Positive Childhood Research Articles

Impacts of Adverse and Positive Childhood Experiences on Psychological and Behavioral Outcomes in a Sample of Chinese Juvenile Offenders

Impacts of Adverse and Positive Childhood Experiences on Psychological and Behavioral Outcomes in a Sample of Chinese Juvenile Offenders

Exploring the Association between Parenting Stress and a Child’s Exposure to Positive Childhood Experiences (PCEs)

AbstractHigh levels of parenting stress, defined as a caregiver or parent feeling stress or aggravation from parenting, has been previously shown to be associated with an increased likelihood of neglect, child maltreatment, and household dysfunction: adverse childhood experiences (ACEs). Despite the potential mitigation of positive childhood experiences (PCEs) on ACEs, prior studies on the increased likelihood of a child experiencing ACEs due to parenting stress have left a critical question unanswered: whether high parenting stress may decrease a child’s likelihood of experiencing PCEs. We analyzed the 2019–2020 National Survey of Children’s Health to examine whether higher levels of parenting stress are associated with the lower likelihood of experiencing PCEs among children. Children with caregivers experiencing high parenting stress had a lower odds of experiencing many types of PCEs, including after school activities (aOR 0.48; 95% CI 0.38–0.57), community volunteer (aOR 0.63; 95% CI 0.52–0.77), and guiding mentor (aOR 0.65; 95% CI 0.50–0.85). Lowering parenting stress through economic supports and parenting programs/interventions could increase the likelihood that a child experiences PCEs.

Digital Health Innovations for Screening and Mitigating Mental Health Impacts of Adverse Childhood Experiences: Narrative Review.

Exposures to both negative and positive experiences in childhood have proven to influence cardiovascular, immune, metabolic, and neurologic function throughout an individual's life. As such, adverse childhood experiences (ACEs) could have severe consequences on health and well-being into adulthood. This study presents a narrative review of the use of digital health technologies (DHTs) and artificial intelligence to screen and mitigate risks and mental health consequences associated with ACEs among children and youth. Several databases were searched for studies published from August 2017 to August 2022. Selected studies (1) explored the relationship between digital health interventions and mitigation of negative health outcomes associated with mental health in childhood and adolescence and (2) examined prevention of ACE occurrence associated with mental illness in childhood and adolescence. A total of 18 search papers were selected, according to our inclusion and exclusion criteria, to evaluate and identify means by which existing digital solutions may be useful in mitigating the mental health consequences associated with the occurrence of ACEs in childhood and adolescence and preventing ACE occurrence due to mental health consequences. We also highlighted a few knowledge gaps or barriers to DHT implementation and usability. Findings from the search suggest that the incorporation of DHTs, if implemented successfully, has the potential to improve the quality of related care provisions for the management of mental health consequences of adverse or traumatic events in childhood, including posttraumatic stress disorder, suicidal behavior or ideation, anxiety or depression, and attention-deficit/hyperactivity disorder. The use of DHTs, machine learning tools, natural learning processing, and artificial intelligence can positively help in mitigating ACEs and associated risk factors. Under proper legal regulations, security, privacy, and confidentiality assurances, digital technologies could also assist in promoting positive childhood experiences in children and young adults, bolstering resilience, and providing reliable public health resources to serve populations in need.

STRYV365 peak team and Brain agents: teacher perspectives on school impact of a trauma-informed, social-emotional learning approach for students facing adverse childhood experiences.

Adverse childhood experiences (ACEs) have a profound impact on children's and adolescents' academic performance and overall wellbeing. In contrast, positive childhood experiences help mitigate the negative effects of ACEs on health and wellbeing. Trauma-informed and social-emotional learning (SEL) programs in schools may address these impacts, with school staff playing a pivotal role in ensuring their success and influencing school outcomes. This study aimed to assess the strengths, weaknesses, and areas for improvement in the STRYV365 peak team and Brain Agents programs. The aim was to refine program implementation and determine the preliminary effects on students, teachers, and the broader school environment. To achieve this goal, four focus groups were conducted after the program concluded, involving 17 school leaders, administrators, and teachers from four urban schools serving students in fifth through ninth grades. The audio transcripts were professionally transcribed and analyzed by four co-authors using Dedoose for inductive coding, leading to the identification of major themes and subthemes. Three key themes were identified from transcripts: school-wide perspectives of STRYV365 programs, strengths and impacts of STRVY365 programs, and suggestions for program improvement. School staff noted that the peak team was particularly engaging for students, helping them develop SEL skills and foster both peer-to-coach and peer-to-peer relationships. Additionally, the STRYV365 programs were found to enhance student-teacher relationships and staff relationships. Teachers expressed strong interest in taking a more active role in future programming. Overall, this study highlights the importance of teacher and administrator involvement in maintaining consistent SEL activities for urban youth. The findings also suggest that short-term, 4-week SEL programs can have a positive effect on school culture, as well as on student-teacher relationships and teacher-teacher relationships.

Association Between Positive Childhood Experiences and Caregiver-Reported ADHD Diagnosis and Severity.

Little is known about the prevalence of positive childhood experiences (PCEs), a counter to adverse childhood experiences, in children with an attention-deficit hyperactivity disorder (ADHD) diagnosis. The purpose of this study was to examine the relationship between PCEs and ADHD diagnosis and severity, adjusting for child, family, and household characteristics, using a nationally representative data set. Using the 2020 to 2021 National Survey of Children's Health, our sample included children 6 years of age or older, as this is the age at which PCE questions are asked (n = 56,224). Multivariable logistic regression was used to examine the association between PCE type and ADHD diagnosis and severity, controlling for child and household characteristics. In multivariable regression analyses, children who had volunteered in their community had lower odds of a reported ADHD diagnosis than children who had not volunteered in their community (adjusted odds ratio [aOR] 0.83; 95% confidence interval [CI], 0.73-0.95). Children with a connected caregiver had a lower likelihood of ADHD diagnosis than children without a connected caregiver (aOR 0.66; 95% CI, 0.58-0.74). Children reporting moderate to severe ADHD were less likely to report exposure to any of the 7 PCEs examined, when compared with children reporting mild ADHD. The findings from this study can be important for clinicians and families to mitigate the negative social and academic outcomes that children with ADHD may face.

Adverse Childhood Experiences, Perceived Discrimination, and Mental Health in Sexual and Gender Minoritized Adults: Comparing Stress Accumulation and Stress Sensitization Models.

Purpose: The purpose of this study was to assess the relationship between adverse childhood experiences (ACEs) exposure, perceived discrimination, and anxiety and depressive symptoms in sexual and gender minoritized (SGM) adults in the United States. Methods: Respondents (n = 4445) from a national Qualtrics research panel completed a web-based survey. Guided by the stress proliferation (mediation model) and stress sensitization (moderation model) models, we examined the relationships between ACEs and perceived discrimination and the severity of anxiety and depressive symptoms in adulthood. Results: Cumulative ACEs exposure was positively associated with everyday discrimination scale (EDS) scores. ACEs and EDS scores had a significant direct association with anxiety and depressive symptoms. We found support for EDS as a mediator for anxiety (β = 0.12, p < 0.001) and depressive symptoms (β = 0.14, p < 0.001) and for ACEs as a moderator of the relationship between EDS and anxiety (β = -0.04, p = 0.004) and depressive (β = -0.05, p = 0.001) symptoms. Conclusions: These findings suggest that both stress proliferation and stress sensitization likely contribute to disparities in anxiety and depressive symptoms in SGM adults. This finding supports the integration of social safety and minority stress perspectives regarding health disparities in SGM populations. Exposure to early life adversity likely alters neurodevelopment, which in turn increases awareness of the lack of social safety in adulthood, reduces capacity to cope with minority stress exposure, and ultimately contributes to increased anxiety and depressive symptoms. Prevention efforts should focus on building positive and compensatory childhood experiences.

Genç Yetişkinlerde Olumlu Çocukluk Yaşantıları ve Sosyal Medya Bağımlılığı İlişkisinde Mutluluğun Aracılık Etkisi

Objective: This study focuses on exploring the connection between positive experiences during childhood, overall happiness, and the propensity for social media addiction in young adults.&#x0D; Method: The study gathered data from 413 young adults in Turkey, averaging 25.73 years in age (Standard Deviation=4.77). Data collection involved using the Positive Childhood Experiences Scale, the Oxford Happiness Questionnaire, and the Social Media Addiction Scale. Mediation analysis was performed to examine the mediating effect of happiness.&#x0D; Results: Positive childhood experiences were positively associated with happiness and negatively associated with social media addiction. There was a negative relationship between happiness and social media addiction. Happiness played a mediating role in the relationship between positive childhood experiences and social media addiction. &#x0D; Conclusion: Participants with favorable experiences in childhood reported higher levels of happiness and less social media addiction. These results suggest that the social media addiction prevention and intervention programs should focus efforts on enhancing happiness and positive childhood experiences.

Literacy Promotion: An Essential Component of Primary Care Pediatric Practice: Technical Report.

Early literacy promotion in pediatric primary care supports parents and caregivers reading with their children from birth, offering counseling in interactive, developmentally appropriate strategies and providing developmentally and culturally appropriate and appealing children's books. This technical report reviews the evidence that reading with young children supports language, cognitive, and social-emotional development. Promoting early literacy in pediatric primary care offers a strengths-based strategy to support families in creating positive childhood experiences, which strengthen early relational health. An increasing body of evidence, reviewed in this report, shows that clinic-based literacy promotion, provided with fidelity to an evidence-based model, has benefits for children, for parents and caregivers, and for pediatric physicians and advanced care providers as well. Reading with young children supports early brain development and the neural "reading network," and improves school readiness. High-quality literacy promotion is especially essential for children who face disparities and inequities because of social factors, systemic racism, and socioeconomic risk. All families benefit from high-quality and diverse books and from developmentally appropriate guidance supporting interactions around books and stories. Thus, literacy promotion can be a universal primary prevention strategy to strengthen families and support healthy development. Partnerships at community, local, and state levels offer opportunities for integration with other programs, services, and platforms. Literacy promotion in primary care pediatric practice, recognized by the AAP as an essential component since 2014, has become increasingly common. There are successful models for public funding at federal, state, county, and municipal levels, but sustainable funding, including payment to pediatric physicians and advanced care providers, remains a need so that the benefits of pediatric early literacy promotion and the joys of books and shared reading can truly be offered on a population level.

Adverse Childhood Experiences, Protective Factors, and Childhood Obesity: Comparing the Effectiveness of Three Resilience Frameworks

Abstract While rates of childhood obesity continue to rise in the United States, multiple studies have linked childhood obesity to adverse childhood experiences (ACEs). ACEs researchers have begun to develop frameworks that identify protective factors that build resilience against ACEs. However, these frameworks have a limited evidence base. Utilizing data from the 2018–2020 National Survey of Children’s Health, this study compared the effectiveness of the National Scientific Council on the Developing Child (NSCDC), Health Outcomes from Positive Experiences (HOPE), and cumulative positive childhood experiences (PCEs) frameworks in mitigating the impact of ACEs on childhood obesity. Based on hierarchical logistic regression conducted on data from 46,672 children between the ages of 10 and 17 years old, this study found that both the NSCDC and HOPE frameworks were associated with childhood obesity, with each framework explaining a similar amount of variance in childhood obesity across analyses. The cumulative PCEs framework did not strengthen the association between either framework and childhood obesity. Across analyses, strong self-regulation, mastery/after-school activities, and living in a supportive neighborhood had the strongest association with childhood obesity. The findings suggest that the most salient protective factors may be those most closely associated with the direct causes of childhood obesity, with the need to identify factors across ecological levels. Future research is needed to validate these frameworks further and explore these frameworks with other outcomes. The findings have important implications for future ACEs research and ACEs interventions. Public Relevance By understanding which resilience frameworks and protective factors have the strongest relationship with childhood obesity among children who experienced ACEs, interventions can potentially be developed using these findings to mitigate the harmful impact of ACEs on childhood obesity. Key Findings This study found that the National Scientific Council on the Developing Child (NSCDC) and Health Outcomes from Positive Experiences (HOPE) frameworks were associated with childhood obesity after controlling for adverse childhood experiences (ACEs) in a sample of children between the ages of 10 and 17 years old. The strongest protective factors against childhood obesity were strong self-regulation, mastery/after-school activities, and living in a supportive neighborhood. Given the relationship between these protective factors along with several covariates in the study with childhood obesity, future ACEs interventions should potentially target these protective factors and other social determinants of health to reduce the negative impact of ACEs on childhood obesity.

"I Just Wouldn't Like Him to go Through What I Went Through as a Kid": A Qualitative Study on the Mitigating Effects of Positive Childhood Experiences in Mothers with a History of Adverse Childhood Experiences in an Irish Population.

Adverse Childhood Experiences (ACEs) are increasingly being acknowledged as a major risk factor for instigating and sustaining cycles of trauma between mother and child. Recently, the concept of Benevolent Childhood Experiences (BCEs) has been introduced to ACEs research as a buffer against the transmission of ACEs between generations. Positive childhood experiences such as attachment to caregivers, positive peer relations and positive sense of self have been found to counteract the effects of adverse childhood experiences. The emergence of positive childhood experiences as an adaptive capacity against ACEs should be explored as a tool for psychological change, to help break the cycle of inherited trauma between generations. The present study aims to examine the lived experiences of mothers with a history of ACEs, if they consider their positive childhood experiences when parenting, and how they use these positive experiences to break the cycle of intergenerational trauma. Three women residing in a low-support service for parenting were recruited for this study. Participants were all low-income, first-time single mothers in their early thirties. A qualitative approach was designed for the study. ACEs and BCEs questionnaires were administered to participants and scores were taken into account to contextualise participant interviews. A semi-structured interview was designed in accordance with IPA guidelines. Questions were directed towards phenomenological material, focusing on participants' understanding of their experiences as mothers. Analysis of the interview data revealed three superordinate themes (replicating positive experiences, creating new positive experiences and protecting children from intergenerational trauma) related to participants' BCEs, their children's BCEs and their desire to break the cycle of intergenerational trauma. The findings of this study, namely that participants intentionally tried to create positive experiences with their own children through drawing on their own positive experiences in childhood, supports the idea that BCEs are a legitimate source of adaptive capacity for mothers with ACEs. Parenting interventions for parents with ACEs should be developed taking into account ACE and BCE scores.

Positive Childhood Experiences are Associated With Alcohol Use in Adolescent and Emerging Adult Females by Adverse Childhood Experiences Dimension

PurposeExperiencing multiple adverse childhood experiences (ACEs) is associated with alcohol use in female adolescents and emerging adults. Protective and compensatory experiences (PACEs) have been theorized to off-set the health and behavioral consequences from the accumulation of ACEs throughout childhood. This study examines the association between protective experiences and subsequent alcohol and binge alcohol use frequency over one month among female adolescent and emerging adults reporting high and low levels of two ACE dimensions (household dysfunction and emotional abuse/neglect). MethodsOne hundred 43 females between the ages of 15–24 who indicated at least one binge episode in the past two weeks completed the six-item ACEs scale, the PACEs scale, and demographics at baseline. Alcohol consumption was measured prospectively over the next month during weekly appointments using the timeline follow back approach. ResultsTwo PACEs factors had significant direct associations, a source of unconditional love was associated with less frequent alcohol use (β = −0.437, 95% confidence interval [CI] -0.744, −0.131, exp(β) = 0.65, p = .005) in the context of high household dysfunction; and having a trusted adult to count on for help and advice (β = −1.373, 95% CI -2.283, −0.464, exp(β) = 0.25, p = .003) predicted fewer binge occasions in the context of high emotional abuse/neglect. Regardless of ACE dimension exposure, nonsport social group membership was associated more frequent alcohol use over the month across all ACE dimensions (β = 0.11-0.74, 95% CI -0.11, 0.74, exp(β) = 1.37 – 1.62, p ≤ .002); and having a trusted adult to count on for help and advice was associated with a 5.7 times more frequent of alcohol use among those with low household dysfunction (β = 1.74, 95% CI 0.83, 2.65, exp(β) = 5.70, p < .001). DiscussionFew PACE items are associated with direct reductions in alcohol outcomes. Indeed, there is consistently heightened risk associated with nonsport group membership for alcohol use frequency, regardless of experiences of childhood adversity. Future research should identify which protective factors have the most potential to off-set alcohol use by ACE dimension.

‘Our biology is listening’: biomarkers as molecular vestiges of early life and the production of positive childhood experiences in behavioral epigenetics

AbstractThe sciences of environmental epigenetics and the Developmental Origins of Health and Disease have become central in efforts to understand how early life experiences impact health across the life course. This paper draws on interviews with epigenetic scientists and laboratory observations in the United States and Canada to show how scientists conceptualize epigenetic biomarkers as molecular vestiges of early life and the consequences this has for postgenomic approaches to health, risk, and intervention. We argue that this process demarcates early life as the optimal time to study and intervene in health and positions biomarkers as conceptual and methodological tools that scientists mobilize to reimagine early life environments. These environments include Positive Childhood Experiences (PCEs), which reflect an emergent and increasingly prominent epistemic object in behavioral epigenetics. Though distinct from widespread research on Early Life Adversity, we show how PCEs continue to essentialize experience in gendered and individualized ways. Further, this paper suggests that focusing on biomarkers as molecular vestiges of early life allows scientists to create stability despite ongoing epistemological and biological unknowns in epigenetics and DOHaD. Our findings contribute new perspectives to social studies of epigenetics, biomarkers, and the production of novel epistemic objects in postgenomic knowledge practices.

A replication and extension of adverse and benevolent childhood experiences along with contemporaneous social support and sociodemographic stress for perinatal mental health problems.

This study replicated and extended Narayan and colleagues' (2018) original benevolent childhood experiences (BCEs) study. We examined associations between adverse and positive childhood experiences and mental health problems in a second sample of low-income, ethnically diverse pregnant individuals (replication). We also examined effects of childhood experiences on perinatal mental health problems while accounting for contemporaneous support and stress (extension). Participants were 175 pregnant individuals (M = 28.07 years, SD = 5.68, range = 18-40; 38.9% White, 25.7% Latina, 16.6% Black, 12.0% biracial/multiracial, 6.8% other) who completed standardized instruments on BCEs, childhood maltreatment and exposure to family dysfunction, sociodemographic stress, and perinatal depression and post-traumatic stress disorder (PTSD) symptoms. They completed the Five-Minute Speech Sample at pregnancy and postpartum to assess social support from the other biological parent. Higher family dysfunction predicted higher prenatal depression symptoms, while higher BCEs and prenatal social support predicted lower prenatal PTSD symptoms. Prenatal depression and prenatal PTSD symptoms were the most robust predictors of postnatal depression and PTSD symptoms, respectively, although higher postnatal social support also predicted lower postnatal PTSD symptoms. Findings replicated many patterns found in the original BCEs study and indicated that contemporaneous experiences are also associated with perinatal mental health problems.

Cross-sectional study on university students' mental health during the COVID-19 pandemic: Exploring the influence of adverse and positive childhood experiences.

This study examined the psychological impact of the COVID-19 pandemic on university students, focusing on how adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) influence mental health. A web-based survey was administered to 3000 university students from October 26 to 31, 2022, following the peak of the COVID-19 pandemic. Mental health assessments included the Japanese version of the Kessler Psychological Distress 6-Item Scale (K6) for depressive/anxiety symptoms, the Impact of Event Scale-Revised (IES-R-J) for distress, fear of COVID-19, and a three-item loneliness scale. Of the respondents, 46.9% reported depressive/anxiety symptoms, 55.4% reported distress, and 37.3% reported fear of COVID-19. Factors such as current psychiatric treatment history and reduced income (either parental or personal) were predictive of worsening depressive/anxiety symptoms, distress, and loneliness. ACEs were found to exacerbate depressive/anxiety symptoms and distress, while PCEs mitigated these symptoms, and vice versa. This study underscores the importance of considering both ACEs and PCEs in supporting the mental health of university students. PCEs were found to independently prevent mental health deterioration, including depressive/anxiety symptoms and distress, which may include post-traumatic stress disorder symptoms, even in the presence of ACEs. Recognizing and fostering PCEs emerged as an effective strategy for mitigating mental health issues.

The influence of Adverse and Positive Childhood Experiences on facets of empathy

BackgroundAlthough Adverse Childhood Experiences (ACEs) have been associated with empathy, research findings have been incongruous. In contrast, positive parenting practices have been consistently, and positively, associated with empathy. ObjectiveThe current study investigated whether the relationship between ACEs and facets of empathy (i.e., perspective taking, empathic concern, personal distress, fantasy) were moderated by Positive Childhood Experiences (PCEs). Participants and settingA sample of 923 participants completed an online survey. MethodParticipants completed online versions of the Childhood Experiences Scale-17, the Benevolent Childhood Experiences Scale, and the Interpersonal Reactivity Index. ResultsWe found that ACEs were not significantly associated with any facet of empathy. PCEs, on the other hand, were positively associated with fantasy, empathic concern, and perspective taking, and moderated the relationships between (a) ACEs and empathic concern, and (b) ACEs and perspective taking. ConclusionsThese results provide a more nuanced understanding of the role ACEs and PCEs play in empathy. Specifically, PCEs appear to be a protective factor when ACEs are low, but when people experience above average levels of childhood adversity, PCEs have little influence on empathic concern or perspective taking.

Facilitation of Positive Childhood Experiences in Public Schools for Children Involved With the Department of Children &amp; Families

Abstract Date Presented 03/23/24 A survey assessed how school personnel implement trauma-informed practices to promote positive childhood experiences (PCEs) among children involved with the Department of Children and Families and social participation. Results suggest improvements to better support children with trauma. Primary Author and Speaker: Jordan Banker Additional Authors and Speakers: Emily Eddy

Childhood Maltreatment and Empathy in Community and Justice Samples: The Moderating Role of Positive Childhood Experiences

ABSTRACT Child maltreatment (CM) has been related to adverse outcomes in adulthood, such as deficits in empathy. However, positive childhood experiences (PCEs) are related to adaptive characteristics in adulthood, mitigating the adverse effects of CM. This study aimed to explore the relationship between CM, PCEs, and empathy and analyze the moderating role of PCEs in the relationship between CM and empathy in a sample of 2310 male and female adults from the community (n = 1886) and justice settings (n = 424). Participants responded to a sociodemographic questionnaire, the Benevolent Childhood Experiences, the Child Trauma Questionnaire, and the Interpersonal Reactivity Index. CM was negatively associated with empathy and PCEs, and PCEs were positively correlated with empathy. Justice-involved individuals scored higher on CM and lower on PCEs and empathy than community individuals. An interaction effect between CM and PCEs was found only for personal distress (empathy subscale) among justice-involved individuals. The results highlight the complexity of human development and the differential impact of PCEs on the relationship between CM and empathy.

‘Back to Basics’: A Practice Approach to Reforming Youth Justice

The delivery of high-quality case work is central to efforts to reform youth justice systems around the world. Youth justice practitioners can be the most effective agents of change when the focus of their casework practice is on listening to justice-involved young people, helping them to feel safe and to avoid re-traumatization, and working in ways that promote positive childhood experiences. It is argued that developing ‘practice-based evidence’ in this way can help to unite the field, to close the policy implementation gap, and simultaneously contribute to the personal wellbeing of young people and the broader agenda of public safety.

Adversity and error-monitoring: Effects of emotional context.

This study tested whether self-reports of childhood adversity would predict altered error processing under emotional versus non-emotional task conditions. N = 99 undergraduates completed two selective attention tasks, a traditional color-word Stroop task and a modified task using emotional words, while EEG was recorded. Participants also completed self-report measures of adverse and positive childhood experiences, executive functioning, depression, current stress, and emotion regulation. Reports of adversity were robustly correlated with self-reported challenges in executive functioning, even when controlling for self-reported depression and stress, but adversity was not correlated with task performance. With regard to neural markers of error processing, adversity predicted an enhanced error-related negativity and blunted error-positivity, but only during the emotion-word blocks of the task. Moreover, error-related changes in alpha oscillations were predicted by adversity, in a pattern that suggested less error responsiveness in alpha patterns during the emotion block, compared to the color block, among participants with higher adversity. Overall, results indicate alterations in error monitoring associated with adversity, such that in an emotional context, initial error detection is enhanced and sustained error processing is blunted, even in the absence of overt performance changes.

Associations between Positive Childhood Experiences (PCEs), Discrimination, and Internalizing/Externalizing in Pre-Adolescents

ObjectiveThis study aimed to investigate the relationships between four types of perceived discrimination (based on race and ethnicity, nationality/country of origin, gender identity, weight/body size), individually and cumulatively; positive childhood experiences (PCEs); and behavioral symptoms among pre-adolescent youth. MethodsThis study was a secondary analysis of data from the Adolescent Brain Cognitive Development (ABCD) Study, a US-based cohort study of pre-adolescent youth in the United States (N = 10,915). Our outcome was emotional/behavioral symptoms measured by the Child Behavior Checklist. Primary exposures were four types of discrimination, a count of 0–5 PCEs, and other adverse childhood experiences (ACEs). Multiple logistic regression models were used to estimate the relationship between perceived discrimination and clinical-range behavioral symptoms, including the role of PCEs and ACEs. ResultsWeight discrimination was the most frequent exposure (n = 643, 5.9%). Race and weight perceived discrimination were associated with clinical-range externalizing and internalizing symptoms, respectively, but these associations were non significant once other ACEs were added to models. Cumulative discrimination was associated with clinical-range Child Behavior Checklist (CBCL) scores, even when accounting for other ACEs (aOR=1.47, 95% CI=1.2–1.8). PCEs slightly reduced the strength of this relationship and were independently associated with reduced symptoms (aOR=0.82, 95% CI=0.72–0.93). ConclusionsResults of this national study suggest cumulative discrimination can exert emotional/behavioral health harm among youth. PCEs were independently associated with reduced behavioral symptoms. There is a need for further research on how to prevent discrimination and bolster PCEs by targeting upstream social inequities in communities.