Degree Name

MA (Master of Arts)



Date of Award


Committee Chair or Co-Chairs

Diana Morelen

Committee Members

Julia Dodd, Andrea Clements


In 1998, a seminal study on adverse childhood experiences (ACEs) and subsequent health risks catapulted ACEs and the study questionnaire into the zeitgeist. However, its childhood sexual abuse (CSA) item is problematic as it requires the perpetrator have been 5-years or older than the victim. To assess whether some survivors’ CSA is not identified by the current item, whether their exclusion prevents access to services requiring a four-threshold ACE score, and how their health outcomes compared to other CSA groups and controls, an international sample of 974 women completed an online survey assessing their current health and CSA history using the original item and an experimental item without the 5-year modifier. Results indicated many CSA survivors are not identified by a 5-year modifier, exclusion has service implications for some, and on most variables, they had increased adverse health outcomes compared to controls. Means of assessing CSA must be thoughtfully revised.

Document Type

Thesis - unrestricted


Copyright by the authors.