The reliability of the adverse childhood experiences questionnaire for late postpartum use in relation to maternal emotional health
6 affiliations
- 1Developmental Neuroscience and Neurogenetics Program, Children's Hospital Los Angeles
- 2The Saban Research Institute, Children's Hospital Los Angeles
- 3Division of Neurology, Children's Hospital Los Angeles
- 4Keck School of Medicine of the University of Southern California
- 5Department of Pediatrics, Children’s Hospital Los Angeles
- 6Department of Pediatrics, Division of Neonatology
Abstract
Background: Childhood Experiences (ACEs) have been linked to poor mental and physical health outcomes in adulthood. The Adverse Childhood Experiences Questionnaire (ACEQ) is commonly used to screen ACEs in many populations. Postpartum women represent a psychologically vulnerable population, possibly impacting recall of ACEs and utility of ACEQ in prognosticating future health problems. In this secondary analysis, we assessed test-retest reliability of the ACEQ among postpartum women, also screened for depressive symptoms and perceived stress.
Methods: 317 mother-infant dyads from a larger longitudinal study completed the deidentified ACEQ, Patient Health Questionnaire-9 (PHQ-9), and Perceived Stress Scale (PSS) at approximately 6 and 12 months postpartum. Test-retest reliability was assessed using Intraclass Correlation Coefficient (ICC) with two-way mixed-effects models; absolute agreement ICC evaluated score stability, a consistency ICC sensitivity analysis assessed systematic bias.
Results: The ACEQ demonstrated good test-retest reliability (absolute agreement ICC = 0.79, p < 0.001), with a nearly identical ICC consistency suggesting no systematic bias. Higher baseline PSS and PHQ-9 were associated with higher ACEQ scores at both timepoints. Although nearly half of mothers reported different ACEQ scores at 12 months, most changes fell within measurement error, and reporting discrepancy was not associated with baseline emotional distress.
Discussion: The de-identified ACEQ is a reliable measure of early adversity during the first year postpartum, though its limited sensitivity to small individual change should be considered when tracking scores over time. Its reliability earlier in the postpartum period or perinatally, when depression is more prevalent and screening is most valuable, warrants future study before clinical application.
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BibTeX
@article{ozuna2026reliability,
title = {{The reliability of the adverse childhood experiences questionnaire for late postpartum use in relation to maternal emotional health}},
author = {Aimé Ozuna and Panteha Hayati Rezvan and Jenny Legido and Sriamsha Dubbaka and Pat Levitt and Kameelah Gateau},
journal = {Frontiers in Psychiatry},
year = {2026},
month = oct,
doi = {10.3389/fpsyt.2026.1914194},
url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1914194/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The reliability of the adverse childhood experiences questionnaire for late postpartum use in relation to maternal emotional health
AU - Aimé Ozuna
AU - Panteha Hayati Rezvan
AU - Jenny Legido
AU - Sriamsha Dubbaka
AU - Pat Levitt
AU - Kameelah Gateau
PY - 2026
DA - 2026/10/19
JO - Frontiers in Psychiatry
DO - 10.3389/fpsyt.2026.1914194
UR - https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1914194/full
AB - Background: Childhood Experiences (ACEs) have been linked to poor mental and physical health outcomes in adulthood. The Adverse Childhood Experiences Questionnaire (ACEQ) is commonly used to screen ACEs in many populations. Postpartum women represent a psychologically vulnerable population, possibly impacting recall of ACEs and utility of ACEQ in prognosticating future health problems. In this secondary analysis, we assessed test-retest reliability of the ACEQ among postpartum women, also screened for depressive symptoms and perceived stress. Methods: 317 mother-infant dyads from a larger longitudinal study completed the deidentified ACEQ, Patient Health Questionnaire-9 (PHQ-9), and Perceived Stress Scale (PSS) at approximately 6 and 12 months postpartum. Test-retest reliability was assessed using Intraclass Correlation Coefficient (ICC) with two-way mixed-effects models; absolute agreement ICC evaluated score stability, a consistency ICC sensitivity analysis assessed systematic bias. Results: The ACEQ demonstrated good test-retest reliability (absolute agreement ICC = 0.79, p < 0.001), with a nearly identical ICC consistency suggesting no systematic bias. Higher baseline PSS and PHQ-9 were associated with higher ACEQ scores at both timepoints. Although nearly half of mothers reported different ACEQ scores at 12 months, most changes fell within measurement error, and reporting discrepancy was not associated with baseline emotional distress. Discussion: The de-identified ACEQ is a reliable measure of early adversity during the first year postpartum, though its limited sensitivity to small individual change should be considered when tracking scores over time. Its reliability earlier in the postpartum period or perinatally, when depression is more prevalent and screening is most valuable, warrants future study before clinical application.
SN - 1664-0640
ER -