A Systematic Review of the Psychometric Quality of Instruments for Assessing Adverse Childhood Experiences

Background/Objectives: The study of adverse childhood experiences (ACEs) has become increasingly important due to its impact on the physical and mental health throughout life. The aim of this study is to assess the psychometric quality of the instruments used to measure ACEs, following the COSMIN guidelines for reviewing patient-reported outcome measures. Methods: A PRISMA-adherent systematic search of scientific databases was conducted to identify empirical studies analysing the psychometric properties of ACE questionnaires used with children, adolescents, and adults. Ultimately, 20 studies were included, covering various instruments such as the ACE-10, ACE-Q, ACE-SQ, ACE-IQ, SC-ACE-IQ, ACE-IQ-10 and the ACE-THL. Results: The results show heterogeneous psychometric evidence. Whilst properties such as internal consistency generally show adequate results, other dimensions, such as responsiveness or measurement error, are scarcely evaluated. Furthermore, methodological limitations were identified, such as the predominant use of young female samples and the lack of longitudinal studies. Conclusions: In conclusion, most available ACE instruments demonstrate good psychometric properties, with the ACE-IQ being the one with the strongest evidence supporting these properties across different contexts.