Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample

Positive and adverse childhood experiences and mental health outcomes of children

Centers for Disease Control and Prevention Investments in Adverse Childhood Experience Prevention Efforts

Background: Maternal adverse childhood experiences (ACEs) are believed to have negative consequences on offspring health. However, positive childhood experiences (PCEs) may be concurrent with ACEs, and little is known about how ACEs and PCEs transmit intergenerationally in the context of each other. Objective: To explore the independent effect of maternal ACEs and PCEs on offspring psychosocial well-being and how ACEs and PCEs are intergenerationally transmitted in their context. Method: Data were 2587 mother–child dyads in Anhui provinces of China. Mothers retrospectively reported their ACEs and PCEs, as well as provided demographic characteristics and their children’s psychosocial well-being. Logistic regression models were performed to explore the associations of maternal ACEs and PCEs with offspring psychosocial well-being. Results: Separate unadjusted logistic regression models showed that children with mothers reported high ACEs scores were more likely to have psychosocial challenges (total difficulties and prosocial problems), while children whose mothers reported high PCEs scores were less likely to have psychosocial challenges. When we added maternal ACEs and PCEs to a same model, we found that PCEs slightly neutralised the negative effects of ACEs on offspring’s total difficulties and prosocial problems. When stratified by sample, mothers with high PCE scores and higher maternal ACEs were related with a higher risk of offspring total difficulties; mothers with low levels of ACEs and high PCEs tend to report a lower risk of offspring total difficulties. Conclusions: Results suggest that PCEs are positively and intergenerationally transmitted. Results suggest that PCEs are positively and intergenerationally transmitted. More programme should be provided to increase maternal PCEs. When preventing the intergenerational transmission of ACEs, specific interventions should be provided to mothers with different levels of PCEs.

Background: Different childhood experiences may affect adult health differently. Objective: To explore the association of different types of positive childhood experiences(PCEs) and adverse childhood experiences (ACEs) with risky behaviours and mental health indicators, andhow PCEs and ACEs are associated with health outcomes in the context of each other. Method: This was an exploratory cross-sectional online survey including 332 university students in Hong Kong. ACEs (abuse and household challenges), PCEs (perceived safety, positive quality of life, and interpersonal support), risky behaviours (smoking, binge drinking, and sexual initiation), and mental health indicators(depression, anxiety, loneliness, self-rated health, multimorbidity, meaning in life, and life satisfaction)were measured. Results: The multivariable logistic regression analysis indicated cumulative effects of PCEs in lowered risks of depression, anxiety, loneliness, as well as better self-rated health, life satisfaction, and meaning in life (p < .05), after adjusting for ACEs. Results also indicated that ACEs had an increasing relationship with poorer mental health indicators, such as anxiety, loneliness, and life satisfaction (p < .05), after adjusting for PCEs. There was also an adverse association between having ≥4 ACEs with smoking and binge drinking. In addition, each type of PCE and ACE was significantly associated with one or more risky behaviours and mental health indicators. Stratified results showed that PCEs had stronger associations with mental health indicators in participants with fewer ACEs. Furthermore, ACEs had stronger associations with mental health indicators in participants with more PCEs than in those with fewer PCEs. Conclusions: In this study, PCE was proven to be an independent protective factor against poor mental health after accounting for ACE. ACE was also proven to be an independent risk factor for poor mental health and risky behaviours. These findings suggest a crucial need for the active promotion of PCEs and the prevention of child maltreatment. The results of subtypes and stratifications can be taken into consideration when developing targeted interventions in the future. HIGHLIGHTS PCE is an independent protective factor against poor mental health after accounting for ACE. ACE is an independent risk factor for poor mental health and risky behaviours. PCEs and ACEs have different associations with health outcomes in the context of one another.

Background: Many studies demonstrated the relationship between adverse childhood experiences (ACEs) and diminished health functioning in adulthood. A growing literature has shown that positive childhood experiences (PCEs) co-occurring with ACEs reduce the risks for negative outcomes. Objective: The aim was to investigate how ACEs and PCEs are simultaneously associated with health outcomes in adulthood, including self-rated health, physical and mental health outcomes, and health-risk behaviours. Methods: A panel sample of 4,847 Slovenian adults was used and the data were weighted to closely resemble the Slovenian population. A series of logistic regression analyses were performed to examine how ACEs and PCEs predict the risk of various health outcomes. Results: Significant associations, as measured by adjusted odds ratios, were found between higher ACEs exposure and each of the 16 health outcomes evaluated. Adjusting for above median PCEs attenuated the association between ACEs and 6 health outcomes (poor self-rated physical and mental health, depression, anxiety, suicide attempt, physical inactivity; OR for ≥ 4 vs. 0 ACEs, 1.48–9.34). Mirroring these findings, above median PCEs were associated with lowered odds of these 6 health outcomes after adjusting for ACEs (OR for above vs. below median PCEs, 0.46–0.67), but not with odds of physical health outcomes and most of the health-risk behaviours. Stratified analyses by ACEs exposure level showed that the association between PCEs and self-rated health remained stable across ACEs exposure levels, while the association between PCEs and mental health outcomes and physical inactivity varied across ACEs exposure levels. Conclusions: Our results suggest that above median PCEs attenuate the association between ACEs and poor self-rated health, mental health problems, and physical inactivity in later life, and are negatively associated with these health problems even in the concurrent presence of ACEs. Interventions to promote PCEs can help to reduce unfavourable long-term health outcomes following childhood adversity.

Positive childhood experiences (PCEs) and adverse childhood experiences (ACEs) influence adult health and well-being. While ACEs are linked to chronic disease and poor mental health, PCEs have been shown to build resilience and promote positive outcomes. This study investigates associations between PCEs and adult health and socioeconomic outcomes and whether ACEs moderate these relationships. We analyzed data from the Behavioral Risk Factor Surveillance Survey from 4 states (2015-2020), including 18 773 adults. PCEs and ACEs were categorized and evaluated against 20 adult health and life opportunity outcomes. Propensity score matching and survey-weighted generalized linear models were used to estimate adjusted prevalence ratios, population attributable fractions, and prevented fractions for the population PFPs. Reports of PCEs and ACEs were inversely related. Higher PCEs were associated with significantly improved outcomes, including reduced depression, better mental health, and increased income and education, regardless of ACEs. Among those reporting ACEs, adults reporting high PCEs reported lower tobacco use, lower chronic diseases (eg, asthma, diabetes, heart disease), and better general health. PFPs indicated that maximizing PCEs at the population level could theoretically prevent up to 36.5% of depression and 30.7% of poor mental health in adulthood. PCEs were strongly associated with better adult health and well-being, even in the presence of adversity. ACEs moderated some but not all associations, highlighting the independent protective associations of PCEs. These findings support the potential value of PCEs as a public health strategy to improve long-term outcomes and reduce societal costs.

Research on adverse childhood experiences (ACEs) often reports lower prevalence among Asian Americans compared to other racial and ethnic groups. However, most studies fail to account for the socioeconomic inequality and cultural heterogeneity in Asian American populations, which may influence the prevalence of ACEs and positive childhood experiences (PCEs). This study compared exposures to ACEs and PCEs among Asian American emerging adults (18-25years) from three ethnic groups: Asian Indian, Chinese, and Hmong and examined factors associated with disparities in ACEs and PCEs. A total of 814 Asian American emerging adults self-identified as Asian Indian, Chinese, or Hmong Americans were recruited online. Participants completed online surveys measuring ACEs (Philadelphia ACE Survey), PCEs (Benevolent Childhood Experience scale), and childhood socioeconomic position (CSEP). Overall, 58.9% of participants reported exposures to four or more ACEs. Hmong participants reported significantly more ACEs and fewer PCEs than Asian Indian participants (ACE score, p < .001; PCE score, p = .005) and Chinese participants (ACE score, p < .001; PCE score, p < .001). CSEP factors accounted for some of the variations in the disparities of ACEs and PCEs among the three ethnic groups. ACEs and PCEs were prevalent in this diverse sample of Asian American emerging adults. Significant disparities in ACE and PCE exposures across the three ethnic groups highlight the importance of accounting for Asian ethnicity and CSEP in future studies.

Building Infrastructure for Surveillance of Adverse and Positive Childhood Experiences: Integrated, Multimethod Approaches to Generate Data for Prevention Action

Network analysis of adverse and positive childhood experiences in a national sample of university students.

Although positive childhood experiences (PCEs) have been reported to be crucial for healthy development and better mental and physical health outcomes, their epidemiology and relationship with adverse childhood experiences (ACE) exposure in low and middle-income countries, including India remain underexplored. The present study aimed to ascertain the prevalence and predictors of PCE exposure and understand the relationship between PCE and ACE exposure among young adults in Delhi-NCR, India. The present cross-sectional study involved a total of 1,573 young adults (18-25 years) of both sexes (69.7% females) recruited from two Universities in Delhi-NCR, India. PCEs and ACEs were measured using the Benevolent Childhood Experiences scale and ACE-International Questionnaire. Of the total participants, 42.6% reported experiencing all 10 PCEs, while 50.2% had experienced 6 to 9, and 7.2% had experienced 0 to 5 PCEs. Further, the mean PCE score of the sample was 8.64. Certain sociodemographic groups, for instance, participants from immigrant families, sexual minority groups and those who were obese during childhood than their respective counterparts were at lower odds of high PCE exposure. Also, the study found a significant inverse correlation between ACE and PCE exposure levels; however, the effect size was moderate. The study indicates the need for targeted PCE promotion interventions for disadvantaged sociodemographic groups. The intervention should simultaneously aim at reducing ACEs, as PCE promotion alone may not always lead to ACE reduction.

Background: Adverse childhood experiences (ACEs) are associated with substance use later in life, including marijuana use. It is unknown whether these behaviors extend to lactating women. Our objective was to examine the association between childhood ACE and marijuana use in lactating individuals and determine whether positive childhood experiences (PCEs) modified this association. Methods: This study included 617 lactating individuals from the UC San Diego Human Milk Research Biorepository enrolled from 2015 to 2020. ACE and PCE histories were assessed by the Positive and Adverse Childhood Experiences questionnaire. Past 2-week marijuana use was self-reported at enrollment. Multivariable log-linear regressions were used to calculate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) for ACE history and marijuana use, and to assess modification by PCE. Results: Marijuana use during lactation was higher among individuals who reported three or more ACEs (aRR = 2.58, 95% CI = 1.23-5.44), household dysfunction (aRR = 3.08, 95% CI = 1.17-8.10), sexual abuse (aRR = 2.25, 95% CI = 1.08-4.68), or physical abuse (aRR = 2.10, 95% CI = 1.02-4.13). There was no association between emotional abuse and marijuana use during lactation. There was no effect modification by PCEs. Conclusion: Higher ACE frequency, and specifically history of household dysfunction, physical abuse, or sexual abuse increased risk for marijuana use during lactation. Because of marijuana's potential adverse effects on the infant through human milk, postpartum ACE screening is warranted.

Associations of positive and adverse childhood experiences and adulthood insomnia in a community sample of Chinese adults

Association of adverse and positive childhood experiences with health-related quality of life in adolescents

Children with intellectual disabilities experience unique developmental, social, and environmental challenges that intersect with adverse childhood experiences (ACEs) and positive childhood experiences (PCEs), shaping their psychosocial outcomes. While prior research has mainly examined single adversities or protective elements, the frameworks of ACEs and PCEs provide a broader understanding of their cumulative and interactive effects. However, these constructs remain underexplored in children with intellectual disabilities. This scoping review maps the range, conceptualization, and impact of ACEs, PCEs, and related concepts on psychosocial outcomes. Following the Joanna Briggs Institute (JBI) methodology, a search of PsycInfo, MEDLINE, CINAHL, Web of Science, and Google Scholar identified studies until October 2024. Two reviewers screened and extracted data using standardized criteria. Findings reveal variability in how ACEs and PCEs are defined and measured. ACE exposure, particularly the cumulative impact of multiple ACEs (polyvictimization), links to adverse psychosocial outcomes, including emotional (e.g., anxiety, depression, Post-Traumatic Stress Disorder), behavioral (e.g., aggression, conduct problems), and developmental (e.g., social and adaptive skill deficits) difficulties. PCEs—such as positive parent–child relationships, teacher–student support, and peer acceptance—mitigate risks, though impact varies by context. Intellectual disabilities severity and socioeconomic adversity shape associations. Further research is needed to inform the adaptation of ACE–PCE frameworks for children with intellectual disabilities.

Association of adverse and positive childhood experiences with subjective age: findings from 5759 Chinese young adults.