Scottish Health Survey: content review outcomes report

Adverse Childhood Experiences (ACE)

A 10-item ACE questionnaire was last included in SHeS in 2019 in the self-completion booklets. The question wording differed from that used in other surveys and did not allow for UK comparisons.

There was strong support received during the review process from the SG Mental Health Directorate and GCPH to include an ACEs module in the survey again but to review the question wording to allow more comparability with English and Welsh ACE data. 

We, therefore, collaborated with policy colleagues and external stakeholders to review the ACE questions for inclusion in 2025. The changes to the ACE questions included updating the response options for the multi category responses to ‘never’, ‘once’, ‘more than once’ to align with those used in England and Wales, the sexual abuse questions were collapsed from two questions into one and we added a new question on neglect. We also agreed to include one additional question asking about resilience as there is a noted data gap and it is valuable to gather this information alongside ACE data.  There were requests to include the line ‘‘this does not include gentle smacking for punishment’’ in the physical abuse question, as this was included in past English and Welsh surveys.  However, this was not included  in SHeS in 2019 to reflect the introduction of legislation related to smacking in Scotland (the Children (Equal Protection from Assault) (Scotland) Act) and will not be included in 2025.

There were requests to add new elements to the ACE questionnaire, such as time spent in care and an additional set of questions called the Benevolent Childhood Experiences (BSE scale) however, due to space limitations, it was not possible to consider these requests at this time.

As the proportion of adults who have experienced adverse childhood experiences should not change much year on year, we do not currently have firm plans to include the ACE module in SHeS after 2025, although we will continue to consider it as an option if space allows in future surveys.

For the full ACEs module with the updated questions see annex 3.