Background

A 1998 seminal study catapulted adverse childhood experiences (ACEs) into the zeitgeist and shaped assessment of these experiences and long-term health consequences via The ACEs Study Questionnaire (ACE-SQ). However, the ACE-SQ’s childhood sexual abuse (CSA) item requires the perpetrator have been 5-years or older than the survivor for endorsement. This may not adequately capture CSA and limit the questionnaire’s ability to detect survivors.

Objective

This study assessed whether CSA survivors were missed by this 5-year modifier, whether service access was restricted, and whether those missed were at elevated risk for adverse outcomes.

Participants and setting

A sample of 974 women (M _age = 30.46) completed an online survey.

Methods

Histories of CSA were assessed using the original ACE-SQ and an alternative version without the 5-year modifier. Participants were grouped by endorsement (Modifier, No Modifier, No CSA) and compared across numerous physical and mental health outcomes using MANOVA, ANOVA, and logistic regression.

Results

Numerous CSA survivors are presently missed by the 5-year modifier (n = 118 of N = 249). This group demonstrated the same elevated depression (t = 3.44, p = .002, d = 0.34), heightened somatic symptom burden (t = 3.34, p = .003, d = 0.35), and poorer subjective health (t = -2.86, p = .012, d = 0.27) as those captured by the modifier.

Conclusions

Recommendations for research, practice, and policy include removing the 5-year modifier from CSA assessment, creating an empirically informed CSA definition, and eliminating or adjusting requisite cut-scores for accessing services.

中文翻译：

---

Pocket ACE：ACEs 研究问卷遗漏的儿童性虐待幸存者

背景

1998 年的一项开创性研究将不良童年经历 (ACE) 纳入时代精神，并通过 ACE 研究问卷 (ACE-SQ) 对这些经历和长期健康后果进行评估。但是，ACE-SQ 的童年性虐待 (CSA) 项目要求肇事者比幸存者年长 5 岁才能获得认可。这可能无法充分捕捉 CSA 并限制调查问卷检测幸存者的能力。

客观的

该研究评估了该 5 年修正是否遗漏了 CSA 幸存者，服务访问是否受到限制，以及遗漏者是否有较高的不良结局风险。

参与者和设置

974 名女性样本（M _年龄= 30.46）完成了一项在线调查。

方法

使用原始 ACE-SQ 和没有 5 年修正的替代版本评估 CSA 的历史。参与者按认可（修饰符、无修饰符、无 CSA）分组，并使用多元方差分析、方差分析和逻辑回归对众多身心健康结果进行比较。

结果

许多 CSA 幸存者目前被 5 年修饰符遗漏（n = 118 of N = 249）。该组表现出同样的抑郁症 ( t = 3.44, p = .002, d = 0.34)、躯体症状负担加重 ( t = 3.34, p = .003, d = 0.35) 和较差的主观健康 ( t = -2.86) , p = .012, d = 0.27) 作为修饰符捕获的那些。

结论

对研究、实践和政策的建议包括从 CSA 评估中删除 5 年修饰符，创建一个有经验的 CSA 定义，以及消除或调整获取服务所需的分数。