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

• Published in: Academic pediatrics 2024-11, Vol.24 (8), p.1236-1245
• Main Authors: Choi, Kristen R., Bravo, Lilian, La Charite, Jaime, Cardona, Elizabeth, Elliott, Thomas, James, Kortney F., Wisk, Lauren E., Dunn, Erin C., Saadi, Altaf
• Format: Article
• Language: English
• Subjects: child behavior; discrimination; positive childhood experiences; pre-adolescence
• ISSN: 1876-2859; 1876-2867; 1876-2867
• DOI: 10.1016/j.acap.2024.07.006

This 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. This 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. Weight 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). Results 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.