The World Health Organisation describes adverse childhood experiences (ACEs) including abuse, neglect, violence and other household dysfunction, as the commonest and most intense childhood stressors. About half of us experience at least one and those exposed to several are likely to experience more health problems later in life, including chronic pain. There is a strong relationship between exposure to multiple ACEs and social deprivation, and additional associations with having a young mother or being male. Although there is increasing evidence that ACEs contribute to health inequalities, there is no widespread screening to identify interventions. Reasons for this include the limited range of ACEs in existing methods of assessment and little consideration of other factors that may contribute to vulnerability.

CAPE will develop a thorough questionnaire for assessing ACEs to enrich large population cohort data. This information will be linked to prescribing, social care records, neuroimaging, genetics and tissue samples, enabling identification of biopsychosocial factors that create vulnerability to chronic pain and adverse responses to treatment.