Beyond cumulative scores: measuring childhood adversity by type

Adverse childhood experiences (ACEs) refer to potentially harmful experiences occurring before age 18 years, including abuse (eg, physical, emotional, and sexual), neglect (eg, physical and emotional), and household dysfunction (eg, exposure to domestic violence, substance misuse in the family of origin, and family imprisonment).1,2 Since Felitti’ seminal ACEs study in 1998,2 evidence has shown that childhood adversity is associated with short-term and long-term outcomes, including health-risk behaviours, mental disorders, chronic disease, and violence.