One of the most important research studies about the impact of domestic violence on children began as a project to treat morbidly obese patients and help them lose substantial amounts of weight by eating no food but taking supplements to satisfy their nutritional needs. Some patients failed to lose the expected weight because they did not follow the protocol, but it was successful patients who were the ones to drop out of the program. Upon studying the personal records and interviewing the patients who left, Dr. Vincent Felitti came to understand that rather than a problem, the patients had viewed their excessive weight as a protective factor. They had experienced childhood trauma, particularly sexual abuse and believed their weight would discourage anyone from attacking them.
These findings led Dr. Felitti with the assistance of Dr. Robert Anda of the Centers for Disease Control and Prevention (CDC) to create a study involving over 17,000 middle-age patients in order to understand how childhood trauma impacted their health. This became the original ACE (Adverse Childhood Experiences) research. The first study was released in 1998 and since that time the CDC has sponsored at least five additional studies in other cities that confirmed and expanded on the findings of Dr. Felitti. There have now been over 80 research papers written for medical professionals about ACE research.
The patients were asked about ten different types of trauma in their childhood. The traumas were selected based on their prevalence in the obesity program. The traumas considered were domestic violence; physical, emotional, or sexual abuse; an adult in the household who engaged in substance abuse; was imprisoned; depressed or mentally ill; separation from at least one of the biological parents; emotional neglect; and physical neglect. An ACE Score was created wherein the patient received one point for exposure to each type of trauma. The point was given whether there was one incident or many so the calculation often understates the harm.