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Examination of the factorial structure of adverse childhood experiences and recommendations for three subscale scores
Open accessAbstract
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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“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
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“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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Citations
Cites
Hu, L., & Bentler, P. M. (1999) · Structural Equation Modeling A Multidisciplinary Journal · doi:10.1080/10705519909540118 · Cited by 108,788
Coefficient Alpha and the Internal Structure of Tests
Cronbach, L. J. (1951) · Psychometrika · doi:10.1007/bf02310555 · Cited by 43,931
Alternative Ways of Assessing Model Fit
Browne, M. W., & Cudeck, R. (1992) · Sociological Methods & Research · doi:10.1177/0049124192021002005 · Cited by 27,200
Comparative fit indexes in structural models.
Bentler, P. M. (1990) · Psychological Bulletin · doi:10.1037/0033-2909.107.2.238 · Cited by 25,266
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(98)00017-8 · Cited by 18,943
Self-citationEvaluating Goodness-of-Fit Indexes for Testing Measurement Invariance
Cheung, G. W., & Rensvold, R. B. (2002) · Structural Equation Modeling: A Multidisciplinary Journal · doi:10.1207/s15328007sem0902_5 · Cited by 16,280
Psychometric theory (2nd ed.).
Sitgreaves, R. (1979) · Contemporary Psychology · doi:10.1037/018882 · Cited by 14,384
Sensitivity of Goodness of Fit Indexes to Lack of Measurement Invariance
Chen, F. F. (2007) · Structural Equation Modeling: A Multidisciplinary Journal · doi:10.1080/10705510701301834 · Cited by 12,217
Child abuse: Adolescent records vs. adult recall
Femina, D. D., Yeager, C. A., & Lewis, D. O. (1990) · Child Abuse & Neglect · doi:10.1016/0145-2134(90)90033-p · Cited by 8,820
The Revised Conflict Tactics Scales (CTS2): Development and Preliminary Psychometric Data
STRAUS, M. A., HAMBY, S. L., BONEY-McCOY, S., & SUGARMAN, D. B. (1996) · Journal of Family Issues · doi:10.1177/019251396017003001 · Cited by 6,923
The PHQ-9: A New Depression Diagnostic and Severity Measure
Kroenke, K., & Spitzer, R. L. (2002) · Psychiatric Annals · doi:10.3928/0048-5713-20020901-06 · Cited by 5,898 · cited 1×
“…health surveys for surveillance purposes and has been demonstrated for assessment of the prevalence of depression and major depression using the Patient Health Questionnaire in the U.S. (PHQ-9 [Kroenke & Spitzer, 2002], PHQ-8 [Kroenke et al., 2009], and PHQ-2 [Löwe, Kroenke, & Grafe, 2005]).”
MethodA scaled difference chi-square test statistic for moment structure analysis
Satorra, A., & Bentler, P. M. (2001) · Psychometrika · doi:10.1007/bf02296192 · Cited by 5,282
The PHQ-8 as a measure of current depression in the general population
Kroenke, K., Strine, T. W., Spitzer, R. L., Williams, J. B. W., Berry, J. T., & Mokdad, A. H. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.06.026 · Cited by 5,121
Measurement Invariance, Factor Analysis and Factorial Invariance
Meredith, W. (1993) · Psychometrika · doi:10.1007/bf02294825 · Cited by 4,536
Starting at the beginning: an introduction to coefficient alpha and internal consistency
Streiner, D. L. (2003) · Journal of Personality Assessment · doi:10.1207/s15327752jpa8001_18 · Cited by 3,794
Sensitive questions in surveys.
Tourangeau, R., & Yan, T. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.5.859 · Cited by 3,057
Ensuring Positiveness of the Scaled Difference Chi-square Test Statistic
Satorra, A., & Bentler, P. M. (2009) · Psychometrika · doi:10.1007/s11336-009-9135-y · Cited by 2,880
Adverse childhood experiences and the risk of depressive disorders in adulthood
Chapman, D. P., Whitfield, C. L., Felitti, V. J., Dube, S. R., Edwards, V. J., & Anda, R. F. (2004) · Journal of Affective Disorders · doi:10.1016/j.jad.2003.12.013 · Cited by 2,267
Self-citationMuthén, B. (1984) · Psychometrika · doi:10.1007/bf02294210 · Cited by 2,029
Edwards, V. J., Holden, G. W., Felitti, V. J., & Anda, R. F. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.8.1453 · Cited by 1,832
Self-citationFinkelhor, D., Hotaling, G., Lewis, I. A., & Smith, C. (1990) · Child Abuse & Neglect · doi:10.1016/0145-2134(90)90077-7 · Cited by 1,754 · cited 2×
“population reports having experienced at least one ACE (Bynum et al., 2010; Felitti et al., 1998; Finkelhor et al., 1990).”
BackgroundThe interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction
Dong, M., Anda, R. F., Felitti, V. J., Dube, S. R., Williamson, D. F., Thompson, T. J., Loo, C. M., & Giles, W. H. (2004) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2004.01.008 · Cited by 1,679
Physical Violence in American Families: Risk Factors and Adaptations to Violence in 8,145 Families.
Goetting, A., Straus, M. A., & Gelles, R. J. (1990) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2073234 · Cited by 1,670
Detecting and monitoring depression with a two-item questionnaire (PHQ-2)
Löwe, B., Kroenke, K., & Gräfe, K. (2005) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2004.09.006 · Cited by 1,473
Widaman, K. F., & Reise, S. P. (1997) · The science of prevention: Methodological advances from alcohol and substance abuse research. · doi:10.1037/10222-009 · Cited by 1,146
Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression
Anda, R. F., Whitfield, C. L., Felitti, V. J., Chapman, D., Edwards, V. J., Dube, S. R., & Williamson, D. F. (2002) · Psychiatric Services · doi:10.1176/appi.ps.53.8.1001 · Cited by 972
Self-citationRecall of childhood trauma: A prospective study of women's memories of child sexual abuse.
Williams, L. M. (1994) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.62.6.1167 · Cited by 947
Anda, R. F., Butchart, A., Felitti, V. J., & Brown, D. W. (2010) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2010.03.015 · Cited by 864
The sexual abuse of Afro-American and White-American women in childhood
Wyatt, G. E. (1985) · Child Abuse & Neglect · doi:10.1016/0145-2134(85)90060-2 · Cited by 826
Disease control priorities in developing countries, second edition
Jamison, D., Breman, J., Measham, A., Alleyne, G., Claeson, M., Evans, D. B., Jha, P., Mills, A., & Musgrove, P. (2006) · World Bank, Washington, DC eBooks · doi:10.1596/978-0-8213-6179-5 · Cited by 812
Do Self-Report Instruments Allow Meaningful Comparisons Across Diverse Population Groups?
Gregorich, S. E. (2006) · Medical Care · doi:10.1097/01.mlr.0000245454.12228.8f · Cited by 802
PUBLIC HEALTH SURVEILLANCE IN THE UNITED STATES
THACKER, S. B., & BERKELMAN, R. L. (1988) · Epidemiologic Reviews · doi:10.1093/oxfordjournals.epirev.a036021 · Cited by 767
Dube, S. R., Miller, J. W., Brown, D. W., Giles, W. H., Felitti, V. J., Dong, M., & Anda, R. F. (2006) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2005.06.006 · Cited by 698
Sass, D. A. (2011) · Journal of Psychoeducational Assessment · doi:10.1177/0734282911406661 · Cited by 531
Toward a Further Understanding of and Improvement in Measurement Invariance Methods and Procedures
Vandenberg, R. (2002) · Organizational Research Methods · doi:10.1177/1094428102005002001 · Cited by 489
Body weight and obesity in adults and self-reported abuse in childhood
Williamson, D., Thompson, T., Anda, R., Dietz, W., & Felitti, V (2002) · International Journal of Obesity · doi:10.1038/sj.ijo.0802038 · Cited by 460
A multidimensional assessment of stressful life events among adolescents: Derivation and correlates
Newcomb, M. D., Huba, G. J., & Bentler, P. M. (1981) · Journal of Health and Social Behavior · doi:10.2307/2136681 · Cited by 359 · cited 3×
“Although the literature has demonstrated that some of the ACE constructs can be measured appropriately with valid and reliable items (Straus, Hamby, Boney-McCoy, & Sugarman, 1996; Newcomb et al., 1981), the 11 items adapted from the original Kaiser/CDC ACE studies have never been examined together in terms of understa…”
BackgroundMethodInfluentialAdverse childhood experiences reported by adults - five states, 2009.
Bynum, L. A., Griffin, T., Riding, D., Wynkoop, K. S., Anda, R. F., Edwards, V., Strine, T. W., Liu, Y., McKnight-Eily, L. R., & Croft, J. B. (2010) · MMWR Morbidity and Mortality Weekly Report · Cited by 331
Self-citationSOME ISSUES IN RESEARCH ON STRESSFUL LIFE EVENTS
Dohrenwend, B. S., & Dohrenwend, B. P. (1978) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-197801000-00003 · Cited by 318
Ross, C. E., & Mirowsky, J. (1979) · Journal of Health and Social Behavior · doi:10.2307/2136437 · Cited by 296
Public Health Surveillance: A Tool for Targeting and Monitoring Interventions
Nsubuga, P., White, M., Thacker, S. B., Anderson, M., Blount, S. B., Broome, C. V., Chiller, T. M., Espitia, V. E., Imtiaz, R., Sosin, D., et al. (2006) · Cited by 272
Leeb, R. T., Lewis, T. H., & Zolotor, A. J. (2011) · American Journal of Lifestyle Medicine · doi:10.1177/1559827611410266 · Cited by 258
Adverse childhood experiences reported by adults --- five states, 2009.
(2010) · PubMed · Cited by 236
Rogosch, F. A., Dackis, M. N., & Cicchetti, D. (2011) · Development and Psychopathology · doi:10.1017/s0954579411000587 · Cited by 138
Horn, J. L., McArdle, J. J., & Mason, R. (1983) · Cited by 63
The Interrelation of Adverse Childhood Experiences within an At-Risk Pediatric Sample
Scott, B. G., Burke, N. J., Weems, C. F., Hellman, J. L., & Carrión, V. G. (2013) · Journal of Child & Adolescent Trauma · doi:10.1080/19361521.2013.811459 · Cited by 60
Autobiographical Memory Disturbances in Childhood Abuse Survivors
Edwards, V. J., Fıvush, R., Anda, R. F., Felitti, V. J., & Nordenberg, D. F. (2001) · Journal of Aggression Maltreatment & Trauma · doi:10.1300/j146v04n02_11 · Cited by 53
Self-citationA checklist for life event research
Cleary, P. J. (1980) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(80)90042-2 · Cited by 42
A Comment on "A Comparison of Life-Event-Weighting Schemes"
Kessler, R. C. (1980) · Journal of Health and Social Behavior · doi:10.2307/2136624 · Cited by 5
Cited by
Sorted by citations
Merrick, M. T., Ford, D. C., Ports, K. A., & Guinn, A. S. (2018) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2018.2537 · Cited by 1,189
Self-citationAdverse childhood experiences and life opportunities: shifting the narrative
Metzler, M., Merrick, M. T., Klevens, J., Ports, K. A., & Ford, D. C. (2017) · Children and Youth Services Review · doi:10.1016/j.childyouth.2016.10.021 · Cited by 713
Self-citationMerrick, M. T., Ford, D. C., Ports, K. A., Guinn, A. S., Chen, J., Klevens, J., Metzler, M. M., Jones, C. M., Simon, T. R., Daniel, V. M., et al. (2019) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6844e1 · Cited by 698
Self-citationThe frequencies and disparities of adverse childhood experiences in the U.S.
Giano, Z. D., Wheeler, D., & Hubach, R. D. (2020) · BMC Public Health · doi:10.1186/s12889-020-09411-z · Cited by 516
Bethell, C. D., Carle, A., Hudziak, J., Gombojav, N., Powers, K., Wade, R., & Braveman, P. (2017) · Academic Pediatrics · doi:10.1016/j.acap.2017.04.161 · Cited by 483
Metadata
- 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 › Sociology and Political Science › 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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