Identifying heterogeneity in cumulative risk scores: a useful visualisation tool for studying adverse childhood experiences

• Grant number: 25/03664-4
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: May 01, 2025
• End date: December 31, 2025
• Field of knowledge: Health Sciences - Collective Health - Epidemiology
• Principal Investigator: Andreas Bauer
• Grantee: Bruna Cardone Pedroso Elorza
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

A large body of research has demonstrated a dose-response relationship between the cumulative number of adverse childhood experiences (ACEs) and a wide range of negative mental and physical health outcomes. However, the ACE risk score has notable limitations, including the assumption of equal weighting for all ACEs in contributing to risk, the lack of consideration for specific ACE exposure patterns and dimensions of adversity, and the failure to account for interactions between individual ACEs. While this measurement approach remains widely used, there has been limited research quantifying and mapping the magnitude of heterogeneity within the ACE risk score. The proposed project aims to use data from two large, population-based samples from the US to reveal the heterogeneity of risk scores, conceptualised as a count variable (e.g., 0-10) and a categorical variable (i.e., exposure to 1, 2, 3, and 4+ ACEs), using an UpSet plot, which has been developed to visualise a large number of intersecting sets of variables. The project will result in a short communication article, with the student as first author, and a presentation in a research group focused on violence exposure. The student will gain preliminary yet essential research skills, including identifying, accessing, and manipulating large-scale quantitative datasets in the software programme R, as well as gaining initial insights into different analytical approaches, such as cumulative risk.