Take the ACE questionnaire

 This questionnaire was formulated in 1994 by Dr Robert Anda, a senior researcher in preventative medicine to determine the effects of childhood trauma on the health of adults. It was completed by 17,337 people and it concluded that the higher the score, the more chance there was of developing a health problem. The study has been repeated more recently with similar results. The questionnaire covers the first 18 years of life.

If you have been suffering from mental or physical health problems why not take the test to see if your childhood may have a bearing on your health. If you have a score shouldn’t you be addressing your past?

 

  1. Did a parent or other adult in the household 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?

If yes add 1 ________

 

  1. Did a parent or other adult in the household often …

Push, grab, slap, or throw something at you?

or

Ever hit you so hard that you had marks or were injured?

If yes add 1 ________

 

  1. 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

Try to or actually have oral, anal, or vaginal sex with you?

If yes add 1 ________

 

  1. Did you often feel that

No one in your family loved you or thought you were important or special?

or

Your family didn’t look out for each other, feel close to each other, or support each other?

If yes add 1 ________

 

  1. Did you 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?

If yes add 1 ________

 

  1. Were your parents ever separated or divorced?

If yes enter 1 ________

 

  1. Was your mother or stepmother:

Often pushed, grabbed, slapped, or had something thrown at her?

or

Sometimes or often kicked, bitten, hit with a fist, or hit with something hard?

or

Ever repeatedly hit over at least a few minutes or threatened with a weapon?

If yes add 1 ________

 

  1. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?

If yes add 1 ________

 

  1. Was a household member depressed or mentally ill or did a household member attempt suicide?

If yes add 1 ________

 

  1. Did a household member go to prison?

Yes No If yes add 1 ________

Now add up your “Yes” answers: _______ This is your ACE Score

 

If you have any questions about Adverse Childhood Experiences or Hypnotherapy please fill in the boxes below.

 

 

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