Childhood Trauma History and Present-Day Impact Survey

Thank you for taking part in this survey. It asks about difficult experiences from childhood and how they may affect you now. Your responses are completely confidential and anonymized. This is sensitive material — you can skip any question, and there's no pressure to share more than feels comfortable. It takes about 6-8 minutes. If anything here brings up distress, please consider reaching out to a mental health professional or a crisis line in your area.

Before we begin, please confirm you understand what this survey covers.

Which of the following did you experience before age 18? Select all that apply — you may choose 'Prefer not to say' instead.

• Emotional neglect (feeling unloved, ignored, or unsupported)
• Physical neglect (basic needs like food, safety, or medical care not met)
• Emotional abuse (frequent verbal harassment, humiliation, or threats)
• Physical abuse
• Sexual abuse or exploitation
• Living with a household member who misused alcohol or drugs
• Living with a household member who had a mental illness or attempted suicide
• Witnessing violence between household members
• Parental separation, divorce, incarceration, or abandonment
• Severe bullying or peer victimization
• Prefer not to say

Overall, how much would you say these childhood experiences affect your day-to-day life now?

How much impact, if any, do these childhood experiences currently have on each of the following areas of your life?

In the last 12 months, which of these supports have you actually used to cope with or process past experiences?

• Therapy or counseling
• A support group
• Medication prescribed for mental health
• A religious or spiritual community
• Friends or family
• Self-help resources (books, apps, workbooks)
• None currently
• Prefer not to say

How supported do you feel by the resources currently available to you for dealing with these experiences?

Thank you for sharing that. The next part is a short guided conversation with our AI interviewer. Please only answer what feels comfortable — you can decline or move on at any point.

Explore how the respondent's most impactful adverse childhood experience (based on their earlier answers) shows up in their present-day relationships, work, or emotional regulation — anchor on a concrete recent example rather than asking them to relive the original event. Ask what has genuinely helped them cope, recover, or grow, and what still feels unresolved today. If the respondent declines to elaborate, shows signs of distress, or says anything like 'I'd rather not say,' immediately validate that choice without pushing further and move toward wrapping up.

Is there anything else about your childhood experiences, or how they affect you today, that you'd like us to know? This is optional — feel free to skip it.

Just a couple of optional background questions left — these help us understand patterns across groups, and you can skip either one.

Which age range do you fall into?

• 18-24
• 25-34
• 35-44
• 45-54
• 55-64
• 65+
• Prefer not to say

Which gender do you identify with?

• Woman
• Man
• Non-binary
• Another identity (please specify)
• Prefer not to say

Thank you for trusting us with this. Your responses will be combined with others' to help improve trauma-informed care and support — no individual answers will be shared without your consent. If today's questions brought anything up for you, please consider reaching out to a counselor, trusted person, or a crisis line in your area.