There are multiple reasons why an ACE score of zero can be a false negative, occurring in someone with a high ACE or high severe Trauma load suffering from consequences of that trauma. Studies that claim an absence of harm from administration of ACE questionnaires also often have a frequency of between 5-30% of participants who report feeling negative from being asked (Jaffe et al). However, unlike our office practice, many if not most studies also provide participants with rapid followup and access to counselling if needed after an ACE or Trauma questionnaire is administered.

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