Two Sides of Childhood: How Adverse and Positive Childhood Experiences Shape Adolescent Substance Use

This study examines the independent and interactive effects of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) on adolescent substance use. Guided by resilience theory, we analyze data from the 2024 Florida Youth Substance Abuse Survey, a representative sample of 18,962 high school students. Negative binomial regression models indicate that greater ACE exposure is significantly associated with increased substance use, whereas greater PCE exposure is associated with decreased substance use. Although the interaction between ACEs and PCEs is statistically significant, analyses of predicted counts and average marginal effects suggest that the moderating effect is modest rather than strongly protective. PCEs decrease overall substance use but do not substantially attenuate the association between ACE exposure and substance use. These findings clarify how compensatory and buffering processes operate differently in shaping adolescent health behavior.