P3.169: The Relationship between Adverse Childhood Experiences and Positive Affect in Black and Non-Black Adolescents

Background: Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur in early life. Youth with high ACEs are also more likely to have worse health outcomes in adulthood, but the influence in adolescence has been less rigorously investigated. Importantly, the relationship between positive affect, a factor for resilience and recovery has largely been ignored in this developmentally vulnerable population. However, highly resilient individuals demonstrate more positive emotions and fewer negative emotions. Further, even less is known about the relationship between ACEs and positive affection in Black youth. Once better studied, positive affect, could serve as an important intervention target for adolescents with ACEs.

Methods: We conducted an online survey of Chicago-based adolescents (N=277) aged 13-20 on their self-reported ACEs and emotional health. Participants were identified through 3 pediatric hospital-based outpatient clinics. ACEs were measured using the ACEs questionnaire and measured continuously and categorized into low (0-1), medium (2-3), and high (4+) ACEs. We measured positive affect using the Pediatric Positive Affect Short form 8-A (scores 8- 40), with higher scores indicating higher positive affect.

Results: Participants included (196 [70.8%] girls; median age, 16.0 (13, 21) years, (63 [22.74.%] Black participants; with a mean ACE score of 3.93 (2.31) in all participants and 3.67 (2.49) in Black participants. In Black participants, the mean score of positive affect was 28.8 (7.21) and 26.7 (6.24) for non-Black participants. The analysis included unadjusted and fully adjusted linear regression models (age, sex, race, ethnicity, and education). We found an inverse relationship between ACEs and positive effect in unadjusted, and adjusted models, both with p-value < 0.0001. The association between positive affect and ACE subgroups (low, medium, high) remained significant in the unadjusted model (p-value < 0.0001), and adjusted model (p-value = 0.0007). The inverse relationship between ACEs and positive affect remained statistically significant for Black participants in the unadjusted model (p-value = 0.007), and adjusted model (p-value = 0.03).

Conclusion: Adolescents with more ACEs have less positive affect, and Black adolescents have higher scores. While this relationship requires more investigation, especially among other racial and ethnic groups, positive affect may be protective for adolescents with ACEs and thus, a target for actionable intervention target.