Each section is ordered with the most recently added research at the top.
Protective Factors/
PCEs/ Resilience
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The Centeredness scale measures family of origin emotional functioning, and was found to be a strong predictor of adult mental health in two diverse samples. Centeredness and benevolent childhood experiences were found to be more predictive of adult mental health than ACEs.
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ACE and BCE scores predicted family health in negative and positive ways, with positive childhood experiences being found to positively impact family health regardless of ACE score.
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Examination of the relationship between contextual and individual resilience and youth and adult outcomes using public health data. Findings indicate both contextual and individual resilience factors mitigated adult outcomes, while contextual resilience mitigated youth outcomes. This research points to the power of community resilience for adult and youth well-being.
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The first study to measure seven PCEs/protective factors as well as ACEs/Toxic Stress/Historical Trauma and correlate them to adult mental health and well-being in a sample of 6188 adults. Findings indicate the powerful impact of PCEs/protective factors to promote positive adult mental health and well- being and to mitigate the deleterious effects of ACEs/Toxic Stress/Historical Trauma on adult well-being.
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A measure of advantageous childhood experiences (counter-ACEs) found that counter-ACEs buffer the effects of ACEs. Counter-ACEs were found to have a positive dose response with stronger effects with higher levels of counter-ACEs.
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Research examining the psychometric properties of the Benevolent Childhood Experiences (BCEs) scale to measure positive early experiences in women with child maltreatment histories. Results indicate reliability and validity of the scale, and indicate more benevolent childhood experiences correlated to lower rate of traumatic stress symptoms and less perinatal stress.
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Suggests that the concept of human flourishing is critical for research study and describes determinants of flourishing, flourishing measures for research use, and policy and practices implications of advancing the field of study in human flourishing.
Secondary Trauma/
Compassion Fatigue/ Burnout
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Early childhood educator support is found to be particularly beneficial for those educators who report past exposure to a higher number of adverse childhood experiences themselves. Impact of support was measured by teacher social and emotional affect and their corresponding ability to promote and sustain a healthy classroom climate for their young participants.
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This study examined the relationship of childhood ACEs/Toxic Stress/Historical Trauma and PCEs/protective factors for mental health counselors on STS, burnout and compassion satisfaction. Findings indicate that only race/ethnicity was a significant predictor of STS, while ACEs/Toxic Stress/Historical Trauma and PCEs/protective factors were significant predictors of burnout, and ACEs/Toxic Stress/Historical Trauma, gender, race/ethnicity and childhood socioeconomic status were significant predictors of compassion satisfaction.
HOPE
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Evaluation of the HOPE Framework using data from the Longitudinal Study of Australian Children finds that the 4-factor structure of the HOPE framework is supported. The HOPE Framework has sufficient psychometric internal coherence and validity to measure positive childhood experiences.
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Describes the development of the HOPE (Healthy Outcomes from Positive Experiences) Framework and ongoing efforts to disseminate HOPE and adapt it to current contexts including the COVID-19 pandemic and the need for increased focus on racial justice and equity.
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Describes the HOPE (Healthy Outcomes from Positive Experiences) framework, how it was developed, and the purpose of the HOPE framework.
Prevention
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A review of the CDC’s investments in programmatic activities to address ACEs/Toxic Stress/Historical Trauma in the 20 years following the original ACEs/Toxic Stress/Historical Trauma study, including surveillance and data-collection, promoting cross-sector partnerships and implementing evidence-based primary prevention efforts.
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Describes the Prevent Adverse Childhood Experiences: Data to Action funding initiative activities as of 2022.
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An overview of public health etiological, evaluation and implementation research between 2012 and 2022, and a description of research funded by the CDC to address prevention of ACEs/Toxic Stress/Historical Trauma.
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Discusses two CDC primary prevention strategies of strengthening economic supports and changing social norms about child abuse and neglect and adverse childhood experiences prevention.
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A white paper from the Center on the Developing Child at Harvard University that extends the three core concepts of early childhood to introduce three additional concepts: connecting the brain and body; supporting universal needs and individual variation; providing young children what they need when they most need it.
Policy
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This 2021 revised policy statement from the American Academy of Pediatrics acknowledges the need to adopt a public health approach and expand the paradigm for clinical, research and advocacy activities by embracing an ecobiological model and prioritizing safe, stable and nurturing relationships.
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This article shares recommendations for “prevention, mitigation, and healing of individual, intergenerational, and community trauma” by addressing ACEs and fostering resilience in practice, research and policy. The four priorities include translating extant science, promoting collaboration, enhancing relationships, and supporting research.
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A compelling argument for promoting positive childhood experiences at the policy and practice level.
Health Care/ Pediatrics
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A review of the literature on ACEs and allostatic load finds that childhood adversity does increase allostatic load into adulthood, which may in turn cause deleterious physical and behavioral health outcomes over the lifespan. The authors suggest advancing “the capacity of caregivers and communities to encourage stable, safe, and nurturing relationships that can assist in switching off the child’s stress response.”
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This 2021 statistical analysis of the original ACE Study data examines the specificity and predictive value of using ACEs to screen for individual health risks. The findings indicate that while using ACEs scores to understand population health may be informative, applying the list of ACEs as an individual screening tool may not be as useful. The authors state, “[a]lthough ACEs scores are important risk indicators across general and clinical populations, their utility in identifying individuals at heightened risk of ill health appears to be overstated”.
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Examination of the correlations between adverse and positive childhood experiences and childhood inflammation. Findings extend the known association between adverse childhood experiences and more inflammation to demonstrate an inverse experience between positive childhood experiences and inflammation, with some evidence the PCEs/protective factors may even reduce inflammation for those who have also experienced ACEs/Toxic Stress/Historical Trauma. Demonstrates the need for additional research.
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The revised policy statement of the American Academy of Pediatrics (AAP) on preventing childhood toxic stress by focusing on safe, stable and nurturing relationships to buffer adversity and build resilience.
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Proposes the Intergenerational and Cumulative Adverse and Resilient Experiences (ICARE) model to identify behavioral and biological adaptations to adversity that can result in epigenetic changes. The authors suggest the ICARE framework can be used to design more comprehensive prevention and intervention programs to enhance neurobiological, cognitive, social and emotional development.
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Reports the findings of a multi-disciplinary process to develop recommendations for enhancing child and family well-being by identifying four overarching priorities, four priority research areas and sixteen translational activities. Additional focus on clarifying language, assessment and measurement; the role of health care providers and other partners; and how best to address provider well-being are suggested.
Mental Health &
Substance Use Disorder
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This study followed youth birth through 15 to examine effects of adverse and positive childhood experiences in three contexts (family, school and neighborhood) on adolescent anxiety and depression. Findings indicate PCEs in the family are the strongest protective factor against adolescent anxiety and depression for youth who have been exposed to ACEs; school PCEs were also found to reduce risk of adolescent anxiety and depression; neighborhood PCEs reduced risk for depression.
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The Centeredness scale measures family of origin emotional functioning, and was found to be a strong predictor of adult mental health in two diverse samples. Centeredness and benevolent childhood experiences were found to be more predictive of adult mental health than ACEs.
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This review of CDC-funded Overdose Data to Action activities that address both ACEs/Toxic Stress/Historical Trauma and SUD finds the most common activities are community-level prevention. The authors suggest expanding interventions to simultaneously address CEs and SUD at multiple social-ecological model levels, with emphasis on addressing neonatal abstinence syndrome at all levels.
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The first study to measure seven PCEs/protective factors as well as ACEs/Toxic Stress/Historical Trauma and correlate them to adult mental health and well-being in a sample of 6188 adults. Findings indicate the powerful impact of PCEs/protective factors to promote positive adult mental health and well- being and to mitigate the deleterious effects of ACEs/Toxic Stress/Historical Trauma on adult well-being
Education & Juvenile Justice
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This research explores the correlation between different types of childhood resilience and academic outcomes. Findings indicate that low cognitive resilience seems particularly pernicious for academic outcomes, even more detrimental than low emotional and behavioral resilience.
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Examines the correlation between ACEs and PCEs for recidivism among adolescents involved in the juvenile justice system. Findings indicate a high number of PCEs makes the correlation between high ACEs and recidivism insignificant. Even for youth with four or more ACEs, having six or more PCEs reduced recidivism by more than 20%.
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A summary of the literature on educational research and practice to address ACEs/Toxic Stress/Historical Trauma, identification of gaps, and directions for future educational directions to integrate trauma-informed care, whole child, culturally responsive and healing centered approaches.
Equity/ Health Equity
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This study uses 2017-2018 National Survey of Children’s Health data to examine differences in the four HOPE building block categories of positive childhood experiences by race and ethnicity. Findings indicate that non-White youth were less likely to have a mentor, live in a safe neighborhood, live in a supportive neighborhood or experience three or more positive childhood experiences. The authors identify this as evidence of the need for increased community-level interventions.
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Accurate and comprehensive population surveillance for both ACEs/Toxic Stress/Historical Trauma and PCEs/protective factors is important and requires standardizing and updating definitions and conceptualizations of adverse and positive childhood experiences and developing reliable and valid proximal means of measurement. The authors argue this is an opportunity to connect ACEs/Toxic Stress/Historical Trauma to social determinants of health, and to standardize data collection across service sectors.
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Comparison of rates of ACEs/Toxic Stress/Historical Trauma and PCEs/protective factors across race and ethnicity in rural communities using data from the National Survey of Children’s Health. Findings indicate non-White rural youth have higher rates of four or more ACEs/Toxic Stress/Historical Trauma, and more poverty, and lower rates of PCEs/protective factors and engagement in known protective factors than their White peers.
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Applies the biopsychosocial-cultural framework to understanding correlates of ACE exposure in Black Americans and recommends culturally-informed, preventive interventions based on cultural strengths.
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Proposes a mechanism for promoting cultural assets and strengths in African American communities to promote resilience. Specifically, the authors suggest “task-shifting” (use of community members in secondary prevention and treatment not just primary prevention) and “youth-partnered advocacy” (creating spACEs/Toxic Stress/Historical Trauma for Black youth to engage in policy and program advocacy, development and implementation).
Parenting
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Examines children’s risk of ACEs based on parent ACEs and PCEs, finding that parental PCEs counter transmission of intergenerational trauma. Other recommendations include recognizing the role of parental PTSD as a mediator for child risk, ACE and PCE screening for parents and children, and tertiary prevention strategies.
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Found that higher BCE scale scores predicted less parenting distress even in those reporting ACEs, and that neither BCE nor ACE score predicted parenting stress. Points to the importance of assessing both positive and adverse childhood experiences and parenting stress as distinct phenomena.
Direct links are provided where available. If you have trouble accessing an article or resource, please contact Miriam Silman.
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