1|Page
ADVERSE CHILDHOOD EXPERIENCES (ACES)
(2026/2027 EDITION)
RATED A+ | 150+ QUESTIONS & ANSWERS
WITH RATIONALES
SECTION 1: DEFINITION & HISTORY OF ACES
(10 Q&As)
Q1: What does the acronym ACEs stand for?
A1: Adverse Childhood Experiences.
Rationale: ACEs refer to potentially traumatic
events occurring before age 18 that can have
lifelong impacts on health and well-being.
Q2: Who conducted the original ACE study and
in which years?
A2: Dr. Vincent Felitti (Kaiser Permanente) and
Dr. Robert Anda (CDC), conducted from 1995 to
1997.
Rationale: The landmark study involved over
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17,000 adult participants, making it one of the
largest investigations of childhood abuse and
neglect.
Q3: What was the original study population for
the ACE study?
A3: Middle-class, predominantly white, college-
educated adults with good jobs and health
insurance (Kaiser Permanente members in San
Diego).
Rationale: Contrary to belief that ACEs only
affect disadvantaged populations, the study
showed ACEs are common across all
socioeconomic groups.
Q4: True or False: The original ACE study only
included physical and sexual abuse categories.
A4: False. The original 10 ACEs include three
categories of abuse (physical, emotional,
sexual), two of neglect (physical, emotional),
and five of household dysfunction (domestic
violence, substance abuse, mental illness,
parental separation/divorce, incarcerated
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household member).
Rationale: The 10-item questionnaire covers
three domains: abuse, neglect, and household
dysfunction.
Q5: What is the ACE Score?
A5: A cumulative score (0-10) representing the
total number of ACE categories an individual
experienced before age 18.
Rationale: Higher scores correlate with worse
health outcomes in a graded, dose-response
relationship.
Q6: What was the single most surprising finding
of the original ACE study?
A6: The strong, graded relationship between
ACE score and adult health outcomes (heart
disease, diabetes, cancer, mental illness, early
death).
Rationale: Prior to this, childhood adversity was
not widely recognized as a root cause of adult
chronic disease.
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Q7: True or False: ACEs only affect mental
health, not physical health.
A7: False. ACEs are associated with a wide
range of physical health conditions including
heart disease, stroke, diabetes, COPD, and
autoimmune disorders.
Rationale: The biological embedding of
adversity affects multiple organ systems via
chronic inflammation and stress response
dysregulation.
Q8: What percentage of the original ACE study
population reported at least one ACE?
A8: Approximately 64% (almost two-thirds of
participants).
Rationale: 1 in 8 participants had 4 or more
ACEs, demonstrating that adversity is common,
not rare.
Q9: What is the "dose-response" relationship in
ACEs research?
A9: The higher the ACE score, the greater the
risk for negative health, social, and behavioral
ADVERSE CHILDHOOD EXPERIENCES (ACES)
(2026/2027 EDITION)
RATED A+ | 150+ QUESTIONS & ANSWERS
WITH RATIONALES
SECTION 1: DEFINITION & HISTORY OF ACES
(10 Q&As)
Q1: What does the acronym ACEs stand for?
A1: Adverse Childhood Experiences.
Rationale: ACEs refer to potentially traumatic
events occurring before age 18 that can have
lifelong impacts on health and well-being.
Q2: Who conducted the original ACE study and
in which years?
A2: Dr. Vincent Felitti (Kaiser Permanente) and
Dr. Robert Anda (CDC), conducted from 1995 to
1997.
Rationale: The landmark study involved over
,2|Page
17,000 adult participants, making it one of the
largest investigations of childhood abuse and
neglect.
Q3: What was the original study population for
the ACE study?
A3: Middle-class, predominantly white, college-
educated adults with good jobs and health
insurance (Kaiser Permanente members in San
Diego).
Rationale: Contrary to belief that ACEs only
affect disadvantaged populations, the study
showed ACEs are common across all
socioeconomic groups.
Q4: True or False: The original ACE study only
included physical and sexual abuse categories.
A4: False. The original 10 ACEs include three
categories of abuse (physical, emotional,
sexual), two of neglect (physical, emotional),
and five of household dysfunction (domestic
violence, substance abuse, mental illness,
parental separation/divorce, incarcerated
,3|Page
household member).
Rationale: The 10-item questionnaire covers
three domains: abuse, neglect, and household
dysfunction.
Q5: What is the ACE Score?
A5: A cumulative score (0-10) representing the
total number of ACE categories an individual
experienced before age 18.
Rationale: Higher scores correlate with worse
health outcomes in a graded, dose-response
relationship.
Q6: What was the single most surprising finding
of the original ACE study?
A6: The strong, graded relationship between
ACE score and adult health outcomes (heart
disease, diabetes, cancer, mental illness, early
death).
Rationale: Prior to this, childhood adversity was
not widely recognized as a root cause of adult
chronic disease.
, 4|Page
Q7: True or False: ACEs only affect mental
health, not physical health.
A7: False. ACEs are associated with a wide
range of physical health conditions including
heart disease, stroke, diabetes, COPD, and
autoimmune disorders.
Rationale: The biological embedding of
adversity affects multiple organ systems via
chronic inflammation and stress response
dysregulation.
Q8: What percentage of the original ACE study
population reported at least one ACE?
A8: Approximately 64% (almost two-thirds of
participants).
Rationale: 1 in 8 participants had 4 or more
ACEs, demonstrating that adversity is common,
not rare.
Q9: What is the "dose-response" relationship in
ACEs research?
A9: The higher the ACE score, the greater the
risk for negative health, social, and behavioral
