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
49 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 · 1 No basis given · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
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
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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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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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 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
boostedcorrelational- 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.”
§ Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study > Abstract
hedgedcorrelational- 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
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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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
boostedcorrelational- 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
plaincorrelational- 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
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- It may state two separate claims as one. 16
- Probably not a substantial claim. 22
- The quote only partly states this claim. 2
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
plaincorrelational- 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
“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
plaincorrelational- 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
“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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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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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
plaincorrelational- 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
“| 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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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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
“| 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
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one. The quote only partly states this claim.
- 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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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one. The quote only partly states this claim.
- 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
plaincorrelational- 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
“| 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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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. 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
boostedcorrelational- 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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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 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
plaincorrelational- 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- 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
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
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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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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
hedgedconditional- 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.
- 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.
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
plaincorrelational- 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
hedgedconditional- 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
boostedcorrelational- 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
hedgedconditional- 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.
- 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
“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
hedgedconditional- 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
plaincorrelational- 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
hedgedconditional- 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
plaincorrelational- 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
“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
“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
“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
“Children enter foster care with a sum of adverse childhood experiences.55–57”
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
“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]
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
“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]
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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Hubel, G. S., Goodrum, N. M., Williams, B., & Srivastav, A. (2025) · Health Communication · doi:10.1080/10410236.2025.2582773
“Research has consistently shown that ACEs are linked to a large range of health risk behaviors and poor mental and physical health outcomes in adulthood (Chapman et al., 2004; Felitti et al., 1998; Hughes et al., 2017).”
Stressful life experiences and mental health symptoms in adults with down syndrome
Hickey, E., Greenlee, J. L., Jenkins, M. R., Schworer, E. K., Brothers, C., Hom, C. L., Handen, B. L., & Hartley, S. L. (2025) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2025.105152
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Freisthler, B., Thurston, H., Sarabia, J., et al. (2025) · International Journal on Child Maltreatment Research Policy and Practice · doi:10.1007/s42448-025-00246-y
“…and emotional injury or death, child maltreatment sequelae also result in lifelong effects, such as learning and memory difficulties (Shonkoff, 2012), and is included in the list of childhood adverse events that are considered risk factors for early morbidity and mortality (Felitti et al., 1998).”
Baschab, J. F., Feindel, K., Möhler, E., & Hussong, J. (2025) · Children · doi:10.3390/children12111519
“To assess the caregivers’ adverse childhood experiences, the German version of the Adverse Childhood Experiences Questionnaire (ACE-D) was used [8,24].”
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Profile of kindergarten children exposed to adverse childhood experiences
Ler, G. Y. L., Chow, W. H., Oh, J. Y., Ong, L. M., Vera, R. A. D., & Yeleswarapu, S. P. (2025) · Proceedings of Singapore Healthcare · doi:10.1177/20101058251396675
“4,30,31 Majority of our study population experienced maltreatment with the most common form being physical abuse (55.8%).”
InfluentialJawad, N., Golkari, A., & Bernabé, E. (2025) · Community Dental Health · doi:10.1177/0265539x251400458
“ACEs include child maltreatment (physical, emotional or sexual abuse, emotional neglect) and household dysfunction (such as parental separation, mental illness, violence, substance abuse or imprisonment) (Bethell et al., 2017; Felitti et al., 1998; Krinner et al., 2021).”
Muruthi, B. A., Ewing, E. S. K., Chou, J. L., Slaughter‐Acey, J., Bennett, D. S., & McRell, A. S. (2025) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-025-02714-0
Adapting an Evidence-Based Group Intervention for Trauma in Telehealth Practice
Elswick, S. E., Latta, C., Mangrum, H., et al. (2025) · Lecture notes in networks and systems · doi:10.1007/978-3-032-07109-5_3
Adaptation of the Russian version of the Somatoform Dissociation Questionnaire-5 (SDQ-5)
Zolotareva, A. A., Викторовна, К. Е., Ulyanova, A. S., Владимирович, Ч. Н., & Kostyuk, G. P. (2025) · V M BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY · doi:10.31363/2313-7053-2025-4-2-1116
Depression in adolescents on treatment for rifampicin-susceptible TB in Lima, Peru
Sanchez-Guzman, V., Tanzer, J. R., Sinche, B. R., Santacruz, J., Contreras, C., Desrosiers, A., Lecca, L. W., & Chiang, S. S. (2025) · IJTLD OPEN · doi:10.5588/ijtldopen.25.0305
Tambyah, M., & Sempowicz, T. (2025) · International Journal of Inclusive Education · doi:10.1080/13603116.2025.2571711
Choi, J., Kim, J.-W., & Kim, K. (2025) · Children and Youth Services Review · doi:10.1016/j.childyouth.2025.108676
Steketee, A., Doria, M. J., & Kile, S. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/979-8-88730-071-920251015
Adverse childhood experiences, adult hardships, and disease severity in peripheral artery disease
Hmeluk, N. V., Jelley, M., Homco, J. B., Nsa, W., Nelson, P. R., Miller‐Cribbs, J., Abadi, A., & Kempe, K. (2025) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2025.11.011
Woon, J. M., Kilpatrick, A., & McLean, K. (2025) · Journal of Paediatrics and Child Health · doi:10.1111/jpc.70235
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Behavioral Science, Trauma, and Higher Education
Demiri, V., Morgan, G., Li, A., et al. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-64802-723-920251025
Trauma-Inclusive Programming Practices
Rampe, R. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-64802-723-920251011
Teaching Upstream Toward Resilient Learning
Wilson, E. J. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-64802-723-920251021
Implementing a Trauma-Informed Care Curriculum in Undergraduate Medical Education
Grossman, S., Berman, S., Brown, T., Lewis-O’Connor, A., McDaniel, K., Mehta, P., Potter, J. E., Radford, C. C., Rittenberg, E., Trinh, N., et al. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-64802-723-920251014 · Cited by 1
Trauma-Informed Counselor Education for Adults in Recovery from Substance Use
Heffner, J. P., & McCadden, T. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-64802-723-920251016
Duwe, G., & Clark, V. A. (2025) · The Prison Journal · doi:10.1177/00328855251396459
“The Childhood Trauma domain is measured using the adverse childhood experiences (ACEs) index adapted from the Family Health History questionnaire developed by Felitti et al. (1998).”
Equipping and Empowering the Next Generation of Teachers
Fantaroni, G., & Bertrand, H. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/979-8-88730-109-920251006
Teacher Candidate Perceptions and Knowledge of Trauma-Informed Practices in Schools
Wells, T., Gee, V., & Chimka, M. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/979-8-88730-109-920251012
Hermosura, L., & Wiebe, M. T. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/979-8-88730-109-920251007
Attachment and Complex Trauma: Evaluating Outcomes for Children in Therapeutic Residential Care
Farnfield, S., & Onions, C. (2025) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045251401092 · Cited by 1
“Adverse childhood experiences (ACEs) (Felitti et al., 1998) can be divided into direct child maltreatment (physical and sexual abuse, neglect) and intra or inter parental problems leading to disruptions in caregiving; i.e. domestic violence, substance abuse, imprisonment, mental illness (Maneiro et…”
A mediation analysis of academic resilience amid COVID-19 pandemic worries
Roach, P., Niyirora, J., Joseph, J., & Jacobs, R. J. (2026) · Discover Psychology · doi:10.1007/s44202-026-00814-4
“The sum of affirmative responses was used as a brief victimization-based proxy indicator of ACEs [9].”
Epidemiology, Ergonomics, and Epigenetics: Performance Traumatic Stress Disorder (PTSD)
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How Deviating Autobiographical Memories Shape the Life Story
Camia, C., & Bohn, A. (2025) · Cambridge University Press eBooks · doi:10.1017/9781009492140.013
Narratives, Perspective-Taking, and Emotion Regulation
Bartoli, E., & Fishere, M. (2025) · Cambridge University Press eBooks · doi:10.1017/9781009492140.018
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“21 In addition, deaths from suicide and drug overdose are often preceded by persistent psychological distress, which independently predicts both suicide 22–24 and drug overdose death 23 25 26 in large prospective studies.”
Jin, C., Tooth, L. R., Xu, X., & Mishra, G. D. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120726
Strengthening Community Relationships with a Symbiotic PDS Partnership
Christopher, S., & Jill, C. (2020) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-64802-191-620251005
Zou, L., Wang, S., Krewski, D. R., Wen, S. W., & Xie, R. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120723
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“The baseline interview incorporated Stressful Life Events [30], Adverse Childhood Experiences [31], Early Trauma Inventory [32,33], and Resilience Scale [34].”
Swift, E., Gylfadóttir, Á. D., Jóhannsdóttir, Ö., Sigurðardóttir, V. L., Thordardottir, E. B., Hauksdóttir, A., Tómasson, G., Aspelund, T., Valdimarsdóttir, U. A., & Zoëga, H. (2025) · Midwifery · doi:10.1016/j.midw.2025.104674 · Cited by 1
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Trauma-informed, Compassionate Crisis and Inpatient Care
Riches, C., Mitchell, S., & Ashton, A. (2025) · doi:10.1093/9780191915543.001.0001
Fostering Well-Being in Youth: Understanding the Influence of Productive and Risk Factors
Çağış, Z. G., & Yıldırım, M. (2025) · Springer eBooks · doi:10.1007/978-3-032-00025-5_25
Tomono, N., Hanazato, M., Kondo, K., Ide, K., & Nakagomi, A. (2025) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2025.103319
“Although not in the original ACEs study (Felitti et al., 1998), a recent study includes childhood poverty (Matsukura et al., 2023).”
Introduction to integrated holistic mental healthcare
Reddy, K. J. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-43908-7.00010-0
Zak-Hunter, L. M., Okitondo, C. D., Tate, A. D., Mulhern, K., Brustad, A., Miller, L., & Berge, J. M. (2025) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-025-01816-5
Türkeli, A. (2025) · Journal of Interpersonal Violence · doi:10.1177/08862605251384935
Lee, C., & Liao, L. (2025) · Journal of Interpersonal Violence · doi:10.1177/08862605251390545
Yu, S., Kim, D. H., Kweon, S., Min, C., & Nam, B. (2025) · Journal of Interpersonal Violence · doi:10.1177/08862605251376346
Kimpel, C. C., Finamore, V., & Clouse, K. (2025) · Journal of Palliative Medicine · doi:10.1177/10966218251395872
Évolution des pratiques au sein de l’Équipe Mobile Intersectorielle pour Enfants Confiés (EMI ECO)
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The Hidden Party in Mentorship Dyads: Trauma’s Influence on Wellbeing
Lindsay, S. G., & Sullivan, D. K. (2025) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-80592-216-220251005
Sacotte, K. A., Nampijja, J., & Torr, C. B. (2025) · Journal of Perinatology · doi:10.1038/s41372-025-02498-5
“The use of the ACEs screening tool during social work assessments [2], completion of the screening tool, and [3] appropriateness and accuracy of documentation.”
Conclusion: Mental Health and Trauma Recovery
Costello, A., & Carson, J. (2025) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-83708-978-920251010
Shirley, H., Amanda, S., Jenny, J., & Jennifer, D. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-64802-994-320251007
Tracey, S. H., & Swain, H. H. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-64802-994-320251006
Introducing a Trauma-Informed Course to Teacher Education in England
Truelove, L., & Mark, B. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-64802-994-320251016
Trauma-Informed Practices in Early Childhood Education
Megan, L. P., & Karen, R. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-64802-994-320251012
Views and Perspectives on Children With Complex Health Complaints and Complex Care Needs
Almgren, P., & Gelander, L. (2025) · Acta Paediatrica · doi:10.1111/apa.70383
“Moreover, conditions resulting from child abuse, parental stress or emotional or physical neglect can present with symptoms that mimic medical problems like chronic pain [5] or growth disorders [6].”
Social Support Among Minoritized Emerging Adults With Serious Psychological Health Issues
Banya, M., Villodas, M. L., Rodwin, A. H., Shimizu, R., Moore, K. L., Magan, I. M., Sapiro, B., & Munson, M. R. (2025) · Emerging Adulthood · doi:10.1177/21676968251399938
“ACEs are stressful and potentially traumatic events that occur during childhood (Felitti et al., 2019).”
Troëng, A., Dolk, J., Vinnars, M., Hallqvist, J., & Kristiansson, P. (2025) · PLoS ONE · doi:10.1371/journal.pone.0333366 · Cited by 1
“Exposure to ACEs is associated with an increased risk a number of health issues, including public health diseases such as stroke and cancer [1,4,5], increased risk behaviors [6], and lower socioeconomic outcomes [7].”
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“That is, environmental risks are often inter-related [21], exacerbating their adverse effects [22], which suggests that the determinants of PPD and anxiety may consist of a combination of different contexts.”
Alam, M. A., Ward, J. S., Callaway, L. K., et al. (2025) · Public Health · doi:10.1016/j.puhe.2025.106061
Ethical Considerations in Research Involving Street
Sadzaglishvili, S. (2025) · Springer eBooks · doi:10.1007/978-3-030-68127-2_576-1
Adverse childhood experiences, emotion regulation and subjective happiness among young adults
Asawa, P., Pandey, S., & Srivastava, A. (2025) · Discover Public Health · doi:10.1186/s12982-025-01126-z
“…Experiences Questionnaire looks at the following ACE categories: physical, sexual, and emotional abuse in childhood; physical and emotional neglect in childhood; witnessing domestic violence as a child; and growing up with a mentally ill, drug-abusing, or imprisoned household member [19, 21].”
InfluentialAdverse Childhood Experiences, DNA Methylation, and Depressive Symptoms in Black Pregnant Women
Nowak, A. L., Solberg, M. A., Liang, X., Magaña, F., Misra, D. P., & Giurgescu, C. (2025) · Epigenomes · doi:10.3390/epigenomes9040048 · Cited by 1
“ACEs have long been known to contribute to adult depression [8–12], including prenatal and postpartum depression [13,14].”
The Trauma-Sensitive Urban Educator Model
Graham, J., Kyere, E., & Jackson, T. O. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-64802-879-320251011
Summers, L. M. (2022) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-64802-879-320251014
Kim, J. Y., Shin, N. E., & Kim, D. H. (2025) · Journal of Interpersonal Violence · doi:10.1177/08862605251392279
Safe haven – a trauma-informed care model for oral health practitioners: a commentary
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Trauma-Informed Support of Young Adolescent Students in Foster Care
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Emmanuel, O. T. (2025) · European Journal of Arts Humanities and Social Sciences · doi:10.59324/ejahss.2025.2(6).11 · Cited by 1
The role of childhood trauma in the development of psychopathology via neurocognitive pathways
Debariya (2025) · International Journal of Research in Medical Sciences · doi:10.18203/2320-6012.ijrms20254002
Trauma and ageism: intersections of harm across the lifespan
Amateau, G., Newbanks-Hawks, C., & MacDonald, C. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-33827-4.00014-6
Shi, Y., Xie, S., & MacBeth, A. M. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120789
Perrins, S. P., Sheremenko, G., King, J., Garraza, L. G., Cincotta, K., Miedema, S. S., Cremer, L. J., D’Inverno, A. S., & Harper, C. R. (2025) · Prevention Science · doi:10.1007/s11121-025-01857-0
“Adverse childhood experiences (ACEs) are potentially traumatic childhood events associated with significant negative health outcomes throughout the lifespan (Anda et al., 2006; Felitti et al., 1998; National Center for Injury Prevention and Control, 2019, 2020).”
Lloyd, C. A., & Ren, K. (2025) · Irish Educational Studies · doi:10.1080/03323315.2025.2591081
Sheehan, P., Deng, Y., Phelps, H. E., Jasinski, N. E., Pyle, K., Coleman, M. M., Sblendorio, D., Talkington, D., Murray, A. M., Memon, A., et al. (2025) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2025.112479
Lu, W., Pole, N., Wang, K., Jia, Y., Rogers, K., Siriram, A., Brown, L., Yao, Y., Yanos, P. T., Waynor, W. R., et al. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116858
Slack, H. R., Fovargue, I., Liu, X., & Matheron, A. (2025) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2025.107829
Bank as financial educator: How childhood financial development shapes investment behaviors
Lei, Y., Zhang, L., Zhang, Y., et al. (2025) · International Review of Financial Analysis · doi:10.1016/j.irfa.2025.104847
Fracture risk in the offspring of individuals with schizophrenia: A cohort study of 71,698 children
Wang, S.-C., Hsu, J.-W., Tsai, S., Bai, Y., Su, T., Chen, T., Huang, W.-S., & Chen, M. (2025) · Schizophrenia Research · doi:10.1016/j.schres.2025.11.015
Karjalainen, K., Raitasalo, K., & Rönkä, S. (2025) · Drug and Alcohol Review · doi:10.1111/dar.70083 · Cited by 1
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“ACEs refer to various forms of adversity experienced during childhood, such as psychological, physical, or sexual abuse; witnessing violence against one’s mother; and living with household members who abused substances, had mental illness or suicidal behaviors, or had been incarcerated [7].”
Mental Health Prevention in Services for Children
Chan, C., Lister, M., & Hindley, N. (2025) · Cambridge University Press eBooks · doi:10.1017/9781009110266.021
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Reduced social support perpetuates disadvantage across the lifespan for Australian women
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Stressful events throughout the life cycle and social inequalities in a cohort study
Lessa, I. M., da Silva, B. G. C., Menezes, A. M. B., Wehrmeister, F. C., & Gonçalves, H. (2025) · Cadernos de Saúde Pública · doi:10.1590/0102-311xen052125
Bao, C.-Q., Zou, H.-W., Zhang, Q.-Y., Xia, Y., Wang, X.-Q., Tian, S., Lu, Q., & Yao, Z. (2025) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-025-02141-6
“ACEs refer to poten - tially traumatic events occurring before the age of 18, pri - marily including abuse, neglect and family dysfunction [ 11 ].”
Vulnérabilités, adversités de vie et passage à l’acte féminin
Doffiny, V., Leclerc, C., & André, S. (2025) · Criminologie · doi:10.7202/1121875ar
Kostić, J. O., Binić, I., Krivokapić, Ž., Milijic, A., Stevanović, S., & Petković, M. (2025) · Psychiatry International · doi:10.3390/psychiatryint6040155
“…in this field, the CDC–Kaiser Permanente Adverse Childhood Experiences (ACE) Study from the late 1990s, established a clear association between ACEs and wide range of negative health outcomes, including risky health behaviors, mental illness, reduced life expectancy, and premature death [2].”
InfluentialResilience Amidst Ambiguity: Considerations for Family Members Affected by Alcohol Use Disorders
Navarro, G. H., & Fickling, M. J. (2025) · Alcoholism Treatment Quarterly · doi:10.1080/07347324.2025.2601679
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Examining Elementary Educators’ Awareness and Perceptions of Trauma-Informed Teaching Approaches
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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.
A language model drew the claims from the paper on 2026-10-11, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-11 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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