Adults reporting positive childhood experiences had lower odds of adult depression and/or poor mental health (D/PMH), according to a study published in JAMA Pediatrics.
In this cross-sectional study, researchers analyzed data from the 2015 Wisconsin Behavioral Risk Factor Survey, a representative, population-based telephone survey taken by noninstitutionalized adults aged ≥18 years (N=6188). The purpose of the survey was to assess the prevalence of positive childhood experiences in an adult sample. A positive childhood experiences cumulative score measure and multivariate regression model were used to assess the magnitude and significance of associations between the score and adult D/PMH, as well as adult-reported social and emotional support.
Participants reporting 6 to 7 positive childhood experiences and either no adverse childhood events (10.5%) or responding “always” to questions on adult-reported social and emotional support (8.5%) had the lowest adult D/PMH prevalences. The participants reporting 0 to 2 positive childhood experiences, 4 to 8 adverse childhood events, and responding “sometimes/rarely/never” on the adult-reported social and emotional support variable had the highest D/PMH prevalences (59.7% and 61.7%, respectively). Among participants reporting favorably on adult-reported social and emotional support, the subset reporting 0 to 2 positive childhood experiences had 4 times greater prevalence of D/PMH, compared with those reporting 6 or 7 positive childhood experiences (33.8% vs 8.5%). After controlling for adverse childhood events, the adjusted odds of D/PMH were 72% lower for adults with the highest vs lowest positive childhood experiences scores (12.6% vs 48.2%; odds ratio, 0.28; 95% CI, 0.21-0.39).
Limitations of this study included its cross-sectional design, and the causal effects cannot be confirmed. The sample is less diverse than the US population as a whole. Researchers were not able to directly examine bias in the reporting of positive childhood experiences among adults with depression. The 2015 Wisconsin Behavioral Risk Factor Survey did not assess overall well-being or flourishing, limiting the ability to assess whether positive childhood experiences affect positive adult health outcomes.
The researchers added to the growing evidence that positive childhood experiences may have lifelong consequences for mental and relational health. Creating positive childhood experiences that reflect and generate resilience within children depends on the full engagement of families and communities, as well as changes in the healthcare, education, and social service systems serving children and families. More research is needed to develop and test additional measures of positive childhood experiences, such as safe and supportive environments, nature or spiritual experiences, and participation in activities.
Bethell C, Jones J, Gombojav N, Linkenbach J, Sege R. Positive childhood experiences and adult mental and relational health in a statewide sample: associations across adverse childhood experiences levels [published online September 9, 2019]. JAMA Pediatr. doi: 10.1001/jamapediatrics.2019.3007