Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity St, Bldg B, Austin, TX, 78712, United States.
Department of Anthropology and Sociology, Trinity University.
J Affect Disord. 2021 Mar 1;282:407-414. doi: 10.1016/j.jad.2020.12.117. Epub 2020 Dec 29.
The manifold consequences of adverse childhood experiences (ACEs) are well-documented. Recent research has demonstrated that sexual and gender minorities (SGMs) typically encounter ACEs more often than cisgender heterosexual individuals. Given the higher exposure rate, the measurement of frequency of exposure to traumatic events may be relevant for SGMs.
We changed the response options of the ACEs index from dichotomous to a five-point Likert scale that described frequency of exposure. As part of a larger community-based participatory research study, the Likert ACEs measure was distributed to a large and diverse sample of SGM participants in San Antonio.
A cross-validation design demonstrated that the Likert ACEs scores outperformed the traditional ACEs index in predicting self-reported anxiety and post-traumatic stress disorder. Half of the SGMs in this sample experienced 3 or more ACEs, compared to only 10% of Americans in a nationally representative sample.
These analyses were based on retrospective self-report data instead of structured clinical interviews. Since only the Likert ACEs was administered, we had to assume that any response other than "never" on Likert ACEs corresponded to "yes" on the ACEs Index.
Future research may assess the utility of the Likert ACEs approach with other minoritized or intersectional populations. For clinical practitioners, these results suggest that a better way to measure ACEs for SGMs is to ask them how often they were exposed, rather than asking whether they were exposed.
不良童年经历（ACEs）的多种后果已有充分记录。最近的研究表明，性少数群体（SGMs）通常比顺性别异性恋个体更频繁地经历 ACEs。鉴于 SGMs 的暴露率较高，对创伤性事件的暴露频率进行测量可能与他们有关。
我们将 ACEs 指数的反应选项从二分法改为五点李克特量表，以描述暴露的频率。作为一项基于社区的参与式研究的一部分，李克特 ACEs 量表被分发给圣安东尼奥的大量不同的 SGM 参与者。
交叉验证设计表明，李克特 ACEs 分数在预测自我报告的焦虑和创伤后应激障碍方面优于传统 ACEs 指数。在这个样本中，一半的 SGM 经历了 3 次或更多的 ACEs，而在全国代表性样本中，只有 10%的美国人经历了 3 次或更多的 ACEs。
这些分析基于回顾性自我报告数据，而不是结构化临床访谈。由于只进行了李克特 ACEs 测试，我们不得不假设李克特 ACEs 上的任何非“从不”的回答都对应 ACEs 指数上的“是”。
未来的研究可能会评估李克特 ACEs 方法在其他少数群体或交叉群体中的效用。对于临床医生来说，这些结果表明，为 SGMs 测量 ACEs 的更好方法是询问他们经历的频率，而不是询问他们是否经历过。
