Associations between Positive Childhood Experiences (PCEs), Discrimination, and Internalizing/Externalizing in Pre-Adolescents.
Kristen R Choi, Lilian Bravo, Jaime La Charite, Elizabeth Cardona, Thomas Elliott, Kortney F James, Lauren E Wisk, Erin C Dunn, Altaf Saadi
Author Information
Kristen R Choi: School of Nursing (KR Choi and E Cardona), UCLA, Los Angeles, Calif; Department of Health Policy and Management (KR Choi, J La Charite, and LE Wisk), Fielding School of Public Health, Los Angeles, Calif. Electronic address: krchoi@ucla.edu.
Lilian Bravo: National Clinician Scholars Program (L Bravo and T Elliott), Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, Calif.
Jaime La Charite: Department of Health Policy and Management (KR Choi, J La Charite, and LE Wisk), Fielding School of Public Health, Los Angeles, Calif.
Elizabeth Cardona: School of Nursing (KR Choi and E Cardona), UCLA, Los Angeles, Calif.
Thomas Elliott: National Clinician Scholars Program (L Bravo and T Elliott), Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, Calif.
Kortney F James: RAND Corporation (KF James), Santa Monica, Calif.
Lauren E Wisk: Department of Health Policy and Management (KR Choi, J La Charite, and LE Wisk), Fielding School of Public Health, Los Angeles, Calif; Division of General Internal Medicine & Health Services Research (LE Wisk), Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, Calif.
Erin C Dunn: Psychiatric and Neurodevelopmental Genetics Unit (EC Dunn), Center for Genomic Medicine, Massachusetts General Hospital, Boston, Mass; Department of Psychiatry (EC Dunn), Harvard Medical School, Boston, Mass.
Altaf Saadi: Harvard Medical School (A Saadi), Boston, Mass; Department of Neurology (A Saadi), Massachusetts General Hospital, Boston, Mass.
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.
