Schenk +, A.N., Vanasse +, R.L., Kaier*, E., Cromer, L.D., Davis, J.L., & Strunk, K.C. (2013, April). An examination of the test-retest reliability of the adverse childhood experiences questionnaire in a sample of collegiate athletes. Poster presented at the Sixteenth Annual University of Tulsa Student Research Colloquium, Tulsa, OK.

Adverse childhood experiences (ACEs) are associated with health risks and concerns, including cancer, heart disease, depressive disorders, and premature death 1, 2. As child maltreatment is a public health issue, it is important that we understand the psychometric properties of instruments measuring adverse childhood experiences. The Adverse Childhood Experiences (ACE) Study Questionnaire is a self-report instrument in which individuals retrospectively report instances of maltreatment that occurred prior to age Little is known about the psychometric properties of the ACE Study Questionnaire. Only one study to date has examined the test-retest reliability of this measure (sample mean age = 64, test- retest reliability Kappa = 0.64) 3. Memory failure and the amount of time since childhood may have reduced test-retest reliability in the study 3, 4. Limitations include that the findings may reflect the stability of an individual’s life story at the age of 64, and therefore may not be generalizable beyond that population 4. The current study sought to expand upon the existing literature by examining the test-retest reliability of the ACE Study Questionnaire with a different sample. Participants Participants were NCAA Division I athletes (N = 141) from 16 athletic teams on campus. M age Year 1: (SD = 1.12), range of 18 – 23 yrs See Figure 1 for self-reported ethnicity. Participants were 53.2% female (n = 75) and 46.8% male (n = 66). Figure 1. Measures The ACE Study Questionnaire is a 10-item retrospective measure that queries experiences of household dysfunction as well as childhood abuse and neglect prior to the age of 18 2 (Figure 2). Responses are provided on a yes/no scale, where yes = 1 and no = 0, and are summed to give a total ACE Score (range: ). In the current sample, at Year 1, Cronbach’s α = 0.73 and at Year 2, Cronbach’s α = Data Analytic Plan Cohen’s Kappa coefficient was calculated using the Statistical Package for the Social Sciences (SPSS), Version 17.0 to provide an estimate of the stability of ACE Scores from Year 1 to Year 2. Cohen’s Kappa measures test-retest reliability, accounting for chance agreement 5. The Year 1 and Year 2 ACE Scores resulted in a Cohen’s Kappa coefficient of The computed Kappa coefficient for the summed ACE Scores indicates moderate reliability across two administrations of the ACE Study Questionnaire 6. The Kappa coefficient from this study, 0.50, indicates moderate consistency. Potential reasons for only moderate consistency include the effects of mood on responses 7, effects of social desirability as a result of the questionnaire being completed in a group setting, and potential issues with recollection and recall 4, 7. Questions with low endorsement rates have artificially low Kappas. The test-retest reliability and response rates of individual questions should further be examined to evaluate if the ACE Score Kappa is influence downward because of questions with low endorsement rates. Future research will consider the test-retest reliability of individual questions to evaluate whether they provide dependable information. Additional consideration of existing research and a comparison of the test-retest reliabilities of other retrospective reporting child abuse measures are also needed. 1 Dube SR, Felitti VJ, Dong M, et al. Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. Pediatrics. 2003; 111(3): Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of child abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventative Medicine. 1998;14(4): Dube SR, Williamson DF, Thompson T et al. Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic. Child Abuse & Neglect. 2004;28(7): Widom CS, Raphael KG, DuMont KA. The case for prospective longitudinal studies in child maltreatment research: commentary on Dube, Williamson, Thompson, Felitti, and Anda (2004). Child Abuse & Neglect. 2004;28(7): Cohen J. A coefficient of agreement for nominal scales. Educational and psychological measurement. 1960;20(1): Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977; Hardt J, Rutter M. Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. Journal of Child Psychology and Psychiatry. 2004;45(2): Acknowledgments Thanks to the University of Tulsa Athletic Department and the student-athletes who participated in this study. Adverse Childhood Experiences (ACEs) Study Questionnaire Sample Questions Household dysfunction question: “Was a household member depressed or mentally ill, or did a household member attempt suicide?” Neglect question: “Did you often or very often feel that you didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you or your parents were too drunk or high to take care of you or take you to the doctor if you needed it?” Physical abuse question: “Did a parent or other adult in the household often or very often push, grab, slap or throw something at you or ever hit you so hard that you had marks or were injured?” Sexual abuse question: “Did an adult or person at least 5 years older than you ever touch or fondle you or have you touch their body in a sexual way or attempt to actually have oral, anal, or vaginal intercourse with you?” Emotional abuse question: “Did a parent or other adult in the household often or very often swear at you, insult you, put you down, or humiliate you or act in a way that made you afraid that you might be physically hurt?” An Examination of the Test-Retest Reliability of the Adverse Childhood Experiences Questionnaire in a Sample of Collegiate Athletes Amanda Schenk, Renee Vanasse, Emily Kaier, B.A., Lisa DeMarni Cromer, Ph.D., Joanne Davis, Ph.D., Kathleen Strunk, APRN, CNS Procedure This study was conducted using data from the Student Health, Athletic Performance, and Education (SHAPE) study, a large ongoing longitudinal study of athletes at The University of Tulsa (TU). This study is a collaboration of The University of Tulsa Institute of Trauma, Abuse, and Neglect (TITAN) and the Athletics Department at TU. Both years of the study, student athletes completed a paper- and-pencil packet of questionnaires that queried student athletes’ health and any experiences of adversity and racism. Informed consent was provided and written consent from participants was obtained. Data was collected in a group setting. Data from two time points were used in the present analyses. The average time between collection dates was days (SD = days), with a range of 199 – 407 days. Figure 2. References Introduction Method Results Discussion