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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“A national telephone survey of adults in 1990 using similar criteria for sexual abuse estimated that 27% of women and 16% of men had been sexually abused.(12) There are several reasons to believe that our estimates of the long-term relationship between adverse childhood experiences and adult health are conservative.”
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Baishya, M. L., Martinasek, M. P., Bell, L., & Wheldon, C. W. (2022) · LGBT Health · doi:10.1089/lgbt.2021.0343 · Cited by 2
Olstad, K., Sørensen, T., Lien, L., & Danbolt, L. J. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.946394 · Cited by 2
The Relationship Between Early Life Adversity and Academic Competence in Early Childhood
Green, A. B., & Hennefield, L. (2023) · Psi Chi Journal of Psychological Research · doi:10.24839/2325-7342.jn28.3.168 · Cited by 2
Du, Y., Luo, Y., Ren, Z., Zheng, X., & Liu, J. (2023) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2023.106383 · Cited by 2
Watkins, L., & Lowery, K. P. (2023) · NASSP Bulletin · doi:10.1177/01926365231198522 · Cited by 2
“Trauma-Informed Care and Leadership Practices Felitti et al. (1998) studied the long-term health consequences that adverse childhood experiences (ACEs) have on adults.”
BackgroundInvestigating hallucination-proneness, dissociative experiences and trauma in the general population
Jones, O., Hughes-Ruiz, L., & Vass, V. (2023) · Psychosis · doi:10.1080/17522439.2023.2254810 · Cited by 3
“This is supported by previous research which has found that adverse childhood experiences (ACE) including forms of abuse and familial dysfunction are reported at least once by 50% and twice by 25% of the sample (Felitti et al., 1998).”
InfluentialTarquinio, C., Trousselard, M., Rotonda, C., & Tarquinio, C. (2023) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2023.06.008 · Cited by 3
Survivors of Child Maltreatment: A Historical Review of Global Health and Research
Rockhold, P. (2023) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-80455-526-220231014 · Cited by 3
Tomlinson, C. A., McDonald, S. E., Brown, S. M., & Shin, S. H. (2023) · Children and Youth Services Review · doi:10.1016/j.childyouth.2023.107242 · Cited by 2
The Intergenerational Impact and Trauma of Child Protective Services Referrals on Families
Ocampo-Chih, C., Nelson, J., Harrington, L., Rush, A., Patrick, S. W., & Anani, U. E. (2023) · NeoReviews · doi:10.1542/neo.24-11-e763 · Cited by 2
Qu, M., Wang, D., Tian, Y., Chen, J., Zhu, R., Li, Y., & Zhang, X. (2023) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-023-01209-5 · Cited by 2
“Adverse childhood experiences (ACEs) are a set of childhood adversities that include family dysfunction, various forms of abuse and neglect (Felitti et al., 1998).”
Trauma-Informed Theory in Criminal Justice
Chapple, C. L., & Maher, E. J. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780197694732.003.0012 · Cited by 2
Adverse childhood experiences, discrimination, and substance use among Latino/a/Hispanic youth
Grest, C. V., Cederbaum, J. A., Lee, J. O., & Unger, J. B. (2023) · Applied Developmental Science · doi:10.1080/10888691.2023.2297024 · Cited by 2
“However, the initial list of ACEs as conceptualized by Felitti et al. (1998, 2019) does not fully capture potential adversities experienced by U.S. Latino/a/Hispanic groups (e.g. children and families), such as contextual and environmental factors, discrimination exposure and acculturation-related…”
InfluentialThe Impact of Adverse Childhood Experiences on College Student Stress and Well-being
Underwood, J. W., Conley, A. H., & Waters, J. M. (2024) · Journal of College Student Retention Research Theory & Practice · doi:10.1177/15210251231225415 · Cited by 2
Steggerda, J. C., Cavell, T. A., Drew, A. L., Nicholson, J. H., Herrera, C., Gaffney, D., Slep, A. M. S., & Spencer, R. (2024) · School Mental Health · doi:10.1007/s12310-024-09631-3 · Cited by 2
“In essence, the ISS-YR operates similarly to measures that allow participants to report on similar experiences, such as the Adverse Childhood Experiences measure (ACE; Felitti et al., 1998).”
Champagne, F. A., Dosanjh, L. H., & Firestein, M. R. (2024) · Springer eBooks · doi:10.1007/978-3-031-48627-2_9 · Cited by 3
The pernicious role of stress on intergenerational continuity of psychopathology
Leve, L. D., Oro, V., Natsuaki, M. N., Harold, G. T., Neiderhiser, J. M., Ganiban, J. M., Shaw, D. S., & DeGarmo, D. S. (2024) · Development and Psychopathology · doi:10.1017/s0954579424000191 · Cited by 5
Toward (Racial) Justice-in-the-Doing of Place-Based Community Engagement
Moore, T., Lindsey, L., Greg, et al. (2024) · Metropolitan Universities · doi:10.18060/27561 · Cited by 2
“University-trained “experts” frame present-day Tulsa by naming systemic racism, the impact of historical trauma and adverse childhood experiences (Felitti et al., 1998), the political determinants of health (Dawes, 2020), and economic under-investment by generations of developers and municipal…”
BackgroundSolheim, K., Reime, M. H., & Eide, L. S. P. (2024) · Global Qualitative Nursing Research · doi:10.1177/23333936241240795 · Cited by 3
“Trauma informed care acknowledges the need to understand a patient’s life experiences in order to deliver effective care (Felitti et al., 1998), and has the potential to improve patient engagement, treatment adherence, health outcomes, and provider and staff wellness (Goddard, 2021).”
BackgroundInfluentialAgwogie, M. O., Kliewer, W. L., & Ibrahim, M. B. (2024) · Journal of Traumatic Stress · doi:10.1002/jts.23043 · Cited by 2
Parents’ Vicarious Event Centrality of Their Child’s Interpersonal Trauma
Willcott-Benoit, W., & Cummings, J. A. (2024) · Journal of Interpersonal Violence · doi:10.1177/08862605241247571 · Cited by 3
“The landmark adverse childhood experiences study (Felitti et al., 1998) illustrated the relationship between a higher number of adverse childhood experiences and adulthood mental health concerns (e.g., depression and suicide attempts), health-risk behaviors (e.g., physical inactivity and alcohol…”
BackgroundDissociation As a Mechanism of Risk for Interpersonal Victimization Among Adolescent Girls
Kouri, N. A., Simon, V. A., & Partridge, T. (2024) · Journal of Interpersonal Violence · doi:10.1177/08862605241248431 · Cited by 5
“Polyvictimization was operationalized as a composite score based on the endorsement of items derived from the University of California, Los Angeles (UCLA) Posttraumatic Stress Disorder (PTSD) Reaction Index Trauma Screener (Pynoos & Steinberg, 2015), the Adverse Child-hood Experiences Scale (Felitti et al., 1998), the…”
Exploring the Link among adverse childhood experiences and commercial sexual exploitation
Hanlin, H., Kivisto, A. J., & Gold, C. (2024) · Child Protection and Practice · doi:10.1016/j.chipro.2024.100042 · Cited by 2
Adverse childhood experiences are associated with HIV risk factors in Agbogbloshie, Ghana
Sznajder, K. K., Eshak, T. B., Biney, A. A. E., Dodoo, N. D., Wang, M., Toprah, T., Blanford, J. I., Jensen, L., & Dodoo, F. N. (2024) · Vulnerable Children and Youth Studies · doi:10.1080/17450128.2024.2354378 · Cited by 2
“ACEs were measured using the Adverse Childhood Experience Study Questionnaire (Felitti et al., 1998).”
MethodPediatric obesity is a complex disease. It is time we start reimbursing for care
Armstrong, S. (2024) · Pediatric Research · doi:10.1038/s41390-024-03201-8 · Cited by 2
Osman, F. A., Eriksen, A. M. A., & Norbye, A. D. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-11211-9 · Cited by 3
“Low socioeconomic status in families has been associated with an increased risk of emotional abuse in childhood [14], as well as being a minority [15], although the direct correlation is not clear.”
BackgroundStrohacker, E. R., Pontes, N. M. H., & Pontes, M. (2024) · Violence and Victims · doi:10.1891/vv-2022-0052 · Cited by 2
Ricks, J. M., Liebhard, B. M., Dush, C. M. K., Manning, W. D., & LoVette, A. (2024) · Partner Abuse · doi:10.1891/pa-2023-0040 · Cited by 3
A Care-Based Approach for Dismantling the Strong Black Woman Schema
Nortey, A. N., & Dowtin, L. L. (2024) · Women & Therapy · doi:10.1080/02703149.2024.2380170 · Cited by 2
“Specifically, as the ACE score increases, the intensity and likelihood of negative outcomes also increases (Burke, 2018; Felitti et al., 1998; Pachter et al., 2017).”
Controlling false discovery rate for mediator selection in high-dimensional data
Dai, R., Li, R., Lee, S., & Liu, Y. (2024) · Biometrics · doi:10.1093/biomtc/ujae064 · Cited by 4
Sarginson, C., Nicoletta, J., Charlebois, T., Enouy, S., & Tabri, N. (2024) · Journal of Eating Disorders · doi:10.1186/s40337-024-01065-1 · Cited by 6
“A 28-item scale [61, 62] was used to measure ACEs that occurred before the age of 18.”
MethodKoppold, A., Ruge, J., Hecker, T., & Lonsdorf, T. B. (2024) · Meta-Psychology · doi:10.15626/mp.2023.3958 · Cited by 8
Besera, G., Annor, F., Swedo, E. A., Aslam, M. V., & Massetti, G. M. (2024) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2024.08.001 · Cited by 2
Adverse Childhood Experiences and Police Contact in Canada
Testa, A. M., Jacobs, B., Thompson, J., Pang, N., Jackson, D. B., Nagata, J. M., & Ganson, K. T. (2024) · Journal of Interpersonal Violence · doi:10.1177/08862605241270047 · Cited by 2
“The ACEs items were adapted from prior research (Felitti et al., 2019).”
Petroff, R., Jester, J. M., Riggs, J. L., Alfafara, E. A., Springer, K., Kerr, N., Issa, M., Hall, A., Rosenblum, K. L., Goodrich, J. M., et al. (2024) · Brain and Behavior · doi:10.1002/brb3.70035 · Cited by 2
“…depression on a self-report screening questionnaire(score > 9onPHQ-9)(Kroenkeetal.,2001),(2)threeormore adverse childhood experiences (ACEs) (Felitti et al., 1998), (3) challenges with parenting and/or their child’s behavior (parent-reported), and (4) household eligibility for public…”
BackgroundSoto, M., Micalizzi, L., Price, D., Rogers, M. L., & Jackson, K. M. (2024) · Journal of Experimental Child Psychology · doi:10.1016/j.jecp.2024.106077 · Cited by 5
Grocott, L. R., Liuzzi, M. T., Harris, J. C., Stuart, G. L., & Shorey, R. C. (2024) · Journal of Interpersonal Violence · doi:10.1177/08862605241284050 · Cited by 2
“ACEs are defined as experiences of abuse and/or household dysfunction in childhood (Felitti et al., 1998).”
Staton, M., Tillson, M. D., Levi, M. M., Leukefeld, C. G., Dickson, M. F., Oser, C. B., Fanucchi, L. C., Annett, J., Winston, E., & Webster, J. M. (2024) · Women s Health Issues · doi:10.1016/j.whi.2024.09.001 · Cited by 2
Prevalence and Risk Factors of Gang Membership in a Brazilian Birth Cohort
Bauer, A., Martins, R. C., Hammerton, G., Gomes, H. S., Gonçalves, H., Menezes, A. M. B., Wehrmeister, F. C., & Murray, J. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.40393 · Cited by 3
Johansson, C., Bador, K., Kmety, K., Johansson, E., Olsson‐Tall, M., Råstam, M., & Kerekes, N. (2024) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.107089 · Cited by 5
“This finding is supported by previous research on the topic (Felitti et al., 1998; Jones et al., 2022; Zhu et al., 2023).”
Parajuli, R. P., Bhandari, S., Ward, L. M., & Suarez-Lopez, J. R. (2024) · Scientific Reports · doi:10.1038/s41598-024-77306-9 · Cited by 3
Nixon, R. D. V., Elizabeth, M., Fassnacht, D. B., van Agteren, J. E., Edney, L. C., & Wild, J. (2024) · European Journal of Psychotraumatology · doi:10.1080/20008066.2024.2420459 · Cited by 3
Eftedal, M., Johansen, T., & Kollerud, R. D. R. (2024) · Frontiers in Rehabilitation Sciences · doi:10.3389/fresc.2024.1389337 · Cited by 2
Mihaila, I., Shiu, C. A., Bernard, L., Herrman, D., Salameh, J., Berg, K. L., & Acharya, K. (2024) · Behavioral Medicine · doi:10.1080/08964289.2024.2424172 · Cited by 2
“15,16 Although research indicates that CYSHCN experience both a higher risk of individual-level ACEs 17 and total ACEs scores, 17,18 limited research has investigated the role of ACEs in the risk of obesity within this population.”
Conway, H. M., Conway, S. H., Schroeder, B., Peskin, M. F., & Jetelina, K. K. (2024) · New Directions for Child and Adolescent Development · doi:10.1155/cad/6678254 · Cited by 2
Childhood Abuse and the Mental Health of Seminary Students: The Mediating Role of R/S Struggles
Upenieks, L., Eagle, D. E., & Holleman, A. (2024) · Review of Religious Research · doi:10.1177/0034673x241302420 · Cited by 3
Trauma informed career counseling for young adults with mental health conditions
Lu, W., Yanos, P. T., Oursler, J. D., Beninato, J., Topitzes, D., Banko, A., Chung, W. E., & Stone, B. (2024) · Journal of Employment Counseling · doi:10.1002/joec.12236 · Cited by 2
Motivations for Juvenile Offending Behaviour and Femicide
Bryce, I., & Schaffer, K. (2024) · Springer eBooks · doi:10.1007/978-3-031-72516-6_5 · Cited by 2
Exploring the Overlap: Suicidal Thoughts and Homicidal Acts Among Incarcerated Offenders
Peterson, J., & Densley, J. A. (2024) · Deviant Behavior · doi:10.1080/01639625.2024.2443778 · Cited by 3
“…school property) and violence against oneself (self-mutilation, suicidal ideation, and suicide attempts (Duke et al. 2010), with a dose-response relationship indicating greater risk of suicide attempts and completion with more ACEs (Brodsky and Stanley 2008; Choi et al. 2017; Felitti et al. 1998).”
Badger, S., Wilkinson, D., & Chopra, I. (2024) · Trauma Violence & Abuse · doi:10.1177/15248380241306040 · Cited by 3
Panisch, L. S., Jansen, S. M., Abudushalamu, F., Petersen, T. R., & Meriwether, K. V. (2025) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-024-09926-y · Cited by 2
Woodley, M. M. O., Zhao, Q., Goldston, D. B., Michael, A. M., Clark, D. B., Brown, S. A., & Nooner, K. B. (2025) · Child Neuropsychology · doi:10.1080/09297049.2025.2451799 · Cited by 2
“The ACE-IQ measures child abuse and neglect, household challenges, and peer and community violence (Felitti et al., 1998; World Health Organization [WHO]; 2018).”
Richmond, T. S., Quinn, R., Duan, A., Morrison, C. N., Kassam‐Adams, N., Boateng, A. C. O., & Jacoby, S. F. (2025) · Journal of Urban Health · doi:10.1007/s11524-024-00956-7 · Cited by 2
“These insights were derived from research on a sample of predominately White, middle-class individuals [7].”
Dickson, S. L., Tracey, I., Cirulli, F., Kas, M. J., Konradsson‐Geuken, Å., Rostasy, K. M., Kestens, E., Arango, C., Mohr, P., Balázs, J., et al. (2025) · European Journal of Neuroscience · doi:10.1111/ejn.16680 · Cited by 2
“Studies have consistently shown that ACEs result in increased risks of physical and mental health problems (Chang et al. 2019; Felitti et al. 1998; Hughes et al. 2017).”
Adverse Childhood Experiences and Subjective Cognitive Decline Among Transgender Adults
Chiow, J., & Cicero, E. C. (2025) · Journal of Nursing Scholarship · doi:10.1111/jnu.13047 · Cited by 3
“Moreover, the proportion of TGN adults in our sample who experienced four or more ACEs was three times greater than what was found by Felitti et al. (1998).”
Therapeutic prevention of child sexual abuse: the Stand Strong, Walk Tall framework and overview
Christofferson, S. M. B., Willis, G. M., Cording, J. R., & Waitoki, W. (2025) · Psychiatry Psychology and Law · doi:10.1080/13218719.2024.2444301 · Cited by 2
“TIC principles are based on a wealth of research documenting the pervasive and enduring impacts of cumulative childhood adversity (Anda et al., 2006; Felitti et al., 1998).”
Psychological Processes Associated With Avatar Choice in Virtual Reality Gaming
Vanderburg, J. L., & Loveland, K. A. (2025) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-83549-376-220251013 · Cited by 2
Adverse Childhood Experiences Influence Longitudinal Changes in Leptin But Not Adiponectin
Matovic, S., Rummel, C. D., Neumann, E., McGrath, J. J., & Gouin, J. (2025) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001366 · Cited by 2
Childhood Adversity and Civic Engagement During Emerging Adulthood
Klein, L. M., Johnson, S. B., Sosnowski, D. W., et al. (2025) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2024.12.010 · Cited by 2
Community Impact of Capacity-Building to Develop Trauma Resilient Communities
Gilmer, T., Romero, N. J., Burgos, L., Greene, J. K., Siantz, E., Palinkas, L. A., & Lansing, A. E. (2025) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-024-01429-4 · Cited by 4
“…traumatic events such as emotional abuse or non-violent loss, or exposure to poverty, historical trauma, systemic racism, or discrimination or disenfranchisement based on race/ethnicity, gender-identity, or sexual orientation (Felitti et al., 1998; Kessler et al., 2017; Sacks & Murphey, 2018).”
Substance use and mental health symptoms in adults with prenatal alcohol exposure
Hunnicutt-Ferguson, K., Stoner, S. A., Kable, J. A., Grant, T. M., & Coles, C. D. (2025) · Neurotoxicology and Teratology · doi:10.1016/j.ntt.2025.107436 · Cited by 2
Boonyananth, N., & Swords, L. (2025) · Trauma Violence & Abuse · doi:10.1177/15248380251320979 · Cited by 2
Suchday, S., Santoro, A. F., Ramanayake, N., & Almeida, M. (2025) · Indian Journal of Social Psychiatry · doi:10.4103/ijsp.ijsp_187_22 · Cited by 2
Asian American Cultural Resources to Protect From Racial Trauma and to Promote Posttraumatic Growth
Jeung, R. M. (2025) · Journal of Psychology and Theology · doi:10.1177/00916471251320665 · Cited by 2
“Most people endure adverse childhood experiences yet grow up to be resilient and healthy (Felitti et al., 1998).”
Maxwell, J. R., Roberts, M. H., Lowe, J. R., Ma, X., Kotulski, J. F., Salisbury, A. L., & Bakhireva, L. N. (2025) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.70013 · Cited by 4
Arnold, A. R., Wang, H., Mehta, C. C., Nesbeth, P.-D. C., Bedi, B., Kirkpatrick, C., Moran, C. A., Powers, A. R., Smith, A. K., Hagen, K., et al. (2025) · Biology of Sex Differences · doi:10.1186/s13293-025-00704-9 · Cited by 2
“These findings align with extensive literature documenting the long-term consequences of childhood trauma on mental health [9, 39].”
Coen, P. M., Yi, F., Lui, L., Distéfano, G., Ramos, S. V., Goodpaster, B. H., Cawthon, P. M., Hepple, R. T., Kritchevsky, S. B., Cummings, S. R., et al. (2025) · Aging Cell · doi:10.1111/acel.70040 · Cited by 2
Childhood adversity in parents of patients with pediatric multiple sclerosis
O’Neill, K. A., Charvet, L. E., George, A., Waltz, M., Casper, T. C., Benson, L. A., Gorman, M., Mar, S., Ness, J., Schreiner, T., et al. (2025) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2025.106424 · Cited by 2
Exploring Factors of Trauma-Related Preparation and Trauma-Related Agency Among School Counselors
Rumsey, A. D., Higdon, K. L., Swisher, S., & Zimmerman, J. A. (2025) · International Journal for the Advancement of Counselling · doi:10.1007/s10447-025-09604-4 · Cited by 3
“Awareness of the negative consequences of CT has grown since the initial report on ACEs (Felitti et al., 1998), but as Chafouleas et al. (2023) and Maddox et al. (2022) point out, schools have only recently been thrust into prevention and intervention efforts for students impacted by trauma.”
Hunt, E. T., Brazendale, K., de Moraes, A. C. F., Ferreira, M. V. N., Pfledderer, C. D., Izabel, S. S., Dooley, E. E., Chen, B., Fernández, A., Johnson, M. E., et al. (2025) · Child Protection and Practice · doi:10.1016/j.chipro.2025.100154 · Cited by 3
“While the ACEs framework has been instrumental in highlighting the long-term dose-dependent effects of early adversity (Felitti et al., 1998), it has limitations in capturing the full spectrum of adversity that children and adolescents may experience, such as social determinants of health, which…”
Childhood immigration enforcement exposure and young adults’ anxiety: A mixed methods study
Lee, E., Dreby, J., Hong, Y., & Seng, T. (2025) · Children and Youth Services Review · doi:10.1016/j.childyouth.2025.108276 · Cited by 2
Le, H., Andescavage, N. N., Keller, J. M., Bassa, M., Danielson, A., Henderson, D., Bond, S., Mjenga, N., Wells, S., Quinn, P., et al. (2025) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2025.101489 · Cited by 3
Rodrigues, S. M., Saghafi, A., Wang, Q., Shin, S. S., Dube, S. L., Diestel, A., Stevens, R. C., & Bounds, D. T. (2025) · Journal of Child and Adolescent Psychiatric Nursing · doi:10.1111/jcap.70017 · Cited by 2
Assessing the Effectiveness of TSL Program for Runaway and Homeless Youth
Kim, J., Kim, J. Y., & Lee, J. (2025) · Research on Social Work Practice · doi:10.1177/10497315251335239 · Cited by 2
“Speci fi cally, ACEs Questionnaire (ACE-Q; Felitti et al., 1998) is widely used 10-item instrument designed to assess exposure to various forms of childhood adversity experienced before the age of 18 (Feltti et al., 1998).”
Marrero‐Polanco, J., Pardo, L. S., Niazi, S. K., Smith, D. G., Stoppel, C. J., Moose, C., Athreya, A. P., Cooper, L. T., & Bobo, W. V. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1581314 · Cited by 2
“…support, resilience to stress, and childhood adversity were measured using the Linear Analog Self-Assessment (LASA) (28, 29), the ENRICHD Social Support Instrument (ESSI) (30), the Brief Resilience Scale (BRS) (31), and the Adverse Childhood Experiences (ACE) questionnaire (32), respectively.”
Espinoza, S., Gutierrez, N. S., Dadras, I., Lee, K. I., Duran, M., & Garabedian, A. A. (2025) · Journal of Marital and Family Therapy · doi:10.1111/jmft.70022 · Cited by 2
Shen, G., Huang, J., Fang, J., Zhen, Y., Tang, J., Wu, L., Yang, X., Wu, S., & Chen, L. (2025) · Population Health Metrics · doi:10.1186/s12963-025-00379-9 · Cited by 2
“For instance, a seminal study by Felitti et al. found that individuals with four or more ACEs were 12 times more likely to attempt suicide, seven times more likely to be alcoholic, and 10 times more likely to inject street drugs compared to those without ACEs [13].”
InfluentialSpearman, K. J., Perrin, N., Bethell, C. D., Alexander, K. A., Hardesty, J. L., & Campbell, J. C. (2025) · Child Maltreatment · doi:10.1177/10775595251339612 · Cited by 2
“IPV and parental separation/divorce are relational health risks and two common adverse childhood experiences (ACEs) (Felitti et al., 1998).”
Laney, S., & Nooner, K. B. (2025) · Discover Mental Health · doi:10.1007/s44192-025-00202-9 · Cited by 2
“For instance, exposure to ACEs is associated with increased risk for alcoholism in adulthood as well as earlier initiation of alcohol use and use of other substances, such as marijuana, in adolescence [15–17].”
Burlaka, V., Shyrokonis, Y., Burlaka, J., Сиводєд, І. С., Serdiuk, O., & Javanbakht, A. (2025) · Current Psychology · doi:10.1007/s12144-025-07859-z · Cited by 3
“Respondents to the ACE Questionnaire are given a cumulative ACE score that represents the sum total of ACEs they report (Felitti et al., 1998).”
InfluentialAreba, E. M., Mathiason, M. A., Jewett, P. I., Taliaferro, L. A., & Borowsky, I. W. (2025) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-025-02431-8 · Cited by 2
Winn, A., Hannan, K., Sege, R. D., & Burstein, D. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22050782 · Cited by 2
“Older research has established the link between ACEs and negative health outcomes [13–18], and has associated ACEs with later violence perpetration [19,20] and other antisocial behaviors [21].”
Exposure to Community Violence and Adverse Childhood Experiences in the Emergency Department
Cachola, L., Guevara, Y., & Ansari, S. (2025) · Western Journal of Emergency Medicine · doi:10.5811/westjem.34857 · Cited by 2
Ellonen, N., Laajasalo, T., Aaltonen, M., Pitkänen, J., & Martikainen, P. (2025) · Nordic Journal of Criminology · doi:10.18261/njc.27.1.1 · Cited by 2
Webb, E. L., Gencarelli, B. L., Khan, M. N., Chatha, K., Umpunjun, P., Kamath, S., Trundle, G., & Morris, D. J. (2025) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2025.107503 · Cited by 2
Haginoya, S., Ibe, T., Yamamoto, S., Yoshimoto, N., Mizushi, H., & Santtila, P. O. (2025) · Child Protection and Practice · doi:10.1016/j.chipro.2025.100188 · Cited by 2
Vowles, K. E., Mallett, C., Brooks, J., Berry, E., Rainey, D., Briggs, C., & McCarron, M. (2025) · European Journal of Pain · doi:10.1002/ejp.70044 · Cited by 2
Roddy, S. M. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-10944-7.00034-2 · Cited by 4
Cho, M., Park, D., Choo, M., Han, D. H., & Kim, J. (2025) · JMIR Human Factors · doi:10.2196/66536 · Cited by 5
“Adolescence is a critical period of physiological, psychological, and social development; as such, mental health during this phase is intricately linked to well-being in adulthood [5].”
Allen, T. L., Lee, J., & Jenkins, P. R. (2024) · Journal of Baccalaureate Social Work · doi:10.1891/jbsw-20210315-6r · Cited by 2
Doorn, G. H. V., Statham, D. J., Dye, J., Teese, R., & Jenkins, M. (2025) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-025-00722-0 · Cited by 3
“As ACEs are interrelated (Anda et al., 1999; Felitti et al., 1998), we thought it important to consider them as a set of experiences that potentially affect depressive symptoms.”
The Road to Unfreedom: Violence and Multidimensional Poverty Among Young Australian Women
Campbell, A., Kuskoff, E., Baxter, J., & Loxton, D. J. (2025) · Violence Against Women · doi:10.1177/10778012251347607 · Cited by 2
“Exposure to DFSV during childhood was measured using 16 binary-response items adapted from the Adverse Childhood Experiences (ACEs) study (Felitti et al., 1998).”
Li, W., Pu, L., Meng, Y., Wang, X., Dong, L., Yang, Y., Liu, H., Wang, X., Liu, J., Wang, C., et al. (2025) · PubMed Central · doi:10.7189/jogh.15.04100 · Cited by 2
“Among the definitions of ACE, seven studies used the Child Trauma Questionnaire [ 20 ], four used the Childhood Family Environments Questionnaire [ 21 ], and three used the Adverse Childhood Experiences International Questionnaire [ 22 ].”
Garcia‐Rodriguez, I., West, S. J., Tirado, C., Hernandez, C. M., Fuentes, L. S., Perrin, P. B., & Moreno, O. (2025) · Behavioral Sciences · doi:10.3390/bs15060826 · Cited by 3
Cooper, C., & Lhussier, M. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-093529 · Cited by 3
Tanaka, Y., Otsuka, Y., Nakajima, S., Itani, O., Miyoshi, T., & Kaneita, Y. (2025) · Clocks & Sleep · doi:10.3390/clockssleep7030034 · Cited by 2
Perspective: Restoring rest—the critical role of sleep in foster care well-being
Shaik, L., McLeigh, J. D., & Wani, A. (2025) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.11806 · Cited by 2
Indicators of Intergenerational Transmission of Cannabis Use Among US Young Adults
Cui, Y., Wang, Y., LoParco, C. R., Romm, K. F., Cavazos‐Rehg, P. A., Chakraborty, R., McCready, D. M., Yang, Y. T., & Berg, C. J. (2025) · Substance Use & Addiction Journal · doi:10.1177/29767342251337212 · Cited by 2
Xiang, X., Zhang, X., Narbut, E., Turner, S., Ash, S., Ciagne, C., & Kong, D. (2025) · Clinical Gerontologist · doi:10.1080/07317115.2025.2528238 · Cited by 2
“…(ACEs), including emotional abuse, physical abuse, sexual abuse, physical neglect, emotional neglect, parent separation or divorce, mental illness in the household, household substance use, parent treated violently, and incarcerated household member (Felitti et al., 1998; Murphy et al., 2014).”
Haga, S. M., Jacobsen, H., & Engell, T. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-12937-w · 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
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