title: Adverse Childhood Experiences (ACEs) questionnaire and Adult Attachment Interview (AAI): implications for parent child relationships.
abstract: Although Adverse Childhood Experiences (ACEs) are linked to increased health problems and risk behaviors in adulthood, there are no studies on the association between ACEs and adults' states of mind regarding their early childhood attachments, loss, and trauma experiences. To validate the ACEs questions, we analyzed the association between ACEs and emotional support indicators and Adult Attachment Interview (AAI) classifications in terms of unresolved mourning regarding past loss or trauma and discordant states of mind in cannot classify (U/CC) interviews. Seventy-five urban women (41 clinical and 34 community) completed a questionnaire on ACEs, which included 10 categories of abuse, neglect, and household dysfunction, in addition to emotional support. Internal psychological processes or states of mind concerning attachment were assessed using the AAI. ACE responses were internally consistent (Cronbach's α=.88). In the clinical sample, 84% reported≥4 ACEs compared to 27% among the community sample. AAIs judged U/CC occurred in 76% of the clinical sample compared to 9% in the community sample. When ACEs were≥4, 65% of AAIs were classified U/CC. Absence of emotional support in the ACEs questionnaire was associated with 72% of AAIs being classified U/CC. As the number of ACEs and the lack of emotional support increases so too does the probability of AAIs being classified as U/CC. Findings provide rationale for including ACEs questions in pediatric screening protocols to identify and offer treatment reducing the intergenerational transmission of risk associated with problematic parenting.
authors.affiliation: Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Murphy
authors.affiliation: Psychology Department, New School for Social Research, New York, NY, USA.
authors.forename: Miriam
authors.initials: M
authors.lastname: Steele
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA.
authors.forename: Shanta Rishi
authors.initials: SR
authors.lastname: Dube
authors.affiliation: Psychology Department, New School for Social Research, New York, NY, USA.
authors.forename: Jordan
authors.initials: J
authors.lastname: Bate
authors.affiliation: Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Bonuck
authors.affiliation: Department of Family and Social Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Meissner
authors.affiliation: Psychology Department, New School for Social Research, New York, NY, USA.
authors.forename: Hannah
authors.initials: H
authors.lastname: Goldman
authors.affiliation: Psychology Department, New School for Social Research, New York, NY, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Steele
mesh_terms: D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D002650:Child Abuse, Sexual / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009769:Object Attachment; D010287:Parent-Child Relations; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adult Attachment Interview (AAI); Adverse Childhood Experiences (ACEs); Child maltreatment; Emotional support; Unresolved mourning/can’t classify