Date of Award

2025

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Graduate Department of Clinical Psychology

First Advisor

Ken Logan

Second Advisor

Amber Nelson

Third Advisor

Shaun Davis

Abstract

The Adverse Childhood Experiences (ACE) survey is a widely used, evidence-based tool that assesses the number of adverse events an individual experienced before the age of 18 years. Research has shown that total ACE scores are associated with physical and mental health outcomes across the lifespan. The original ACE survey—often referred to as the conventional, standard, or primary version—consists of 10 items measuring adverse experiences across categories of abuse, neglect, and household dysfunction. However, it does not fully capture experiences that are increasingly relevant when assessing childhood adversity and trauma, particularly among historically marginalized minority and socio-economic populations. One area of importance includes community-level adversity, such as witnessing violence, experiencing racism, or experiencing bullying. This study introduces the Inclusive-ACE, or I-ACE, survey—a trauma-informed, modernized version of the original tool. The I-ACE expands on the original framework by adding 15 new items and revising the wording of four items from the original 10. Additionally, a Likert scale has been incorporated, allowing patients to rate the perceived impact of each endorsed adverse experience on their current functioning. These revisions aim to improve the relevance, inclusivity, and clinical utility of ACE assessments while strengthening their predictive value for health outcomes. The I-ACE was designed to enhance score comparability, better predict health outcomes, and more accurately reflect modern and culturally relevant experiences of adversity

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