Front Cover
Adverse Childhood Experiences: Using Evidence to Advance Research, Practice, Policy, and Prevention
Copyright
Dedication
Contents
Contributors
Preface
Section I
Chapter 1 Twenty years and counting: The past, present, and future of ACEs research
Introduction
Past: Initial clinical observations leading to the ACE Study
Present: Increasing integration of ACEs science
Raising awareness: ACEs research, surveillance, and assessments
Promoting acceptance: Policy to address and prevent ACEs
Active adoption: Efforts to address and prevent ACEs
Future of ACEs science
Research
Education and training
Practice
Summary
Disclosure statement
References
Chapter 2 ACEs: Definitions, measurement, and prevalence ☆
Introduction
Measuring ACEs
CDC and Kaiser Permanente ACE Study
Child abuse items
Child neglect items
Household challenges
Behavioral risk factor surveillance system ACEs module
Other ACEs measures
The ACEs score
ACEs prevalence across populations
ACEs by demographic characteristics
Co-occurrence of ACEs
Considerations for ACEs measurement and directions for future research
Implications for policy and practice
Conclusion
References
Chapter 3 Considerations for expanding the definition of ACEs
Introduction
The original 10 ACEs
Defining ACEs from a global perspective
Directions for future research: Recommendations and cautions for expanding the definition of ACEs
Implications for policy and practice
Conclusion
References
Section II
Chapter 4 ACEs and mental health outcomes
Introduction
Underlying mechanisms
Biological processes
Behavioral processes
Psychological
Summary of underlying mechanisms
ACEs and mental disorders
Mood and anxiety disorders
Ptsd
Substance use.

Personality disorders
Eating disorders
Psychotic disorders
Obsessive-compulsive disorder
Sleep disorders
Suicidal ideation, plans, and attempts
Summary
Psychosocial functioning and quality of life
Prevention and intervention
Implications for public policy
Future directions
References
Further reading
Chapter 5 ACEs and physical health outcomes
Introduction
Mechanisms
Allostatic load and biological embedding
Behavioral and related psychological processes
Biological processes
Summary
Specific physical health conditions and risk factors
Cardiovascular conditions
Metabolic disorders
Other physical health conditions
Risk factors for poor physical health
Summary
Clinical implications
Health service utilization
Prevention and treatment
Public policy implications
Summary
Future directions
Conclusion
References
Further reading
Chapter 6 ACEs, sexual violence, and sexual health
Introduction
Child sexual abuse as a key childhood adversity
ACEs and issues in SV perpetration
ACEs and issues in SV
ACEs and issues in sexual health
Specific at-risk youth populations
Child welfare-involved youth
Street-involved youth
Indigenous youth
Sexual minority youth
Directions for future research
Implications for policy and practice
Conclusion
Acknowledgments
References
Further reading
Chapter 7 ACEs and violence in adulthood
Introduction
Physical violence in relationships
Child maltreatment ACEs
Household dysfunction ACEs
Cumulative effects of ACEs
Summary
Sexual violence in relationships
Child maltreatment ACEs
Household dysfunction ACEs
Cumulative effects of ACEs
Summary
Emotional violence in relationships
Child maltreatment ACEs
Household dysfunction ACEs.

Cumulative effects of ACEs
Summary
Other forms of interpersonal violence
Child maltreatment ACEs
Household dysfunction ACEs
Cumulative effects of ACEs
Summary
Directions for future research
Policy and practice implications
Conclusion
References
Section III
Chapter 8 Routine screening of ACEs: should we or shouldn't we?
Introduction
What questions need to be answered favorably when deciding whether or not to implement a specific risk factor screening ...
How does the proposal for ACEs screening fair on this set of questions?
Directions for future research
Implications for policy and practice
Conclusion
References
Chapter 9 Methodological considerations in ACEs research
Introduction
Multiple manifestations of the ACEs instrument
The original ACEs instrument
Modified ACEs measures
Psychometric properties of the ACEs instruments
Reliability
Validity
Methodological issues of ACEs instruments
Measurement invariance
The assessment of adversities
Factor structure
Retrospective recall
Directions for future research: Recommendations for methodological improvements
Implications for policy and practice
Conclusion
References
Further reading
Section IV
Chapter 10 The public health issue of ACEs in Canada
Introduction
ACEs as a public health issue
Implications of a public health approach to ACEs
Surveillance
Building the evidence
Prevention
Policies and strategies to prevent ACEs
Implications for policy and practice
Directions for future research
Conclusion
Appendix. Selected peer-reviewed articles using ACEs data from the 2012 Canadian Community Health Survey-Mental Health, b ...
Maltreatment
Physical health
Mental health
Social and health problems
Combined problems
Child protection.

Positive mental health indicators
References
Further reading
Chapter 11 Global perspective on ACEs ☆
Introduction
Measurement and definitions in global settings
Prevalence of ACEs globally
ACEs among vulnerable populations
Directions for future research
Implications for policy and practice
Conclusion
Acknowledgments
References
Chapter 12 Effective prevention of ACEs
Introduction
Utility of ACEs screening tools
Prevention framework
Social determinants of health
Beyond ACEs: A new paradigm to address social needs
Barriers to screening
Summary
ACEs prevention strategies
Interventions across the social-ecological continuum
Home visitation
Nurse F amily P artnership
Healthy F amilies A merica
Parents as T eachers
Early S tart H ome V isiting P rogram
Project S afe C are
Summary
Positive parenting interventions
The T riple P - P ositive P arenting P rogram
Parent C hild I nteraction T herapy (PCIT)
Child A dult R elationship E nhancement ( CARE) and P ri CA RE
Enhanced medical homes
Community-based interventions
Strengthening F amilies I nitiative
Strong C ommunities
Cost outcomes of ACEs prevention interventions
The future landscape in ACEs prevention
References
Further reading
Chapter 13 Neurodevelopmental mechanisms linking ACEs with psychopathology
Introduction
Cumulative risk model
Dimensional model of adversity and psychopathology
Threat
Deprivation
Current evidence for the dimensional model
Directions for future research
Policy and practice implications
Conclusion
Conflict of interest statement
References
Further reading
Chapter 14 ACEs and resilience: Methodological and conceptual issues
Introduction
Resilience in the context of ACEs: A brief historical recount.

Current methodological and conceptual consensus
Common models of resilience
Promotive factors models
Protective factors model
Modeling promotive and protective factors together
Current state of resilience research
Future and emerging directions in resilience research: The challenges and promise of evolutionary developmental perspect ...
Stress inoculation and the steeling effect
Evolutionary developmental psychology
Summary
References
Chapter 15 ACEs and trauma-informed care
Introduction
Origins and definitions: What happened to you?
Benefits and outcomes of TIC
Unintended consequences: The absence of TIC
Recommendations
Directions for future research
Implications for practice and policy
Conclusion
References
Further reading
Chapter 16 Safe, stable, nurturing environments for children ☆
Introduction
CDC's child abuse and neglect technical package
Strategy 1: Strengthen economic supports for families
Strategy 2: Change social norms to support parents and positive parenting
Strategy 3: Provide quality care and education early in life
Strategy 4: Enhance parenting skills to promote healthy child development
Strategy 5: Intervene to lessen harms and prevent future risk
WHO's INSPIRE technical package
Directions for future research
Implications for policy and practice
Conclusion
References
Further reading
Chapter 17 Current knowledge and future directions for the ACEs field
Introduction
Measurement
Definitions
Screening
Intervention
Upstream public health approaches and prevention
Setting the research agenda
Conclusion
References
Index
Back Cover.