Learning Objective

After reading this article, you should be able to:

1. Recognize ACE prevalence disparities among demographic groups, informing targeted interventions and support strategies.

REVIEW OF: Madigan et al World Psychiatry 2023;22:463-471

STUDY TYPE: Research Review

Our childhood experiences impact and shape our lives in profound ways. The Adverse Childhood Experience (ACE) Questionnaire, developed 25 years ago, has been pivotal in unraveling the ramifications of ACEs. But what's the true prevalence, and who's most at risk?

To delve deeper into the demographics and repercussions of ACEs, a team of Canadian researchers performed a systematic review and metanalysis of ACE studies published between January 1998 and August 2021. 

Of 11,920 entries, 206 studies met their criteria for inclusion. The total study population consisted of 456,458 adults across 22 countries, with Americans dominating the pool. The average age was 34 years, and men made up about two-thirds (64.5%) of the group.

Sixty percent of participants reported at least one ACE, while 16% had four or more. Those with a heavy ACE burden were more likely to hail from low-income families, experience homelessness, and/or have a history of substance abuse or mental health issues. Notably, 55% of individuals grappling with addiction or substance abuse had a history of four or more ACEs. Similarly, individuals who grew up in poverty, faced homelessness, or struggled with mental health issues were also likely to report ACEs.

ACE prevalence was higher among racial/ethnic minorities, men compared to women, and Americans versus Europeans. Data on ACE prevalence concerning sexual orientation/gender identity were scant, highlighting the need for future research in this area.

CARLAT TAKE:

This study expands on our understanding of ACEs, affirming the existence of prevalence disparities. It underscores how the socially and economically disadvantaged are most susceptible, which may not be surprising to many clinicians but is still important information.