How Positive Childhood Experiences Offset Adversity

Esta historia está disponible en español. This story is available in Spanish. 

In 1995, a research team in Southern California launched an inquiry into how the challenges people experience during their younger years impact them as adults. They asked approximately 17,000 adults 10 yes-or-no questions about their exposure to physical, emotional, and sexual abuse; neglect; and household challenges including mental illness, substance abuse, domestic violence, divorce, and incarceration. Those factors were collectively called Adverse Childhood Experiences, or ACEs.

The results were staggering. Over 60% of respondents reported at least one ACE, while 17% reported four or more. That initial analysis showed the more ACEs one had, the greater their chance of experiencing a wide range of health issues. Adults who experienced four or more ACEs as kids were twice as likely to develop heart disease, three times more likely to have clinical depression, five times more likely to develop an addiction to alcohol, and 17 times more likely to attempt suicide.

The research was foundational to our understanding of how childhood trauma and household dysfunction relate to health risks and disease later in life, but it is not the whole story. “This message that we hear, if you have a trauma, is that you’re going to have poor health outcomes. And while that can be true, it’s not a guarantee,” says Dr. Christine Forke, assistant professor of family medicine and community health in the Perelman School of Medicine at the University of Pennsylvania. “We see many people that have a number of ACE exposures, yet they go on to live healthy, happy, long lives.”

We Are More Than Our Challenges

The connection between adverse childhood experiences and health risks has been explored in many studies. But there’s been little investigation into the effect of positive experiences. Now that’s changing. An emerging field of research spearheaded by Dr. Christina Bethell, a professor at the Bloomberg School of Public Health at Johns Hopkins University, is exploring the impacts of safety, stability, and nurturing environments and relationships on physical and emotional well-being. In 2019, Bethell and her colleagues released a study showing that these factors, which they call Positive Childhood Experiences (PCEs) can be just as influential as negative ones.

The research team conducted a telephone survey of 6,188 adults based in Wisconsin and formulated a PCE score based on questions about their positive experiences before age 18. Had respondents been able to communicate about their feelings and feel safe within their families? Were they supported by friends and non-parental adults? Did they feel a sense of belonging in high school? Were they able to engage in community traditions?

The data showed that people with more PCEs had better mental health outcomes and stronger social relationships, even among those who had significant ACEs. “We found that adults with higher levels of positive experiences were 72% less likely to have adult depression, even if they had higher ACEs,” Bethell says.

The researchers concluded that early positive experiences don’t just buffer against adversity—they also help create the emotional foundation necessary for lifelong well-being. For example, adults who had more positive experiences in childhood were more likely to build and maintain social connections and to seek help. PCEs have also been associated with reduced rates of substance use, depression, risky sexual behavior, and persistent insomnia.

“Safe, stable, nurturing relationships and environments are protective,” Bethell says. “It’s not to say adverse experiences don’t have an impact, but hopefully positive experiences can help you navigate their impact. They give you a way to build on your strengths and work to address what’s hard.”

Another critical finding was that the absence of a negative experience was not the same as having a positive one. For example, Bethell says, “if you don’t have somebody in the home that is emotionally abusive, that doesn’t mean you had emotional nurturance. It just means you weren’t abused. Positive childhood experiences are proactively experienced, lived, embodied senses of being safe.”

Expanded research with a more diverse pool of participants has shown there are important variations in PCEs across gender, race and ethnicity, sexual orientation, age, income level, and educational status. But, regardless of background, most respondents report having at least some positive experiences.

Creating The Conditions For Flourishing

These findings point to a shift in how researchers think about childhood development and addressing trauma. “Clinically, we’re only now just thinking about approaching patients assuming that we’ve all had trauma of some sort in our life, but there’s plenty of opportunity for our brains to heal and change and to live a long, prosperous life,” Forke says.

One way to begin that healing is to acknowledge that we have strengths, and that we have had good experiences, Bethell says. “Even if we had bad ones, we can lean into those good ones and start to develop resilience.”

While preventing adverse childhood experiences remains crucial, fostering positive experiences is equally important, Bethell says. “It implicates all of us because those positive experiences happen in our communities, schools, and homes,” she says. “Even if we can’t make the negative go away, we should never underestimate the power of our care and nurturance.

Sign Up For The Week In Science Newsletter

Keep up with the week’s essential science news headlines, plus stories that offer extra joy and awe.

Subscribe