BACKGROUND: While adverse childhood experiences (ACEs) predict poorer mental health across the life course, positive childhood experiences (PCEs) predict better mental health. It is unclear whether PCEs protect against poor mental health outcomes and promote mental well-being in pandemic-era adolescents with ACEs.
METHODS: We examined the individual and joint contributions of ACEs and PCEs to mental health and well-being (MHW) in eleventh-grade British Columbian adolescents (N = 8864) during the fifth wave of COVID-19. We used a novel measure of ACEs that included community- and societal-level ACEs in addition to ACEs experienced at home to investigate the role of social and structural determinants of mental health in supporting the MHW of pandemic-era adolescents. A series of two-way ANCOVAs were conducted comparing MHW outcomes between adolescents with and without ACEs. Interaction effects were examined to investigate whether PCEs moderated the association between ACEs and MHW.
RESULTS: Adolescents with no ACEs had significantly better MHW than those with one or more ACE. Having six or more PCEs was associated with better MHW in adolescents with and without ACEs. PCEs significantly moderated the association between ACEs and depression. Effect sizes were larger for PCEs than ACEs in relation to depression, mental well-being, and life satisfaction.
CONCLUSIONS: PCEs may protect against depression among adolescents with ACEs and promote MHW among all pandemic-era adolescents. These findings emphasize the importance of addressing social determinants of mental health to mitigate the impact of ACEs and promote PCEs as part of a public health approach to MHW.