Pocket Ace: Neglect of Child Sexual Abuse Survivors in the ACE Study Questionnaire

Authors' Affiliations

Robyn A. Dolson, Department of Psychology, College of Arts and Sciences, East Tennessee State University Diana Morelen, Department of Psychology, College of Arts and Sciences, East Tennessee State University Julia Dodd, Department of Psychology, College of Arts and Sciences, East Tennessee State University Andrea Clements, Department of Psychology, College of Arts and Sciences, East Tennessee State University

Location

AUDITORIUM ROOM 137A

Start Date

4-12-2019 10:20 AM

End Date

4-12-2019 10:35 AM

Faculty Sponsor’s Department

Psychology

Name of Project's Faculty Sponsor

Dr. Diana Morelen

Classification of First Author

Graduate Student-Master’s

Type

Oral Presentation

Project's Category

Womens Health, Mental Health, Health of Underserved Populations

Abstract or Artist's Statement

Twenty years ago, a seminal study on adverse childhood experiences (ACEs) and subsequent increased health risks catapulted ACEs into the zeitgeist of research and application. Though a validated construct, the questionnaire, particularly the child sexual abuse (CSA) item is not without limitation and yet is used by the Centers for Disease Control and state agencies to quantify need and allocate resources to services accordingly. Currently, CSA is counted only when the perpetrator is 5-years or older than the victim. This requirement makes neglect of sibling and peer assault very likely. Accordingly, this study aimed to assess whether individuals with CSA experiences within an age gap smaller than 5 years are missed by the 5-year modifier embedded in CSA assessment wording and whether this missed group would otherwise qualify for services if detected. The study also aimed to assess whether this missed group has equivalently poor health outcomes to CSA groups currently captured by the 5-year modifier and whether outcomes for all CSA groups were higher than those who did not have a CSA history. An international sample of 974 women aged 18 to 50 completed an online survey hosted by Reddit regarding their substance use, multiple domains of current health, and CSA history using the original ACEs questionnaire and an experimental version of the CSA item without the 5-year modifier. All statistical analyses were completed in R. Results indicated there was a group of survivors with CSA experiences missed by the 5-year modifier and this had implications for reducing their total ACE scores. This group was nearly equal in size to CSA groups captured by the 5-year modifier and demonstrated equivalently poor health and substance use outcomes. On nearly all variables, CSA groups demonstrated poorer health outcomes than those who had never experienced CSA. These findings suggest the language of how CSA is assessed must be thoughtfully revised to include all CSA experiences as all are equally at risk for adverse outcomes and thus all warrant consideration for services currently afforded those with CSA histories and high ACE scores.

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Apr 12th, 10:20 AM Apr 12th, 10:35 AM

Pocket Ace: Neglect of Child Sexual Abuse Survivors in the ACE Study Questionnaire

AUDITORIUM ROOM 137A

Twenty years ago, a seminal study on adverse childhood experiences (ACEs) and subsequent increased health risks catapulted ACEs into the zeitgeist of research and application. Though a validated construct, the questionnaire, particularly the child sexual abuse (CSA) item is not without limitation and yet is used by the Centers for Disease Control and state agencies to quantify need and allocate resources to services accordingly. Currently, CSA is counted only when the perpetrator is 5-years or older than the victim. This requirement makes neglect of sibling and peer assault very likely. Accordingly, this study aimed to assess whether individuals with CSA experiences within an age gap smaller than 5 years are missed by the 5-year modifier embedded in CSA assessment wording and whether this missed group would otherwise qualify for services if detected. The study also aimed to assess whether this missed group has equivalently poor health outcomes to CSA groups currently captured by the 5-year modifier and whether outcomes for all CSA groups were higher than those who did not have a CSA history. An international sample of 974 women aged 18 to 50 completed an online survey hosted by Reddit regarding their substance use, multiple domains of current health, and CSA history using the original ACEs questionnaire and an experimental version of the CSA item without the 5-year modifier. All statistical analyses were completed in R. Results indicated there was a group of survivors with CSA experiences missed by the 5-year modifier and this had implications for reducing their total ACE scores. This group was nearly equal in size to CSA groups captured by the 5-year modifier and demonstrated equivalently poor health and substance use outcomes. On nearly all variables, CSA groups demonstrated poorer health outcomes than those who had never experienced CSA. These findings suggest the language of how CSA is assessed must be thoughtfully revised to include all CSA experiences as all are equally at risk for adverse outcomes and thus all warrant consideration for services currently afforded those with CSA histories and high ACE scores.