High scores have been associated with adverse health behaviours and outcomes, including cigarette smoking, coronary artery disease and cancer (Felitti et al., 1998). It can be used to quantify childhood exposure to trauma (although it does not encompass all types of events that would be considered traumatic). The Adverse Childhood Experiences questionnaire (ACE) assesses for seven types of early-life adversity. Given the wide range of experiences that can be considered traumatic, it can be worthwhile to ask a more general question, such as “Have you ever experienced any other difficult event that overwhelmed your ability to cope?” With patients at high risk for occupational exposures to trauma, such as first responders, explore the impact of vicarious exposures.
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