Adverse childhood experiences: terms, concepts, and study methods

Adverse childhood experience (ACE) is considered one of the key predictors of the development of mental disorders. The findings of recent research show the stable and significant association of ACE with increased suicide risk in general, and primarily in patients with mental disorders such as depression, schizophrenia, and bipolar affective disorder. This makes the study of ACE particularly relevant. Thus, correct analysis of the spectrum, intensity, and severity of ACE is extremely important for the construction of complex multidimensional predicting models of the level of suicide risk in patients with mental disorders. However, to date, there is no unique and universally accepted approach to assessment of ACE, which may lead to controversy and low reproducibility of results. The purpose of this review is to examine and compare various methods of assessing and interpreting of ACE in order to identify optimal research algorithms within the current interpretation of the biopsychosocial model in psychiatry. This article reviews current terms, concepts, and methods of studying ACE. We discuss the definitions and phenomenology of the ACE, the specificity and features of some of the methodological approaches to measuring ACE, and various approaches to using ACE to build predictive models. To summarize, research on ACE and its consequences is actively developing: earlier studies’ data are being corrected and clarified, methods of detecting and grading ACE are being improved, and ways of forecasting the consequences of ACE in adulthood are being improved. We can see that theoretical claims are becoming more developed and refined; rigorous definitions are emerging, despite not previously being the focus of attention. Despite the existence of different approaches to the examination of the consequences of ACE in adulthood, at the current stage of research development, the best approach is to analyze ACE within the framework of the biopsychosocial model, focusing on the interaction of genome and environment and taking into account the complex effects of genetic, social, and personal factors.