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Folks here will be well acquainted with the presentation of outcomes of ACEs often being displayed in terms of outcomes from 1-4, then 4+  but is anyone familiar with the research pertaining to this question -- again very hard to determine, depending on differences between genders, types of resilience, age of occurrence of particular forms of adversity etc etc -- is a score of 4 meant to represent some sort of threshold -- response relationship between adversity and problematic outcomes -- anything above 4 can result in "clinically" or "socially" significant outcomes; or is the overall cumulation of adverse experiences the thing that determines problematic outcomes -- a dose-response relationship -- allowing for the mitigating effects of resilience.

Is there research bearing on this difference? -- I haven't seen it addressed in terms of  dose vs threshold / response, but of course that doesn't mean it hasn't been addressed -- if it can be, that is. If it does exist, it probably depends on the sort of outcome of the sorts of adversity experienced, it seems an important question for an "ACEs Science" to address -- one amongst the hundreds waiting to be addressed.

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