ACE/PCE scores

[tofubreadchillicoriander]

I've an ACE score of 7 and a PCE (Positive Childhood Experiences) score of 2-ish


As the disclaimer says,

The most important thing to remember is that the ACE score is meant as a guideline: If you experienced other types of toxic stress over months or years, then those would likely increase your risk of health consequences, depending on the positive childhood experiences you had.

What're your ACE/PCE scores?

https://acestoohigh.com/got-your-ace-score/

[Armee]

10, if you count the prenatal environment, 7 or 8 if you don't. I've struggled with the ace test for years not knowing how to "count" things. Well yes dad went to jail but that was while my mom was pregnant. Does it count since I wasn't yet born to see it? He was addicted but never lived with us after I was born does that count as a member of the household? I dunno. Positive score is 2 or 3. Thank God for my grandparents.

[blue_sky]

ACE score of 4 as my family looked very normal for the outer world. Would be a 5 if the question about SA didn't specify that the perpetrator had to be 5+ years older.

PCE of 2; friends and the two adults whom I trusted enough to open up to.

[Armee]

Oh wow. That question should definitely be changed. Less than 5 yrs older doesn't make it less traumatizing.

It also doesn't do justice to the extent of the trauma either. I might check 10 because both my parents were quite mentally ill so the household was dysfunctional on multiple levels, but the severity of trauma is quite minor compared to say what you experienced.

[tofubreadchillicoriander]

10, if you count the prenatal environment, 7 or 8 if you don't. I've struggled with the ace test for years not knowing how to "count" things. Well yes dad went to jail but that was while my mom was pregnant. Does it count since I wasn't yet born to see it? He was addicted but never lived with us after I was born does that count as a member of the household? I dunno. Positive score is 2 or 3. Thank God for my grandparents.

Being in womb we can definitely get influenced by outside factors (it's backed up by science) - all the cortisol that mom faces, directly affects us. And yes, living without a father is lacking that nurturing, paternal connection. Not to be against mothers who parent alone (sometimes circumstances are what they are), however, families come in two (usually a male and a female - however, not always the case [and that's ok]). So I would count them up as they were on a large timespan (months to years) during development years.


 

ACE score of 4 as my family looked very normal for the outer world. Would be a 5 if the question about SA didn't specify that the perpetrator had to be 5+ years older.

PCE of 2; friends and the two adults whom I trusted enough to open up to.

Indeed the SA age difference should go IMHO. If you experienced it as a trauma, then it is a trauma. It's good that you had connection, though, be it in the form of friends and the two adults.

Oh wow. That question should definitely be changed. Less than 5 yrs older doesn't make it less traumatizing.

It also doesn't do justice to the extent of the trauma either. I might check 10 because both my parents were quite mentally ill so the household was dysfunctional on multiple levels, but the severity of trauma is quite minor compared to say what you experienced.

I only have 7 so I can only imagine what scoring 10 might be. You made it thus far, you're resilient. It's good that you had experienced safety with your grandparents. For me it was my schema therapist who was very nurturing, however there was countertransference so that lasted until I had a mental breakdown.

I'd be careful though, minimizing one's experience by comparing it to another. Not that the other person what she,he or they/them have went through is not valid, is just more to do justice to what we've been through and how much we've survived too.

[NarcKiddo]

My ACE score is 4. It would be 5 had I answered "yes" to the physical violence section. I did not, because I was too terrified to get as far as incurring physical punishment and when any was given it was calculated not to cause physical marks apart from once. It would be 6 had I also answered "yes" to the feeling that nobody thought I was special. I am conflicted about that because I was constantly told I was clever etc, when I was conforming to family standards. As an adult looking back I think my answer should be yes. From the point of view of a child living my life I was conditioned to believe what I was told. I am also conflicted about the sexual touching question but I stand by my "yes" answer, although the perp was my mother, the touching was dressed up as mere affection and she would deny to her grave that there was any sexual element. The fact it was body parts mothers do not (I suppose) usually touch when their child is not in need of constant physical care tells me otherwise.

I agree with the comments about it being hard to know how to answer correctly. I could make a case for a yes or no answer to most of those questions, apart from divorce, prison and not having food/clothes/housing. Actually, I could even make a lawyer's case for divorce because they might as well have done. That would take me up to 7.

What has really struck me this time, when I consider the scores, is the PCE scores. I've come across them before but not really paid them any mind. My score is 1. One. Did I have at least two non-parent adults who took interest in me? I answered yes to that one question. And even then I could make a case for "no" because only one person stands out. My paternal grandmother. And she lived quite far so I only ever saw her for a maximum of 6 weeks per year and otherwise there were letters and the occasional phone call. I have counted other relatives because they took an interest in me when I was visiting. My paternal grandfather, for example, and his sisters who lived nearby. My godmother took an interest in me but we had no real connection because she lives on another continent. My access to people was tightly controlled and I mostly kept them out anyway because I had been trained to believe all people outside FOO have malign intent and are only interested in themselves.

I've ended up feeling thoroughly sorry for little NK, with at the most one PCE and in truth probably none on that scoring system. And there's me going around saying I had a happy childhood if ever asked.

[Bermuda]

4. These questions are far too nuanced and self-reported retrospective data is unreliable, especially in trauma survivors. Trauma does not care if it was your mother being hit or your father, or grandparent, or a pet, or lizard they found under a rock. Trauma cares not if it is was a parent or a sibling hitting you, or if it was only spitting. Trauma doesn't care if it physically harmed you. Trauma doesn't care the age of your abuser. These questions are inadequate and perpetuate horrible stereotypes. Outdated, harmful, and scientifically inaccurate at predicting health outcomes.

The PCE questions are simple to answer. No's all around.

[tofubreadchillicoriander]

My ACE score is 4. It would be 5 had I answered "yes" to the physical violence section. I did not, because I was too terrified to get as far as incurring physical punishment and when any was given it was calculated not to cause physical marks apart from once. It would be 6 had I also answered "yes" to the feeling that nobody thought I was special. I am conflicted about that because I was constantly told I was clever etc, when I was conforming to family standards. As an adult looking back I think my answer should be yes. From the point of view of a child living my life I was conditioned to believe what I was told. I am also conflicted about the sexual touching question but I stand by my "yes" answer, although the perp was my mother, the touching was dressed up as mere affection and she would deny to her grave that there was any sexual element. The fact it was body parts mothers do not (I suppose) usually touch when their child is not in need of constant physical care tells me otherwise.

I agree with the comments about it being hard to know how to answer correctly. I could make a case for a yes or no answer to most of those questions, apart from divorce, prison and not having food/clothes/housing. Actually, I could even make a lawyer's case for divorce because they might as well have done. That would take me up to 7.

What has really struck me this time, when I consider the scores, is the PCE scores. I've come across them before but not really paid them any mind. My score is 1. One. Did I have at least two non-parent adults who took interest in me? I answered yes to that one question. And even then I could make a case for "no" because only one person stands out. My paternal grandmother. And she lived quite far so I only ever saw her for a maximum of 6 weeks per year and otherwise there were letters and the occasional phone call. I have counted other relatives because they took an interest in me when I was visiting. My paternal grandfather, for example, and his sisters who lived nearby. My godmother took an interest in me but we had no real connection because she lives on another continent. My access to people was tightly controlled and I mostly kept them out anyway because I had been trained to believe all people outside FOO have malign intent and are only interested in themselves.

I've ended up feeling thoroughly sorry for little NK, with at the most one PCE and in truth probably none on that scoring system. And there's me going around saying I had a happy childhood if ever asked.

I received physical violence from all members of my FOO. I answered yes even though I had no marks. It's enough to be hit once to count that as trauma. Especially us, the more sensitive types.

If there was no real connection (authentic, vulnerable connection) coming from your primary caregivers, then it's unlikely you felt truly special. You were manipulated into believing so which can be damaging and affect our attachment (making it insecure).

I think your intuition is right when it comes to fondling. You should be touched only in specific cases and not all the time. If this is what happened to you, and, as you said, you didn't need continuous care, it's possible that it was CSA - alas only a trauma therapist (likely one specialized in sexual abuse) can tell as I'm not a professional. However, going on my instinct with my past CSA coming from my father, it's not normal to be touched in any sexual way. This is one of, if not the most, insidious ways one can be abused.

I'm sorry you didn't get the support you needed in your childhood and that you feel thoroughly sorry for little NK. Have you considered seeing a trauma therapist? There are many modalities out there so, if you can afford one (I don't know where you live, though it may be worth considering going through free services such as National Counseling Service which may focus on childhood abuse and neglect), I strongly recommend starting therapy. Modalities that you may have to try before finding one that works for you (or a combination) are: somatic experiencing (body based therapy), sensorimotor psychotherapy, EMDR, IFS (internal family systems) and schema therapy.

[tofubreadchillicoriander]

4. These questions are far too nuanced and self-reported retrospective data is unreliable, especially in trauma survivors. Trauma does not care if it was your mother being hit or your father, or grandparent, or a pet, or lizard they found under a rock. Trauma cares not if it is was a parent or a sibling hitting you, or if it was only spitting. Trauma doesn't care if it physically harmed you. Trauma doesn't care the age of your abuser. These questions are inadequate and perpetuate horrible stereotypes. Outdated, harmful, and scientifically inaccurate at predicting health outcomes.

The PCE questions are simple to answer. No's all around.

Indeed, they may not offer an objective view of what happened to you, though it helps you get a baseline of your past. The study has shown however, that an ACE score of 4 and above contributes greatly to health issues. Current psychotherapists argue that there should be an extra question: any other event or set of events that you consider they have been traumatic to you. This is to honor, I presume, the sensitivity each one of us carries. Some are more sensitive than others so they may be more easily traumatized if lacking in PCE to have that resilience.

Sorry to hear you had no PCEs. The only adult in my life that interacted in an authentic way with me when I grew up was my aunt, though I didn't see her very often. I had friends but there was no real connection, only at times so I couldn't count them as a PCE. It's tough when dealing with isolation as a child, we cope how we can by building defense mechanisms.

[NarcKiddo]

Thanks, Tofu. I am having therapy and my therapist is trauma informed. It is helping but the road is long, slow, rocky and full of twists.

I'm interested to see how uncomfortable many of us are with the ACE score rubric. It feels to me a bit like the BMI (body mass index) indicator of whether a person is a healthy weight. Many people kick against it and point out, for example, elite sportsmen who are obese according to their BMI. In my opinion BMI is actually a decent starting point for the majority of the population. Elite sportsmen are outliers. I think we CPTSD sufferers are outliers, too. So we are always likely to have difficulty with the ACE score rubric, not least because we are generally adept at minimising our experiences in order to survive and are liable to spend ages analysing just what the ACE score rubric is getting at. Another problem is that so many CPTSD sufferers began suffering their trauma in childhood (or even in utero). It is their "normal". Even after starting therapy I would not have said for some time that I had suffered trauma. I thought maybe I was over-sensitive to behaviour that might have been difficult but was not abusive, until eventually my therapist confirmed otherwise. Even so, I am not always 100% sure she is right. So the extra question about suffering traumatic events is not really of any use to the likes of me.

But as a link to health issues I think it is of some interest and if it is a way to get medical practitioners at least to consider the possible role of trauma then I am broadly in favour of its use. The questions are probably best used as a basis for discussion with a therapist, rather than as a self-score tool, but not everyone has access to therapy.

I very much like the consideration of PCE scores in conjunction with the ACE scores because I think that gives a much more rounded picture. Instead of beating myself up for feeling bad when I "only" have a score of 4, I can say "well, the bad may not look drastic but where is the good to balance it out? Nowhere."

It is certainly an interesting topic.

[Armee]

I do like that where I live they are starting to use it as a required screening in pediatrician offices. Once the kids are 12 they give it to both the kids and parents to fill out. A score of 4 I think sets in motion some interventions.

The questions used where I live have been changed in ways that make it much easier to answer yes and harder to brush off some experiences and do the minimization we tend to do...it also fixes the issues with age of the abuser in sexual abuse or the gender of the perpetrator in domestic violence and adds a separate screen for community trauma.

https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:e9206c69-0451-4991-a07c-0b7d5f72e0e9

The California one I am just noticing clarifies the question of prenatal in that it is supposed to be after you were born. Except the question about addiction specifies biogical parent or caregiver ever having addiction.

The physical abuse question still misses the boat but is better than the original question in my opinion. But it doesn't include sibling abuse as it should.

My score on this one would be an 8 or 9 depending on if I endorse physical abuse which is borderline in my case. Sometimes when I am answering I answer yes othertimes no. Like many others I saw what happened to my sibling and decided to be ultra good to prevent much physical abuse. My sister could answer yes. I slipped up once (had the nerve to say "ok OK I'm going!" when I was screamed at to get my coat and was spanked and thrown across the room. I don't know if I had bruises I didn't check. Was I ever seriously harmed? No..Was I afraid they would kill me? No. Did I know I'd get a beating if I messed up? Yes. Was there frequent spanking? Yes.

Thanks for starting a good discussion TofuBreadChiliCoriander

[blue_sky]

Oh dear, after reading all these comments, my inner critic is going "see I told you, it's not that bad, you're just exaggerating your story". And probably also because FOO always had the "others have so much worse so you shouldn't be complaining".

My M is/was undiagnosed depressed when we were young. F also has undiagnosed narcissistic traits. Sibling and cousin involved in CSA towards me but both were merely 2 years older. Was always told that since no "insertion", it's not "wrong" or "it's like this in every family" or "everybody does it".

Everything looked so normal to the outer world, even to relatives who were there in the same house, at the same events. Sometimes I question myself whether I'm making it all up in my head. IC is being too mean to me right now

[Armee]

Aw Blue. That's why the ACE scores are so wrong. What happened to you...it was awful. Massively massively traumatizing. Betrayal. Blind eye by your parents.  So so damaging. You are so strong to be rising out of it. So incredibly strong. It is debilitating what you went through.

I might check the boxes for the ace score but it wasn't that bad, truly. So you can have a lot of little things or one really big ongoing thing. I went through one singular event that is similar to what you went through and that singular one time event has left a tremendous lasting impact. It was not by someone I knew well or had to live with. It was not repeated. And it was absolutely life altering. And it pales compared to what you had to survive. 

[tofubreadchillicoriander]

Oh dear, after reading all these comments, my inner critic is going "see I told you, it's not that bad, you're just exaggerating your story". And probably also because FOO always had the "others have so much worse so you shouldn't be complaining".

My M is/was undiagnosed depressed when we were young. F also has undiagnosed narcissistic traits. Sibling and cousin involved in CSA towards me but both were merely 2 years older. Was always told that since no "insertion", it's not "wrong" or "it's like this in every family" or "everybody does it".

Everything looked so normal to the outer world, even to relatives who were there in the same house, at the same events. Sometimes I question myself whether I'm making it all up in my head. IC is being too mean to me right now

Being sensitive to other's stories and honoring that doesn't make your story less worthy. If what you went through left lasting marks on your body and mind, then it's valid. My story is similar, my mother, neglectful, with undiagnosed depression and father who was abusive with narcissistic traits. In my case it was my father who sexually abused me when I was 3 and a neighbor who was an adolescent when I was 5 or 6. So insertion or not, if you registered it as inappropriate, it's sexual abuse.

My family was good at keeping appearances too. The outer world had no clue. Still has no clue. You're definitely not making it up and your story is valid and you're lovable.

[Blueberry]

I'm sorry, blue_sky    Most of those things your FOO said, my FOO said too. They are/were wrong and your ICr is as well. My ICr no longer says those things.

I haven't read / looked up the ACE scores recently. But somewhere on some list there's criteria for sibling physical abuse as sib being at least 5 years older than you. My B is only 1.5 years older but it still was physical abuse in our childhood and particularly teen years. The ACE scores give some idea to professionals but they still need to look at the whole picture. In early days of my healing journey this "your B is only 1.5 years older than you" was used dismissively against me but not anymore. My parents - as your parents - allowed sibling abuse to happen and it was over and over again in a place where I and you should have felt safe, should have been safe. In both our cases there have been long-lasting effects.

It was real, blue_sky. It was debilitating, it was awful. I believe you.