How Positive are PCEs? Exploring the Associations Between Adverse and Positive Childhood Experiences and Mental Health and Behavioral Concerns Among Youth

Adverse childhood experiences (ACEs) are associated with enduring risks to well-being, while positive childhood experiences (PCEs) may help buffer against these risks. However, evidence regarding the moderating role of PCEs remains inconsistent, likely reflecting differences in how PCEs are conceptualized and measured, the outcomes examined, and the populations studied. This study draws on data from the 2020–2021 National Survey of Children’s Health (NSCH), a nationally representative dataset that includes validated measures of ACEs and PCEs. Results indicate that PCEs were associated with lower odds of youth anxiety/depression and conduct/behavior concerns, whereas ACEs were associated with higher odds of youth anxiety/depression and conduct/behavior concerns. Findings also suggest that PCEs moderated the associations between ACEs and anxiety/depression and conduct/behavior concerns although this buffering influence appeared more evident at lower levels of ACE exposure. Taken together, these results highlight the potential value of promoting access to PCEs for children experiencing modest adversity, while pointing to the need for more intensive supports for those with high ACE exposure.