Ace Score Test

The CDC’s Adverse Childhood Experiences Study (ACE Study) uncovered a stunning link between childhood trauma and the chronic diseases people develop as adults, as well as social and emotional problems

The first research results were published in 1998, followed by 57 other publications through 2011.  They showed that: Childhood abuse, neglect, and household dysfunction were very common, even in employed white middle-class, college-educated people with great health insurance.


What's Your ACE Score?

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How Resilience Factors Can Offset the Negative Outcomes of a High ACE Score

When I first learned having an ACE score of 6 meant my chances of experiencing serious negative health, behavioral and social outcomes were between 2-12 times greater than those with zero or just a few ACEs,

I was pretty freaked out.

But after I took a deeper dive into understanding how ACEs and the risk of negative health outcomes worked, I discovered that my ACE score alone wasn’t the most accurate way to assess my health risks. I learned that a more accurate way to assess my risks was to include my resilience score and also take into account the number of positive childhood experiences (PCEs) I had growing up.

What’s Your Resilience Score?

Studies show that resilience and positive childhood experiences can offset high ACE scores’ negative health and social outcomes. The below questionnaire is designed to assess the strength of your resilience based on what you experienced growing up. To determine your resilience score, answer the questions below:

How Positive Childhood Experiences (PCEs) Can Offset A High ACE Score

 PCEs are considered protective factors known to offset negative ACE-related mental and physical health and social outcomes. According to Dr. Christina Bethell’s research, the following seven positive childhood experiences can offset the negative outcomes of a high ACE score.

Resilience research shows that our brains are plastic and can heal through positive childhood experiences (PCEs) and resilience-building practices such as eating nutritious foods, getting adequate hydration, sleep and exercise, being in nature, and connecting with safe friends. Early intervention for food, smoking, substance misuse, and other high-risk- behavior also mitigates the risks of negative health outcomes associated with a high ACE score.

My ACE, Positive Childhood Experiences, & Resilience Scores

After answering the questions from the ACE, Resilience, and Positive Childhood Experiences Questionnaires, I calculated my ACE score to be 6, my Resilience score to be 5, and my PCE score to be a 2. According to the ACE study, an ACE score of 4 or higher is considered a high ACE score. This is due to the ACE study proving that people with ACE scores of 4 or higher have much higher rates of negative health and social outcomes in adulthood than those with zero or lower ACE scores. However, research has also shown that the more positive childhood experiences-PCEs and the higher the resilience a child has, the more they can offset the risk of experiencing negative health and social outcomes from a high ACE score.

What Do Your ACE, PCE, and Resilience Scores Mean?

Although I have not found any hard or fast rules to measure PCE or resilience scores in terms of their exact ability to offset specific negative ACE-related outcomes due to a high ACE score, the value I’ve found in completing the PCE and resilience questionnaire has been twofold.
  1. Completing the Positive Childhood Experiences and the Resilience Questionnaires has helped me identify which areas in my life I received support in and which I didn’t while growing up. This has directed me to focus on shoring up my resilience in the areas where I didn’t receive support as a child.
  2. Learning I have an ACE score of 6 (which is high,) a PCE score of 2 (which is low), and a Resilience score of 6 (which is medium) has made me aware that I have a much higher risk of experiencing negative health and social outcomes as I age. I’ve put this knowledge to use by making healthy lifestyle choices, staying committed to self-care and making sure I get in for regular checkups with my doctor to stay on top of my health.

Handling Negative ACE-Related Health or Social Outcomes

Once you have added up your ACE, PCE, and resilience scores, it’s important to look at what, if any, negative ACE-related health, behavioral, or social outcomes have come to pass for you and then look at what actions you can take to eliminate or mitigate them. Doing so will automatically improve your ability to avoid additional negative ACE-related outcomes down the road.

Since I had already intervened in several of my ACE-related negative outcomes by getting into recovery with substances, smoking, food, weight, anxiety, depression, and codependency, I didn’t need to focus on these issues.

The primary focus of my trauma healing has been on finding ways to regulate my nervous system, minimizing stress in my life, healing the relational aspects of my trauma, as well as implementing trauma-based self-care and resilience-building practices.

What To Do If You Have an ACE Score of 4 or Higher

If you have an ACE score of 4 or higher, you’re likely dealing with nervous system dysregulation since it is the most common symptom of C-PTSD. This can manifest as anxiety, depression, relationship difficulties, addictions, guilt, shame, chronic illness and pain, and other symptoms I’ve discussed throughout this book.

The first thing to remember is these symptoms are not your fault.

However, if you’re interested in experiencing more fulfillment and joy in your life, it’s your responsibility to heal or manage them. The good news is complex trauma is treatable; therefore, if you’re willing to get into action about your healing, you can experience significant improvements in your life. I am a living example of this.

The first step to getting on track with healing is to gain an in-depth understanding of the nature of C-PTSD. The second step is to learn what treatments, practices, and support systems are available to give yourself the best chance at optimal healing and recovery.

To accomplish both of these steps, you’ll need to either read my book “It’s Not About Food, Drugs, or Alcohol: It’s About Healing Complex PTSD” and complete the worksheets in the CPTD workbook section, and also access the resources you need to heal in its appendix, and/or read additional books about complex PTSD.

Complex Trauma Is Treatable & You Can Heal

To be clear, your ACE score does not have to become your destiny.   There are proven interventions that can mitigate or even eliminate the many challenges that can come up with high ACE scores, no matter how old you are, your ACE score, or your resources. My life and the lives of millions of survivors are a testament to this.

In addition, many people with high ACEs may have already reduced their chances for ACE-related health, behavioral, or relationship issues by getting support during their childhood or as young adults.

To find out what you can do to reduce or eliminate your ACEs risk factors, increase resilience, heal existing ACEs-related issues (struggles with anxiety, depression, food, obesity, addiction or relationships,) prevent future ACEs, and live a fulfilling and meaningful life you can find support through:

Mary Giuliani
Complex Trauma & Resilience Coach

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