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. 2024 Nov-Dec;24(8):1236-1245.
doi: 10.1016/j.acap.2024.07.006. Epub 2024 Jul 14.

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

Kristen R Choi  1 , Lilian Bravo  2 , Jaime La Charite  3 , Elizabeth Cardona  4 , Thomas Elliott  2 , Kortney F James  5 , Lauren E Wisk  6 , Erin C Dunn  7 , Altaf Saadi  8
Affiliations

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

Kristen R Choi et al. Acad Pediatr. 2024 Nov-Dec.

Abstract

Objective: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: child behavior; discrimination; positive childhood experiences; pre-adolescence.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following additional funding unrelated to the contents of this manuscript: Dr. Saadi was supported by a grant from the National Institute of Neurological Disorders and Stroke (K23NS128164); Drs. Bravo, La Charite, and Elliot acknowledge fellowship funding from the UCLA National Clinician Scholars program and its partners; Dr. Choi was supported by a grant from the Gordon and Betty Moore Foundation; Dr. Wisk receives research funding from the National Institute of Diabetes and Digestive and Kidney Diseases and the Centers for Disease Control and Prevention; and Dr. Dunn receives research funding from the National Institute of Mental Health.

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