A note on the ACE test

Over the years, our understanding of trauma has increased, especially in light of recent events. Psych Central’s ACE test consists of 22 questions, and should only be used for personal use.

This quiz was adapted from the original ACE questionnaire, which only consists of 10 questions. This questionnaire also adapted questions from more recent measures like the Trauma History Questionnaire, and the Childhood Trauma Questionnaire.

12 additional questions are included to further access how you may also be impacted by circumstances, such as bullying, racial trauma, and the global pandemic.

Therefore, the scoring system used in the original ACE questionnaire from 1995 will differ from the Psych Central ACE test.

If you believe you’ve been impacted by adverse childhood experiences, consider speaking with a mental health professional for support.

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An adverse childhood experience (ACE) such as abuse, neglect, or household dysfunction can negatively impact an individual’s health for the rest of their life. Adverse childhood experiences cause toxic stress, which differs from other stressors such as studying for a test or preparing for a presentation.

Toxic stress creates a near-constant activation of the stress response system, which has a negative impact on other bodily systems.

Researchers have found a correlation between people who sustained high levels of toxic stress in their formative years with having certain mental and physical ailments later in life.

The cardiovascular system, immune system, metabolic regulatory system, and the developing brain are all known to be at particular risk from ongoing toxic stress.

The ACE test originates from a 1995 study conducted by the Centers for Disease Control (CDC) and the Kaiser Permanente healthcare organization.

The list of adverse childhood experiences known to foster toxic stress (ACEs) are:

  • physical abuse
  • sexual abuse
  • emotional abuse
  • physical neglect
  • emotional neglect
  • mental illness
  • violence toward a primary caregiver
  • substance use
  • divorce

This isn’t a complete list of factors that contribute to toxic stress. Other factors that stem from outside a child’s home, such as racism and community violence, are also known to cause toxic stress.

It’s important to know that even people who score very high on the ACE test can and do lead healthy, fulfilling lives. But people who have a high ACE score may have a higher predisposition to certain health outcomes. For that reason, the ACE test is considered a screening tool rather than a diagnostic tool.

It’s also important to note that people who score lower on the ACE test can experience a multitude of both physical and mental health issues. While there’s a connection between a high ACE score and negative health outcomes, the ACE test shouldn’t be used as a definitive measure of future health.

Another shortcoming of the ACE test is that it doesn’t factor in positive experiences in a child’s life that work to buffer the effects of toxic stress. Having a trusted grandparent, godparent, teacher, or another community member who creates a safe environment for the child can help mitigate the negative effects of toxic stress.

This brief quiz is designed for anyone who might be wondering whether they experienced trauma as a child, and to what degree.

Because adverse childhood experiences are linked to potential health risks, this quiz serves as a screening tool for anyone who’s wondering if they may be predisposed to certain health outcomes.

This quiz is meant to help you answer questions, such as:

  • Could my childhood trauma affect my current or future health?
  • How traumatic was my childhood?

This ACE test is not meant to definitively tell you if you have health concerns associated with adverse childhood experiences. This quiz is designed to help you understand if you have an increased risk of health concerns associated with adverse childhood experiences.

The results from this test can’t tell you your actual health outcomes. A high test result can illuminate the benefit of regular preventive health screenings and support from a mental health professional.

A high score also may suggest the importance of working with trauma-informed professionals.

This free quiz was adapted from the Adverse Childhood Experiences Questionnaire for Adults, the Trauma History Questionnaire, and the Childhood Trauma Questionnaire.

Since Psych Central’s ACE quiz consists of 22 questions, we’ve curated a different scoring system. But the questions and answers below can help you understand the scoring system for the original ACE questionnaire, which consists of 10 questions.

What is a normal ACE score?

Rather than framing the scores as “normal” or “abnormal,” it may be helpful to think of them as “low risk” vs. “high risk” spectrum.

A score from 0-3 puts an individual at low risk for the health concerns associated with adverse childhood experiences. Around 58% of Americans have an ACE score of 1, which is a low risk score. A result of 6 or higher puts an individual at a heightened risk for health concerns.

Is an ACE score of 7 high?

Yes. A score higher than 6 puts an individual at a heightened risk for the health concerns associated with adverse childhood experiences.

What does a 6 on the ACE test mean?

A score of 6 means the individual answered “yes” to 6 of the 10 ACE questions. A score of 6 suggests that the person may have an increased risk of the health concerns associated with adverse childhood experiences, but that isn’t always the case.

What does an ACE test score of 9 mean?

A score of 9 means the individual answered “yes” to 9 of 10 ACE questions. A score of 9 suggests that the person may have an increased risk of the health concerns associated with adverse childhood experiences.