About the ACEs Questionnaire

What the ACEs Questionnaire Is

The ACEs questionnaire grew out of the CDC-Kaiser Permanente Adverse Childhood Experiences Study, a partnership between the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente in Southern California. Between 1995 and 1997, more than 17,000 adult health plan members completed confidential surveys about their childhood experiences and their current health (CDC, 2021). The first major report, led by Vincent Felitti and Robert Anda, was published in 1998 (Felitti et al., 1998).

What It Measures

The ACEs questionnaire asks whether certain experiences happened during your first 18 years of life. The CDC groups the 10 original categories into three areas (CDC, 2021):

• Abuse: emotional, physical, and sexual abuse.
• Household challenges: violence against a mother or stepmother, substance misuse in the household, mental illness in the household, parental separation or divorce, and a household member who went to prison.
• Neglect: emotional neglect and physical neglect.

How the Self-Check Works

Time Frame and Responses

Unlike the other self-checks on our site, the ACEs questionnaire does not ask about the last few weeks. It asks about your childhood, from birth through age 17. Each question asks whether a particular kind of experience happened, and each category you report adds one point.

Scoring

Your ACE score is the total number of categories you experienced, so it ranges from 0 to 10 (CDC, 2021). It counts the kinds of adversity, not how often they happened or how severe they were. There is no official clinical cutoff. Research often compares people with four or more ACEs with people who have none (Felitti et al., 1998; Hughes et al., 2017), so a score of 4 or higher is commonly used as a marker of higher risk at the population level. ACEs are common: in the original study, about 64% of participants reported at least one category and 12.5% reported four or more (CDC, 2021), and across 25 U.S. states from 2015 to 2017, about one in six adults (15.6%) reported four or more (Merrick et al., 2019).

What the Research Shows

The first ACE Study found a graded, step-by-step relationship: the more categories of childhood adversity people reported, the higher their risk for many adult health problems. Compared with people who had none, those with four or more categories had 4 to 12 times the risk of alcohol and drug problems, depression, and suicide attempts, along with higher rates of heart disease, lung disease, and other conditions (Felitti et al., 1998). Later work with the full sample of 17,337 adults found the same graded pattern across 18 outcomes in areas such as mood, physical health, memory, and substance use (Anda et al., 2006). A meta-analysis of 37 studies with 253,719 participants confirmed that people with four or more ACEs were at higher risk for every health outcome examined, with the strongest links to mental health, substance use, and violence (Hughes et al., 2017).

Research With Veterans, First Responders, and Corrections Officers

Using national survey data from 60,598 U.S. adults, researchers found that men who served in the all-volunteer era reported higher rates of all 11 types of adversity measured than men who had not served (Blosnich et al., 2014). Among 8,391 Marines, those who reported adversity in more than one category were significantly more likely to experience PTSD after deployment (LeardMann et al., 2010).

Among 183 police officers, higher ACE scores were linked with more PTSD and depressive symptoms, and resilience changed the strength of the link with PTSD (Violanti et al., 2021). In 294 public safety personnel in Canada and the United States, ACEs predicted adult mental health symptoms, partly through moral injury, and the effect was weaker among those with stronger emotion regulation skills (Roth et al., 2022). Researchers studying corrections officers note that public safety personnel, and correctional workers in particular, report more childhood abuse than the general population in Canada (Johnston et al., 2025).

Limitations

This self-check is a screening self-check, not a diagnosis. Your ACE score describes past experiences, not who you are or who you will become. The research shows risk across large groups of people; it cannot predict what will happen to any one person. The questionnaire relies on memory, which researchers recognize can affect results (Violanti et al., 2021). It also leaves out many hardships that the CDC recognizes can affect health, such as not having enough food to eat, homelessness, or unstable housing (CDC, 2026), as well as experiences like losing a parent in the line of duty. The CDC emphasizes that safe, stable, nurturing relationships and environments protect children (CDC, 2026), and the research with first responders suggests that skills like emotion regulation and resilience matter for adults, too (Roth et al., 2022; Violanti et al., 2021). Please discuss your results with a qualified professional, especially if answering these questions stirred up difficult feelings.

How Healing the Hero Uses This Self-Check

Healing the Hero USA offers this self-check free of charge to veterans, first responders, corrections officers, Gold Star Families, Families of the Fallen, and the people who love them. It is confidential. Your answers are scored right on the page, and your results stay private unless you choose to share them with us. If you do choose to share, a Healing the Hero coach will connect with you within 24 hours to talk through what you are noticing and to help you find peer support or a qualified professional who fits your needs. You never have to explain yourself to a stranger first, and you are never obligated to take a next step you are not ready for.