Improving the Conceptualization and Assessment of Adverse Childhood Experiences Using Causal Indicator Models

Adverse Childhood Experiences (ACEs) are highly impactful stressors that increase individuals’ risk for a plethora of negative health outcomes. Further, minoritized groups and under-resourced individuals are at higher risk for ACEs, positioning these stressors as plausible mechanisms driving health disparities. Given this importance, a strong methodological foundation is necessary to ensure maximal clinical value. As emphasized by Jensen, Bernard, & Lanier (2024), this needs to start with rigorous ACEs measurement—a goal that requires careful matching between ACEs measures and the scoring procedures used. To amplify their message while advocating for an alternative approach that may better reflect ACEs conceptualization, we write this commentary to highlight the merits of causal indicator models as a better match between theory and methodology.