Assessing Adverse Childhood Experiences

ACEs were assessed using the ACEs-10, a 10-item measure adapted from the CDC-Kaiser Permanente Ace Study [15 (link)], assessing maltreatment and other adverse experiences before the age of 18. To remain consistent with the typical ACEs measure, dichotomous variables were created with a score of 0 (‘No, has not happened to me’) or 1 (‘Yes, has happened to me’). Due to experimenter error, one item was entered incorrectly, capturing personal experience of physical violence rather than witnessing intimate partner violence. Since another item already assesses experiencing physical abuse, this item was removed for a total of 9 items. We expect minimal effect of the missing item because research has demostrated that witnessing intimate partner violence is only weakly associated with EDs versus other ACEs items (e.g., emotional negelct, physical abuse, sexual abuse). A study examining ACEs in adults with EDs found individuals with EDs actually were significantly less likely to report witnessing intimate partner violence on the ACEs checklist than a nationally representative sample of adults [40 (link)]. In a clinical ED sample, witnessing intimate partner violence was one of the least likely ACEs to be endorsed, with only physical neglect and having a family member in prison being less likely [41 (link)]. Yet another study found that emotional neglect, physical abuse, and sexual abuse, but not witnessing intimate partner violence, predicted binge eating disorder [42 ]. In our sample, total scores ranged from 0 to 8 (M = 1.57, SD = 1.77), with higher total scores indicating greater number of ACEs. In order to be consistent with our reporting of other measures, we have calculated internal consistency for the nine included items of the ACEs checklist. The Cronbach's alpha was α = .671. Exposure to traumatic events is not considered a latent psychological construct [43 (link)]. It is instead measured as a checklist of events, which may or may not be related to each other. Therefore, we would not necessarily expect high internal consistency between items of the ACEs checklist.