Table 6 Adverse Childhood Experiences International Questionnaire (ACE-IQ)
Category | Questions | Response | |
|---|---|---|---|
P1 | Did your parents/guardians understand your problems and worries? | Always Most of the time Sometimes Rarely Never | 1 2 3 4 5 |
P2 | Did your parents/guardians really know what you were doing with your free time when you were not at school or work? | Always Most of the time Sometimes Rarely Never | 1 2 3 4 5 |
P3 | How often did your parents/guardians not give you enough food even when they could easily have done so? | Many times A few times Once Never | 1 2 3 4 |
P4 | Were your parents/guardians too drunk or intoxicated ( | Many times A few times Once Never | 1 2 3 4 |
P5 | How often did your parents/guardians not send you to school even when it was available? | Many times A few times Once Never | 1 2 3 4 |
F1 | Did you live with a household member who was a problem drinker ( | Yes No | 1 2 |
F2 | Did you live with a household member who was depressed, mentally ill, or suicidal? | Yes No | 1 2 |
F3 | Did you live with a household member who was ever sent to jail or prison? | Yes No | 1 2 |
F4 | Were your parents ever separated or divorced? | Yes No | 1 2 |
F5 | Did your mother, father, or guardian die? | Yes No | 1 2 |
F6 | Did you see or hear a parent or household member in your home being yelled ( | Many times A few times Once Never | 1 2 3 4 |
F7 | Did you see or hear a parent or household member in your home being slapped ( | Many times A few times Once Never | 1 2 3 4 |
F8 | Did you see or hear a parent or household member in your home being hit or cut with an object, such as a stick (or cane), bottle, knife, belt ( | Many times A few times Once Never | 1 2 3 4 |
A1 | Did a parent, guardian, or other household member yell, scream or swear at you, insult, or humiliate you? | Many times A few times Once Never | 1 2 3 4 |
A2 | Did a parent, guardian, or other household member threaten to, or actually, abandon | Many times A few times Once Never | 1 2 3 4 |
A3 | Did a parent, guardian, or other household member, slap, kick, punch ( | Many times A few times Once Never | 1 2 3 4 |
A4 | Did a parent, guardian or other household member hit or cut you with an object, such as a stick, bottle, knife, belt, whip, etc.? | Many times A few times Once Never | 1 2 3 4 |
A5 | Did someone touch or fondle ( | Many times A few times Once Never | 1 2 3 4 |
A6 | Did someone make you touch their body in a sexual way when you did not want them to? | Many times A few times Once Never | 1 2 3 4 |
A7 | Did someone attempt sexual intercourse with you when you did not want them to? | Many times A few times Once Never | 1 2 3 4 |
A8 | Did someone actually have sexual intercourse with you when you did not want them to? | Many times A few times Once Never | 1 2 3 4 |
V1 | Did other kids, including brothers or sisters, hit you, threaten you, or insult you? | Many times A few times Once Never | 1 2 3 4 |
V2 | Did you see or hear someone being beaten up in real life? | Many times A few times Once Never | 1 2 3 4 |
V3 | Did you see or hear someone being stabbed ( | Many times A few times Once Never | 1 2 3 4 |
V4 | Did you see or hear someone being threatened ( | Many times A few times Once Never | 1 2 3 4 |
V5 | Were you forced to go and live in another place due to any of these events? | Many times A few times Once Never | 1 2 3 4 |
V6 | Did you experience the deliberate ( | Many times A few times Once Never | 1 2 3 4 |
V7 | Were you beaten up by soldiers, police, militia, or gangs? | Many times A few times Once Never | 1 2 3 4 |
V8 | Was a family member or friend killed or beaten up by soldiers, police, militia, or gangs? | Many times A few times Once Never | 1 2 3 4 |
) by alcohol/drugs to take care of you?
) or alcoholic?
) at, screamed at and sworn (
) at, insulted, or humiliated (
)?
), kicked, punched (
), or beaten up?
), whip (
) etc.?
) you or throw you out of the house?
), or beat you up?
) you in a sexual way when you did not want them to?
) in real life?
) with a knife or gun in real life?
) destruction of your home due to any of these events?