, death of a parent, violence against one ’ s mother, parental separation or divorce, or living with caregivers who misuse substances, experience mental illness or suicidal behavior, and/or were ever imprisoned (Felitti et al., 1998).”
Coughlan, B., Marshall, N., Woolgar, M., Mannes, J., Erkiert, P., Humphrey, A., Smith, J., Drayak, T., Crozier‐Roche, F., Morgan, T., et al. (2024) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2024.152568 · Cited by 3
A Primary Care Group Resilience Intervention Promotes Child and Caregiver Behavioral Health
Jeung, J., Nguyen, A., Martinez, J. L., et al. (2025) · JMIR Pediatrics and Parenting · doi:10.2196/67638 · Cited by 3
“…experiences (ACEs) including child maltreatment, family violence, parental substance abuse, and parental mental illness may increase health and behavioral risks [1,2], further research into preventive early childhood interventions, before the onset of ACE-associated sequelae is required [3].”
Saunders, B. J., Lansdell, G. T., & Eriksson, A. (2025) · Psychiatry Psychology and Law · doi:10.1080/13218719.2024.2416637 · Cited by 3
“ABI resulting from family violence has detrimental effects extending into adult-hood (Felitti et al., 1998; Williams et al., 2021).”
Explore-exploit behavior in humans as a sequential sampling process
Houser, T. M. (2025) · Current Psychology · doi:10.1007/s12144-024-07257-x · Cited by 4
“47 of these participants had four or more adverse childhood experiences (ACEs; self-reported via the Adverse Childhood Events Scale, Felitti et al., 1998) and 98 had fewer than four ACEs.”
Perryman, K. L., Schoonover, T., & Thomas, H. F. (2025) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-024-00680-z · Cited by 3
“These challenges can manifest in numerous ways, including lower academic performance and a higher likelihood of behavioral issues (Felitti et al., 1998).”
Clum, G. A., Madkour, A. S., Judson, J., Tokarz, S., Smith, E. A., Stojanovski, K., Ferguson, T. F., Welsh, D. A., Molina, P. E., & Theall, K. P. (2025) · AIDS Care · doi:10.1080/09540121.2024.2445202 · Cited by 2
“…ACE questionnaire is a 10-item inventory of childhood hardships including physical, sexual, and emotional abuse, neglect, and household dysfunction, where a higher score indicates a higher risk for issues later in life such chronic disease, violence, mental illness, and more (Felitti et al., 1998).”
Ellicott, C., Rubab, S. U., McGowan, A., Neale, B., Bidaran, A., Dewsbery, F., Norman, A., & Lloyd, H. M. (2025) · Healthcare · doi:10.3390/healthcare13030280 · Cited by 3
“Such a perspec-Healthcare tive gives insight into mitigating the risks of associated biopsychosocial factors resulting from adverse childhood experiences (ACES) [74–76]. resulting from adverse childhood experiences (ACES) [74,75,76].”
Napier, T. R., Howell, K. H., Thomsen, K. N., Maye, C. E., & Thurston, I. B. (2025) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2025.107298 · Cited by 3
Childhood adversity and adolescent epigenetic age acceleration: the role of adolescent sleep health
DiMarzio, K., Rojo‐Wissar, D. M., Valencia, E. M. H., Pault, M. V., Denherder, S., Lopez, A., Lerch, J., Metrailer, G., Merrill, S. M., Highlander, A., et al. (2025) · SLEEP Advances · doi:10.1093/sleepadvances/zpaf003 · Cited by 5
Kabir, A., Loveday, S., Hiscock, H., Bosward, R., Ebbett, W., Liu, H., White, N. O., & Chen, L. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-086710 · Cited by 3
Fine, S. L., Willis, K., Lucas, I. L., Siebach, K. F., Glick, J. L., Valentine-Graves, M., Winter, S., Smith, M. S., Waltz, T. J., Herring, G. B., et al. (2025) · BMC Public Health · doi:10.1186/s12889-024-21151-y · Cited by 10
“Traumatic experiences will be assessed using the Adverse Childhood Experiences Questionnaire [90], which evaluates childhood trauma experienced prior to age 18, and the Life Events List [91], which evaluates general stressors experienced within the past year (or the past three months at follow-up).”
Vignato, J. A., Perkhounkova, Y., Marilim, H., Lee, J., Hein, M., Santillan, D. A., & Santillan, M. K. O. (2025) · Western Journal of Nursing Research · doi:10.1177/01939459251317270 · Cited by 3
Sex-Specific Outcomes in a Rat Model of Early-Life Stress Due to Adverse Caregiving
Balboa, J. G., Colapietro, A. A., Cantarelli, V. I., Ponzio, M. F., Retamal, M. N. C., Pallarés, M. E., Antonelli, M. C., & Chertoff, M. (2025) · Neurotoxicity Research · doi:10.1007/s12640-025-00731-9 · Cited by 4
“…have associated early-life adversity with blunted cortisol levels (Bernard et al. 2017; Schär et al. 2022; Young et al. 2019) and atypical behavioral responses in adulthood, including anhedonia, anxiety, and depression (Condon et al. 2018; Felitti et al. 1998; Gonzalez 2013 ; Shonkoff et al. 2012).”
Ferrajão, P. C., Frias, F., & Elklit, A. (2025) · Open Journal of Epidemiology · doi:10.4236/ojepi.2025.151011 · Cited by 3
Shen, J., Zhu, Y., & Zhang, G. (2025) · BMC Psychology · doi:10.1186/s40359-025-02408-6 · Cited by 3
Mahmood, S., & Fatmi, Z. (2025) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2025.107318 · Cited by 3
Psychological interventions across a stepped care framework: special issue editorial
Hronis, A. (2025) · Discover Psychology · doi:10.1007/s44202-025-00332-9 · Cited by 3
A phenomenological analysis of young male prisoners’ experiences of trauma: 'Trauma is every day'
O’Rourke, R., Marriott, M., Trigg, R., & Kitson‐Boyce, R. (2025) · International journal of law, crime and justice · doi:10.1016/j.ijlcj.2025.100732 · Cited by 4
Afifi, T. O., Osorio, A., Fortier, J., Stewart-Tufescu, A., Taillieu, T., & McCarthy, J. (2025) · Canadian Journal of Public Health · doi:10.17269/s41997-024-00992-5 · Cited by 4
“When child maltreatment occurs, the odds of having substance use problems, mental disorders, and thinking about or attempting suicide increase (Afifi et al., 2011, 2012a, 2013, 2014, 2017a, 2020b; Anda et al., 2002; Dube et al., 2002; Felitti et al., 1998; Merrick et al., 2017).”
Implementing a Trauma‐Informed Parenting Program in Urban Schools Serving High Poverty Communities
Yu, Z., Gross, D. A., Wyatt, K., Cunningham, E., Hoppe, E. R., Chen, W., Plesko, C. M., Bower, K. M., & Bettencourt, A. F. (2025) · Psychology in the Schools · doi:10.1002/pits.23466 · Cited by 3
Han, Y., Gaietto, K. M., Chen, W., Perreira, K. M., Oren, E., Pirzada, A., Garcia‐Bedoya, O., Kaplan, R. C., Isasi, C. R., & Celedon, J. C. (2025) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2025.02.031 · Cited by 4
Asselman, M. W., Offerman, E., Koomen, H. M. Y., Bolling, F., Hoeve, M., & Bosman, R. J. (2025) · International Journal of School & Educational Psychology · doi:10.1080/21683603.2025.2473897 · Cited by 4
“ACEs are broadly defined as single or chronic exposures in the environment during childhood (0–18 years) that are distressing, potentially harmful and traumatic (Asmundson & Afifi, 2019; Felitti et al., 1998).”
Keane, K. J., Evans, R. R., Wilkinson, L. L., King, D. M., Leban, L., & Macrina, D. M. (2025) · Children and Youth Services Review · doi:10.1016/j.childyouth.2025.108237 · Cited by 3
Tschida, L., de Brito, J. N., Sapkota, S., Fertig, A. R., Trofholz, A. C., & Berge, J. M. (2025) · American Journal of Health Promotion · doi:10.1177/08901171251327452 · Cited by 3
Trudel, S. M., Bray, M. A., McCoach, D. B., Kaufman, J. C., McGrath, R. E., Brunzell, T., & Winter, E. L. (2025) · Contemporary School Psychology · doi:10.1007/s40688-025-00542-x · Cited by 4
The new role of teachers today: Being a trauma-informed teacher
Ahmetoğlu, E., Şirin, T. S., & Kurtça, T. T. (2024) · Erken Çocukluk Çalışmaları Dergisi · doi:10.24130/eccdjecs.1967202481571 · Cited by 4
“Teachers acknowledge that students may have encountered various traumas such as abuse, neglect, violence, or loss; they recognize that these experiences can deeply impact students' cognitive, emotional, and behavioral responses within the educational environment (Felitti et al., 1998).”
Almeida, T. C., & Redondo, T. G. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.03.156 · Cited by 5
Weiler, L. M., Díaz-Howard, A. M., Racz, S. J., Zhou, H., He, Y., McIntyre, G., & Taussig, H. N. (2025) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-025-00703-3 · Cited by 3
“Numerous studies have linked poor mental health to adverse childhood experiences (ACEs; i.e., child abuse, neglect, violence exposure, and other adversities; Anda et al., 2006; Dube et al., 2006; Felitti et al., 1998).”
Calkins, M. E., Jumper, M. B. E., Ered, A., Dong, F., Sarpal, D. K., Baker, K. K., Bencivengo, D. J., Margolis, R. L., Buchanan, R. W., Boumaiz, Y., et al. (2025) · Early Intervention in Psychiatry · doi:10.1111/eip.70031 · Cited by 3
Metadata
- Authors
- Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S.
- Affiliations
- Kaiser Permanente (US)
- Centers for Disease Control and Prevention (US)
- Emory University (US)
- University of Arizona (US)
- Corresponding author
- Felitti, Vincent J
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 1998-05
- Volume
- 14
- Issue
- 4
- Pages
- 245-258
- ISSN
- 0749-3797 (ISSN-L)
- OpenAlex
- W2116839388
- Cited by
- 18,943
- References
- 97
- Citations by year
- 2026: 1615 · 2025: 1790 · 2024: 1720 · 2023: 1711 · 2022: 1648 · 2021: 1720 · 2020: 1565 · 2019: 1232 · 2018: 963 · 2017: 825 · 2016: 666 · 2015: 573 · 2014: 446 · 2013: 413 · 2012: 340
- FWCI
- 57.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention (TS-44-10/12)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Health › Intimate Partner and Family Violence
- Social Sciences › Sociology and Political Science › Child Welfare and Adoption
- Keywords
- adverse childhood experiences, childhood abuse, household dysfunction, childhood emotional abuse, child physical abuse, child sexual abuse, alcoholism, drug abuse, depression, suicide attempts, smoking, sexually transmitted infections, obesity, physical inactivity, ischemic heart disease, cancer, chronic lung disease, liver disease, cumulative exposure, leading causes of death
- MeSH terms
- Adult, Aged, Aged, 80 and over, California, Cause of Death, Child, Child Abuse, Family, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Risk Factors, Social Problems, Violence, Health Behavior, Logistic Models, Child of Impaired Parents, Domestic Violence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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