Examination of the factorial structure of adverse childhood experiences and recommendations for three subscale scores
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OBJECTIVE: The purpose of the current investigation is to assess and validate the factor structure of the Behavioral Risk Factor Surveillance System's (BRFSS) Adverse Childhood Experience (ACE) module. METHOD: ACE data available from the 2009 BRFSS survey were fit using exploratory factor analysis (EFA) to estimate an initial factorial structure. The exploratory solution was then validated using confirmatory factor analysis (CFA) with data from the 2010 BRFSS survey. Lastly, ACE factors were tested for measurement invariance using multiple group factor analysis. RESULTS: EFA results suggested that a 3-factor solution adequately fit the data. Examination of factor loadings and item content suggested the factors represented the following construct areas: Household Dysfunction, Emotional/Physical Abuse, and Sexual Abuse. Subsequent CFA results confirmed the 3-factor solution and provided preliminary support for estimation of an overall latent ACE score summarizing the responses to all available items. Measurement invariance was supported across both gender and age. CONCLUSIONS: Results of this study provides support for the use of the current ACE module scoring algorithm, which uses the sum of the number of items endorsed to estimate exposure. However, the results also suggest potential benefits to estimating 3 separate composite scores to estimate the specific effects of exposure to Household Dysfunction, Emotional/Physical Abuse, and Sexual Abuse.
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The ACE module has overall internal consistency of 0.78, with subscale alphas ranging between 0.61 and 0.80.
“In terms of psychometric properties for the ACE module, overall internal consistency is reported to be 0.78, with subscale alphas ranging between 0.61 and 0.80 (Ford et al., 2014).”
From Assessing the Validity of the Trauma Inventory for Partners of Sex Addicts (TIPSA) (2020) · cites this paper as Ford et al., 2014
The Results section, “Factor Means and Reliabilities” (page unavailable), reports alphas from 0.61 to 0.80, supporting the stated subscale range. It reports 0.80—not 0.78—for the Overall ACE score. (LLM, conf=0.92)
Experimental — accuracy not yet measuredThe 11-item ACE module was used to measure childhood adversity.
“Childhood adversity was measured using the 11-item Adverse Childhood Experience (ACE) module from the Behavioral Risk Factor Surveillance System (Ford et al., 2014).”
From Prevalence of meditation-related adverse effects in a population-based sample in the United States (2022) · cites this paper as Ford et al., 2014
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- Authors
- Ford, D. C., Merrick, M. T., Parks, S. E., Breiding, M. J., Gilbert, L. K., Edwards, V. J., Dhingra, S. S., Barile, J. P., & Thompson, W. W.
- Affiliations
- Centers for Disease Control and Prevention (US)
- University of Hawaiʻi at Mānoa (US)
- ORCID
- Venue
- Psychology of Violence
- Published
- 2014-10
- Volume
- 4
- Issue
- 4
- Pages
- 432-444
- ISSN
- 2152-081X (ISSN-L)
- 2152-0828
- PMC
- PMC4587306
- OpenAlex
- W1972154151
- Cited by
- 301
- References
- 49
- Citations by year
- 2026: 27 · 2025: 38 · 2024: 35 · 2023: 41 · 2022: 37 · 2021: 36 · 2020: 37 · 2019: 17 · 2018: 13 · 2017: 11 · 2016: 5 · 2015: 2 · 2014: 1
- FWCI
- 7.44
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychology of Violence (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Safety Research › Child Welfare and Adoption
- Keywords
- adverse childhood experiences, factor structure, Behavioral Risk Factor Surveillance System, household dysfunction, sexual abuse, measurement invariance, composite score, child abuse
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