I’ve been spending the past few years getting my doctorate degree in creative writing with the thesis Breaking the Curse: Retelling a Folk Fairy Tale to Explore Trauma and Healing in Novels for Young People. As part of my research, I came across the Adverse Childhood Experiences quiz. I have adapted the quiz for creative writers to use in their character development process. I recommend taking this alongside the resilience questionnaire.
The CDC’s Adverse Childhood Experiences Study (ACE Study) uncovered a stunning link between childhood trauma and the chronic diseases people develop as adults, as well as social and emotional problems. This includes heart disease, lung cancer, diabetes and many autoimmune diseases, as well as depression, violence, being a victim of violence, and suicide.
For this quiz, assign 1 to “yes” and 0 to “no”.
The Quiz
- Did a parent or other adult in the household often or very often… swear at your character, insult them, put them down, or humiliate them? Or act in a way that made them afraid that they might be physically hurt?
- Did a parent or other adult in the household often or very often… push, grab, slap, or throw something at your character? Or ever hit them so hard that they had marks or were injured?
- Did an adult or person at least 5 years older than your character ever… touch or fondle them in a sexual way? Or attempt or actually have oral, anal, or vaginal intercourse with your character?
- Did your character often or very often feel that… no one in their family loved them or thought they were important or special? Or feel that their family didn’t look out for each other, feel close to each other, or support each other?
- Did your character often or very often feel that… they didn’t have enough to eat, had to wear dirty clothes, and had no one to protect them? Or their parents were too drunk or high to take care of them or take them to the doctor if they needed it?
- Was a biological parent ever lost to your character through divorce, abandonment, or another reason?
- Was your character’s mother mother or stepmother often or very often pushed, grabbed, slapped, or had something thrown at her? Or sometimes, often, or very 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 gun or knife?
- Did your character live with anyone who was a problem drinker or alcoholic, or who used street drugs?
- Was a household member depressed or mentally ill, or did a household member attempt suicide?
- Did a household member go to prison?
What’s your character’s score?
Tally up your character’s score to find out their number. Does it change between the beginning and end of your story?
The effects
Score of 1 (or more)
- 64% of surveyed people
- For each ACE Score, the chance of being hospitalized with an autoimmune disease in adulthood rises 20%
Score of 2 (or more)
- Twice as likely to develop autoimmune disease
- Twice as likely to be hospitalized for autoimmune disease
Score of 4 (or more)
- 5% of total people surveyed
- Twice as likely to be diagnosed with cancer or heart disease that someone with an ACE Score of 0
- Three and a half times as likely to develop chronic obstructive pulmonary disease (COPD)
- Twice as likely to suffer childhood obesity
- 6% more likely to be diagnosed with learning and behavioral problems
- 460% more likely to be facing depression than someone with a Score of 0
- 1 in 5 will attempt suicide—1220% more likely than Score of 0
- Twice as likely to have learning or behavioral problems
- Seven times more likely to be an alcoholic
- Two and a half times more likely to smoke
- Ten times as likely to use intravenous drugs
Score of 6 (or more)
- Lifespan shortened by almost 20 years
- 5,000% more likely to attempt suicide than those with a Score of 0
- 4,500% more likely to use IV drugs than those with a Score of 0
Score of 7 (or more)
- Otherwise healthy adults are 360% higher risk for heart disease than those with an ACE Score of 0
- Three times as likely of getting lung cancer
Writing prompts
Choose the prompt that speaks to you:
- What was the original trauma?
- A time when your character is reminded of the trauma.
- An incident where your character reacts in an unusual way because of their trauma.
References
Harris, Nadine Burke. The Deepest Well: Healing the Long-Term Effects of Childhood Adversity. Mariner Books, 2018.
Nakazawa, Donna Jackson. Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal. Atria Books, 2016.
van der Kolk, Bessel. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Group, 2014.