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Conceptualizing and measuring childhood adversity

A comprehensive critique of the adverse childhood experiences measure and offering a new conceptualization of childhood adversity

Bibliographic Data

ID9050671
AuthorsMichael Fitzgerald (0000-0002-2161-3792, Oklahoma State University), Kami Gallus (0000-0003-1644-1479, Oklahoma State University)
Year2025
Volume95
Issue3
Pages274-287
Publication date2025-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Orthopsychiatry (JOURNAL)
Journal identifiersISSN: 0002-9432 • E-ISSN: 1939-0025
PublisherAmerican Psychological Association (APA) (PUBLISHER)
DOI10.1037/ort0000785
PMID39298243
OpenAlexW4402641975
LanguageEN
Citations received6

The landmark adverse childhood experiences (ACEs) study conducted by Kaiser Permanente and the Centers for Disease Control shook the bedrock of the scientific community, highlighting the commonality of ACEs and identifying a dose-response relationship with poor health outcomes. The seminal findings led to a surge in ACEs research and a growing body of empirical literature; however, the ACEs measure has numerous conceptual and measurement issues that are often overlooked in the research. Such problems include a lack of a clear conceptual definition of what constitutes an ACE, item formulation and coverage, item scoring, and lack of contextual information. The current article aims to integrate existing critiques of the ACEs measure, extend critiques in greater detail, and proffer new ideas related to the conceptualization and study of ACEs. In preference to conceptualizing ACEs consistent with existing literature, we make a case that there are four unique and conceptually distinct subcategories of ACEs that should be conceptualized independently as individual adversities that frequently co-occur. We provide recommendations for researchers and discuss the utility of the ACEs measure as a screening tool. (PsycInfo Database Record (c) 2025 APA, all rights reserved)

Adverse Childhood Experiences · Conceptualization · Developmental psychology · Early childhood · Measure (data warehouse) · Mental health · Psychiatry · Child Abuse and Trauma · Psychology · Resilience and Mental Health

  • The trauma turn in mental health care

    Open Access•Sebastian Monteux, Mark Smith et al.•Health An Interdisciplinary…•2026

  • Maltreatment-Exposure Screening and Adolescent Mental Health

    Open Access•Jae Wan Choi, Joseph R Cohen•Journal of Child & Adolescent…•2025

  • Individual Contributions of Adverse Childhood Experiences to Adolescent Substance Use

    Open Access•Chelsea R Moore, Philip T Veliz et al.•Substance Use & Misuse•2026

  • Adverse Childhood Experiences and Other Predictors of Psychological Strain in College Students in a Post-Pandemic World

    Randy Mark Ludwig•The Journal of Psychology•2026

  • Within, Between, and Beyond

    Open Access•Olivia D Chang, Grace W Pierpont et al.•Trauma Violence & Abuse•2026

  • Conceptualizing self-reported adverse childhood experiences

    Open Access•Marianna D Lanoue, Rafael Ha et al.•Social Science & Medicine•2025

Unique citing works6
Citations per year6
Citation span2025 - 2026 (2)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 5

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